Chuan Xin Lian

Herba Andrographitis

Chemical Constituents

Diterpenes, including andrographolide, 14-deoxy-11,12-didehydroandrographolide, bisandrographolide A, andrographic acid, andrographiside and neoandrographolide Arabinogalactan proteins; Andrograpanin. Flavonoid glycosides including 5-hydroxy-7,8-dimethoxy (2R)-flavanone-5-O-beta-D-glucopyranoside and 5-hydroxy-7,8,2',5'-tetramethoxy-flavone-5-O-beta-D-glucopyranoside. [2][3][4][5][6][7][8]

Dosage

Six to nine grams crude herb daily prepared as directed. [1]

Pharmacology

Pre-clinical

Chuan Xin Lian properties are bitter and cold. It works through the intestines, lungs and stomach. It is used to clear heat and resolve fire toxicity in various disorders. It removes dampness and heat toxicity. It is used in combination with a variety of other herbs. [11]

General 

Antioxidant activity

Laboratory studies have found that constituents contained in andrographis have antioxidant properties, including neuroprotection, [12] nephroprotection [13] and also hepatic protection by decreasing lipid peroxidation and increasing glutathione levels similar to the popular hepatoprotective herb milk thistle (Silymarin). [2] [8] 

Antiviral activity

The constituent andrographolide is reported to have anti-viral activity against Epstein Barr virus and also HIV. [14] [15] 

Glucose regulation activity

Chuan Xin Lian has been reported to have blood sugar regulating properties. Studies have reported that andrographis is a strong, dose dependent insulinotropic agent, glucose dependent and independent insulin secreting agent. [17] Part of the pharmacology behind blood sugar regulation is the antioxidant potential of androphophis. In laboratory studies, andrographis has been reported to increase the activity of superoxide dismutase (SOD) and catalase (CAT), leading to a decrease in oxidative stress. [18][19][20] 

Antitumor activity

The constituent andrographolide is reported in laboratory studies to have anti-tumor activity in gastric cancer, liver cancer, lung cancer and breast cancer. [21] Andrographolide has been reported to induce the apoptosis of cancer cell, inhibit the cell cycle, and increase the antitumor activity of lymphocytes. [22][23] 

Andrographolide is reported to cause cell-cycle arrest at G0/G1 phase through induction of cell-cycle inhibitory protein p27 and decreased expression of cyclin-dependent kinase 4 (CDK4). [24] Andrographolide also is reported to increase tumor necrosis factor-alpha (TNF-alpha) production and CD marker expression, resulting in increased cytotoxic activity of lymphocytes against cancer cells. [25] 

Anti-inflammatory activity

Andrographolide may be useful in the treatment of inflammatory conditions, such as asthma, by inhibiting the NF-kappaB pathway at the level of inhibitory kappaB kinase-beta activation. [7][26][27]  A laboratory study found that andrographolide’s anti-inflammatory effect was also in part due to prevention of oxygen radical production by human neutrophils through modulation of PKC-dependent pathway. [28]

Clinical

A small study found that andrographolide may inhibit HIV-induced cell cycle dysregulation, leading to a rise in CD4(+) lymphocyte levels in HIV-1 infected individuals. [16] However, dosages used in this study caused side effects, including headache, fatigue, a bitter/metallic taste in the mouth, and elevated liver enzymes (which returned to normal after the medication was stopped).

In clinical studies, Chuan Xin Lian (sometimes combined with eleuthero) have been found to decrease severity and duration of upper respiratory tract infections. [29][30][31] Improvements in muscle pain, cough, throat symptoms, headache, nasal symptoms, eye symptoms and temperature have been reported. [32] Also, andrographis has been reported to relieve the inflammatory symptoms of sinusitis, such as stuffy nose and sinus pressure. 

A small clinical study in 60 patients with rheumatoid arthritis found that an extract of andrographis (standardized to 30% andrographolide) reduced rheumatoid factor, IgA, and C4 while improving joint pain. [33]  

Interaction and Depletions

Interaction with other Herbs

No documentation

Interaction with Drugs

Not to be used with anticoagulant medications.

