Scientific Name
Echinacea purpurea (L.) Moench
Synonyms
Brauneria purpurea (L.) Britton, Echinacea intermedia Lindl. ex Paxton, Echinacea serotina (Sweet) D.Don ex G.Don f., Echinacea speciosa (Wender.) Paxton, Helichroa purpurea (L.) Raf., Rudbeckia purpurea L. [1]
Vernacular Name
| English | Eastern purple coneflower, purple coneflower, coneflower [2] |
| China | Zi hua song guo ju, zhi zui ju [3] |
| Brazil | Equineacea,equinocea, f;or de cone [3] |
| Denmark | Have purpursolhat, pupur solhat, solhat [3] |
| Netherland | Kogelbloomsort, purperen rudbeekia, rode zoonehoed [3] |
| France | Echinacee, echinacin, echter sommenhut, kegelblume, purporoter somenhut, roter scheinsomenhut, roter somenhut, rudbeekie somenhut [3] |
| Poland | Jezowka purpotowa, jezowka purpurowa, rudbekia purporawa [3] |
| Hungary | Bibor kasvirag, bibor kipvirag, piras kas virag [3] |
| Italy | Ecgunacea solhatur [3] |
| Portugal | Equinacea purpurea [3] |
| Rusian | Echinacija purporavaja [3]. |
Geographical Distributions
Echinacea purpurea originated with North American Native Americans. However, there are reports its early use in Europe. It grows in Mid-West to Southern United States. Although this plant can thrive in basic, acidic, or neutral soils, it cannot grow in the shade. E. purpurea needs complete sun. E. purpurea can tolerate drought very well, as well as frost. It is common to see E. purpurea growing in prairies and along roadsides. [4]
Botanical Description
E. purpurea belongs to the Asteraceae family and is found actively growing during the spring and summer months with blooms beginning to appear during the early summer. [4]
The leaves are 15 x 10 cm from the base of the stem. [4]
The flowers is characterized as purple colour and oval shaped . The diameter of capitula are up to 15 cm. [4]
The fruits are black, small and dry. [4]
Cultivation
No documentation
Chemical Constituent
E. purpurea has been reported to contain caffeic acid derivatives (e.g., cichoric acid), alkylamides (e.g. dodeca-2E,4E,8Z,10E/Z-tetraenoic acid isobutylamides), polysaccharides (e.g. acidic arabinogalactan, acidic arabinorhamno-galactans), polyynes (e.g. trideca-1,11-dien-3,5,7,9,-tetraine), sesquiterpenes (e.g. germacrene D), and glycoproteins (arabinogalactan-proteins). [5][6][7][8][9]
Plant Part Used
Root and aerial portions [4]
Traditional Use
E. purpurea is easily recognizable and one of the most popular botanicals used in medicinal preparations worldwide. E. purpurea has been employed as an immunomodulatory agent due to its ability to enhance the body’s natural defenses against pathogens. As a result, E. purpurea is marketed commercially for the treatment of viral infections including, but not limited to, the common cold, influenza, herpes, etc. [4]
Preclinical Data
Pharmacology
Upper respiratory infections
Prophylaxis and treatment of upper respiratory infections (URIs) and additional infections of varying etiologies. [10][11][12][13]
Wound healing activity
Prophylaxis of infection and enhanced wound healing by external application to wounds and treatment of inflammatory conditions. [14][15]
Immunostimulatory activity
Ethnomedicine has long employed E. purpurea in the treatment of immune-related illnesses. E. purpurea and its constituents have been shown to possess immunostimulatory activity in laboratory investigations. These investigations have utilized in vitro methods to demonstrate that administration of E. purpurea preparations, and/or its constituents, produces activation of human and murine macrophages, increased T-cell proliferation, enhanced viability of human peripheral blood mononuclear cells, increased macrophage secretion of tumor necrosis factor-alpha and several interleukins including interleukin-1 and interleukin-6, and enhanced cytotoxicity. [5][11][16][17][18][19] These studies illustrate the nonspecific, cell-mediated immune response attributable to administration or consumption of E. purpurea preparations and the potential for increased pathogenic resistance conferred upon its users. The immunostimulatory effects of E. purpurea preparations appear to be dose-dependent, as evidenced by quantitative assays for E. purpurea-induced increases in TNF-α, nitric oxide and human peripheral blood mononuclear cell viability. [19] E. purpurea herb processed through simulated digestion dose-dependently induced secretion of macrophage-derived TNF-α, nitric oxide, interleukin-1α, interleukin-1β and interleukin-6. [19] E. purpurea preparations that failed to stimulate TNF-α production also failed to enhance human peripheral blood mononuclear cell viability. Thereby, it appears that the ability of E. purpurea to alter the activities of the immune system may be due, at least in part, to the modulatory effects E. purpurea exhibits on cytokines. [19]
The in vivo studies in mice demonstrate that consumption of E. purpurea root extract increased the number of natural-killer cells and monocytes within bone marrow and spleen, when compared to control animals; the increases were observed as early as approximately 1 week after commencement of treatment. [3][20] Furthermore, in vivo administration of purified polysaccharides from E. purpurea produced proliferation of phagocytes within bone marrow and spleen of mice whilst also inducing migration of granulocytes to the peripheral blood. [17] These immunostimulatory activities may explain the immunoprotection against systemic infection by Listeria monocytogenes and Candida albicans observed in subsequent experiments. [17] Studies employing cyclophosphamide or cyclosporine A-induced immunosuppressed mice show that treatment with polysaccharides isolated from E. purpurea restores resistance to infection by Listeria monocytogenes and Candida albicans. [5] Extract of E. purpurea and two of its alkylamide constituents have been shown to dose-dependently inhibit interleukin-2 production through suppression of the ability of activated Jurkat T cells to produce interleukin-2; these actions may influence the infection response and amelioration of infectious symptoms attributed to E. purpurea use. [21] Despite cellular evidence of immunostimulation in laboratory studies, the precise pathways by which E. purpurea may confer resistance against infectious diseases remain elusive and it appears that the precise constituents comprising E. purpurea preparations impact the pharmacological effects associated with Echinacea use.
A plethora of research has focused on the constituents of Echinacea to elucidate the mechanisms of action by which Echinacea produces its effects. The alkylamides, detectable in human blood samples in relevant concentrations following oral E. purpurea administration, are structurally similar to anandamide, an endogenous agonist for cannabinoid receptors. [6][22] In vitro, alkylamides have been shown to bind to cannabinoid type 2 (CB2)receptors with high affinity and to subsequently increase total intracellular calcium and activate mitogen-activated kinases, presumably through a g-protein coupled mechanism; the alkylamide-induced increased intracellular calcium is inhibited in the presence of a CB2 antagonist. [6][22] The expression of CB2 receptors is abundant within immune and inflammatory-competent cells; hence, the interactions of constituents of E. purpurea with this receptor population and the subsequent cascades initiated may modulate the inflammatory and immunological effects associated with Echinacea use. [22][23][24]Furthermore, it appears that the alkylamides may influence the inflammatory and immunological effects of E. purpurea through upregulation of the expression of constitutive interleukin-6 in human whole blood and inhibition of lipopolysaccharide-induced secretion of TNF-α and interleukin-1β but in a manner that appears to be independent of the CB2 receptor. [22] Several alkylamides isolated from E. purpurea have been shown to inhibit cyclooxygenase-I and cyclooxygenase-II enzymes in vitro and may modulate inflammation and the perception of pain through these actions. [15] In vivo experiments in rats have shown oral gavage of alkylamides isolated and purified from E. purpurea to increase the phagocytic activity of alveolar macrophages. [25]
Acidic arabinogalactan, another constituent of Echinacea, has been shown to increase the production of immunological mediators (including TNF-α, interferon-β2, and interleukin-1) through its actions on macrophages and to produce a slight increase in T-cell proliferation. [17] Arabinogalactan has exhibited cytotoxicity against tumor cells in laboratory studies and antiparasitic activity against parasites responsible for Leishmaniasis. [17] Glycoproteins isolated and purified from the pressed juice of E. purpurea, the arabinogalactan-proteins, have shown only weak stimulation of interleukin-6 and nitrite production in alveolar mouse macrophage cultures. [9][26] Extracts of E. purpurea have been shown to have phototoxic antimicrobial activity against clinically relevant pathogenic fungi and E. purpurea has shown antioxidant activity in assays assessing the scavenging of hydroxyl radical, 1,1-diphenyl-2-picrylhydrazyl radical and ABTS radical. [8][27] Taken together, the biological activities of E. purpurea, and its constituents, have therapeutic implications in the treatment of infectious disease, inflammatory conditions and tumors.