Precautions and Contraindications

Side effects

Chuan Xin Lian has been reported safe in recommended doses. [9] 

High doses may lead to side effects such as headache, fatigue, a bitter/metallic taste in the mouth, and elevated liver enzymes. 

Use with caution in pre-existing liver conditions. 

Pregnancy

Do not use in pregnancy, as laboratory studies report uterine smooth muscle relaxation when using Chuan Xin Lian in rats. [10]

Age limitation

No documentation

Adverse reaction

LD50 of the lactones in Chuan Xin Lian was measured at 3.4g/kg in mice. [1] Large doses may result in gastrointestinal pain.

References

  1. Z. You-Ping. Chinese Matria Medica: Chemistry, Pharmacology and Applications. Florida: CRC Press;. 189-193.
  2. A. Kapil, I.B. Koul, S.K. Banerjee, B.D. Gupta. Antihepatotoxic effects of major diterpenoid constituents of Andrographis paniculata. Biochem Pharmacol. 6Jul1993;46(1):182-185.
  3. S. Suebsasana, P. Pongnaratorn, J. Sattayasai. Analgesic, antipyretic, anti-inflammatory and toxic effects of andrographolide derivatives in experimental animals. Arch Pharm Res. Sep2009;32(9):1191-1200.
  4. P.L. Smith, K.N. Maloney, R.G. Pothen, J. Clardy, D.E. Clapham. Bisandrographolide from Andrographis paniculata activates TRPV4 channels. J Biol Chem. 6Oct2006;281(40):29897-29904.
  5. R.J.C. Kleipool. Constituents of Andrographis paniculata Nees. Nature. 1952;169:33-34.
  6. P.K. Singha, S. Roy, S. Dey. Protective activity of andrographolide and arabinogalactan proteins from Andrographis paniculata Nees. against ethanol-induced toxicity in mice. J Ethnopharmacol. 20Apr 2007;111(1):13-21.
  7. L.L. Ji, Z. Wang, F. Dong, W.B. Zhang, Z.T. Wang. Andrograpanin, a compound isolated from anti-inflammatory traditional Chinese medicine Andrographis paniculata, enhances chemokine SDF-1alpha-induced leukocytes chemotaxis. J Cell Biochem. 1Aug2005;95(5):970-978.
  8. W. Li, X. Xu, H. Zhang, C. Ma, H. Fong, R. van Breemen, J. Fitzloff. Secondary metabolites from Andrographis paniculata. Chem Pharm Bull (Tokyo). Mar2007;55(3):455-458.
  9. J.T. Coon, E. Ernst. Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy. Planta Med. Apr2004;70(4):293-298.
  10. R.A. Burgos, M.J. Aguila, E.T. Santiesteban, N.S. Sánchez, J.L. Hancke. Andrographis paniculata (Ness) induces relaxation of uterus by blocking voltage operated calcium channels and inhibits Ca(+2) influx. Phytother Res. May2001;15(3):235-239.
  11. D. Bensky, S. Clavey, E. Stoger, A. Gamble. Chinese Herbal Medicine Materia Medica, 3rd Edition. Seattle WA:Eastland Press;2004.30.
  12. S. Das, N. Gautam, S.K. Dey, T. Maiti, S. Roy. Oxidative stress in the brain of nicotine-induced toxicity: protective role of Andrographis paniculata Nees and vitamin E. Appl Physiol Nutr Metab. Apr2009;34(2):124-135.
  13. P. Singh, M.M. Srivastava, L.D. Khemani. Renoprotective effects of Andrographis paniculata (Burm. f.) Nees in rats. Ups J Med Sci. 2009;114(3):136-139.
  14. T.P. Lin, S.Y. Chen, P.D. Duh, L.K. Chang, Y.N. Liu. Inhibition of the epstein-barr virus lytic cycle by andrographolide. Biol Pharm Bull. Nov2008;31(11):2018-2023.
  15. V.L. Reddy, S.M. Reddy, V. Ravikanth. A new bis-andrographolide ether from Andrographis paniculata nees and evaluation of anti-HIV activity.Nat Prod Res. Apr2005;19(3):223-230.
  16. C. Calabrese, S.H. Berman, J.G. Babish. A phase I trial of andrographolide in HIV positive patients and normal volunteers. Phytother Res. 2000;14(5):333-338.
  17. A. Wibudi, B. Kiranadi, W. Manalu, A. Winarto, S. Suyono. The traditional plant, Andrographis paniculata (Sambiloto), exhibits insulin-releasing actions in vitro. Acta Med Indones. Apr2008;40(2):63-68.
  18. N. Verma, M. Vinayak. Antioxidant action of Andrographis paniculata on lymphoma. Mol Biol Rep. Dec 2008;35(4):535-540.
  19. X.F. Zhang, B.K. Tan. Anti-diabetic property of ethanolic extract of Andrographis paniculata in streptozotocin-diabetic rats. Acta Pharmacol Sin. Dec2000;21(12):1157-1164.
  20. A.M. Dandu, N.M. Inamdar. Evaluation of beneficial effects of antioxidant properties of aqueous leaf extract of Andrographis paniculata in STZ-induced diabetes. Pak J Pharm Sci. Jan2009;22(1):49-52.
  21. N.P. Trivedi, U.M. Rawal, B.P. Patel. Potency of andrographolide as an antitumor compound in BHC-induced liver damage. Integr Cancer Ther. Jun2009;8(2):177-189.
  22. S. Rajagopal, R.A. Kumar, D.S. Deevi, C. Satyanarayana, R. Rajagopalan. Andrographolide, a potential cancer therapeutic agent isolated from Andrographis paniculata. J Exp Ther Oncol. May-Jun2003;3(3):147-158.
  23. A. Varma, H. Padh, N. Shrivastava. Andrographolide: A New Plant-Derived Antineoplastic Entity on Horizon.Evid Based Complement Alternat Med. 14Sep2009.
  24. J.H. Chen, G. Hsiao, A.R. Lee, C.C. Wu, M.H. Yen. Andrographolide suppresses endothelial cell apoptosis via activation of phosphatidyl inositol-3-kinase/Akt pathway. Biochem Pharmacol. 1Apr2004;67(7):1337-1345.
  25. R.A. Kumar, K. Sridevi, N.V. Kumar, S. Nanduri, S. Rajagopal. Anticancer and immunostimulatory compounds from Andrographis paniculata. J Ethnopharmacol. Jun2004;92(2-3):291-295.
  26. Z. Bao, S. Guan, C. Cheng, S. Wu. A novel antiinflammatory role for andrographolide in asthma via inhibition of the nuclear factor-kappaB pathway. Am J Respir Crit Care Med.15Apr2009;179(8):657-665.
  27. Y.F. Xia, B.Q. Ye, Y.D. Li. Andrographolide attenuates inflammation by inhibition of NF-kappa B activation through covalent modification of reduced cysteine 62 of p50. J Immunol. 15Sep2004;173(6):4207-4217.
  28. Y.C. Shen, C.F. Chen, W.F. Chiou. Andrographolide prevents oxygen radical production by human neutrophils: possible mechanism(s) involved in its anti-inflammatory effect. Br J Pharmacol. Jan2002;135(2):399-406.
  29. E.S. Gabrielian, A.K. Shukarian, G.I. Goukasova. A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis. Phytomedicine. Oct2002;9(7):589-597.
  30. E.G. Shakhova, A.A. Spasov, O.V. Ostrovskiĭ. Effectiveness of using the drug Kan-Yang in children with acute respiratory viral infection (clinico-functional data). Vestn Otorinolaringol. 2003;(3):48-50.
  31. D.D. Cáceres, J.L. Hancke, R.A. Burgos, F. Sandberg, G.K. Wikman. Use of visual analogue scale measurements (VAS) to asses the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study. Phytomedicine. Oct1999;6(4):217-223.
  32. J. Melchior, A.A. Spasov, O.V. Ostrovskij, A.E. Bulanov, G. Wikman. Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infection. Phytomedicine. Oct2000;7(5):341-350.
  33. R.A.Burgos, J.L. Hancke, J.C. Bertoglio. Efficacy of an Andrographis paniculata composition for the relief of rheumatoid arthritis symptoms: a prospective randomized placebo-controlled trial. Clin Rheumatol. Aug 2009;28(8):931-946.