Toxicity
No documentation
Clinical Data
Clinical findings
Several studies have shownE. purpurea to be effective in the prophylaxis and/or attenuation of illnesses such as the common cold, while several other studies have reported no clinical benefits. [13][28][29][30] Preclinical studies provide support for the immunostimulatory effects associated with Echinacea use; clinical trials assessing E. purpurea preparations in the prophylaxis and treatment of upper respiratory infections have demonstrated favorable differences in the treatment versus control groups. [3][10] The conflicting conclusions of these studies may be attributable to varying factors within the experimental designs, such as the use of different doses and/or preparations of E. purpurea, different animal models employed, and/or differing parameters measured to evaluate outcome in patients. The discrepancy in findings may also be due to failure of E. purpurea products to meet recognized pharmaceutical quality standards. [10] The immunostimulatory activity of E. purpurea preparations has been found to vary significantly by preparation and even raw material obtained from the same supplier varied greatly by lot when examined for immunostimulatory activity. [19] This occurrence may explain why some studies have shown immunostimulatory activity to be specific to E. purpurea herb and root powder preparations (when compared to extracts or fresh pressed juice) whilst others have demonstrated that the extracts display immunostimulatory activity (when compared to whole herb preparations). [19][31]
Precautions
Patients possessing allergies to members of the Asteraceae family (e.g. sunflower, safflower, ragweed, chamomile and mugwort) should use E. purpurea with caution due to an established cross-reactivity between members within this family. Allergic reactions have been documented in individuals with sensitivities to other members of the Asteraceae family following use of E. purpurea; following exposure to Echinacea, allergic patients present with symptoms that range in severity from localized symptoms (rhinitis and/or urticaria) to acute asthma attack to generalized, life-threatening anaphylaxis. [10][12][32][33]
If you have kidney disease or an active infection do not use this dietary supplement for more than 10 days. If you have a weakened immune system, talk to your doctor before taking this dietary supplement. [34]
Side effects
No documentation
Pregnancy/Breast Feeding
Patients planning to become pregnant, who are pregnant or breastfeeding should not use Echinacea supplements without first consulting their medical practitioner due to the lack of information concerning the use of supplements during pregnancy and lactation. [35][36]
Adverse reaction
The parental administration of Echinacea preparations has produced adverse reactions, including but not limited to urticaria, pyrexia and muscle weakness. [33]
Patients suffering from kidney, liver, immunosuppressive or chronic diseases should not begin any medicinal therapy without a consultation with their medical practitioner.
Some individuals experience an allergic reaction when taking this dietary supplement. These reactions include skin rash, asthma attacks and anaphylaxis, a life threatening allergic reaction. [37] Call your doctor or seek medical attention if you have fast or irregular breathing, skin rash, hives or itching.
Interaction & Depletion
Interaction with drug
No documentation
Interaction with other Herbs
No documentation
Contraindications
No documentation
Case Report
Echinacea has positive activity on the immune system. A study in mice found that alcohol root extracts from E. purpurea, E. pallida and E. angustifolia were found to enhance phagocytosis significantly. [38] Phagocytosis is the process in which a cell from the immune system response “eats” the foreign cell, such as a virus or bacteria. E. purpurea is also claimed to activate and increase white blood cell activity and cell-mediated immunity. [18][39][40] Cell-mediated immunity provides resistance to a variety of pathogens and guards against the development of arthritis, allergies and other potential disorders. E. purpurea contains arabinogalactan which is reported to increase the activity of other elements of the immune system including interferon, TNF and interleukin-1. [16]
One study evaluating the effectiveness of E. purpurea for the prevention of colds concluded that the preparation of E. purpurea used in the study had no effect on either the occurrence of infection or the severity of illness. Further investigation of the Echinacea product used questioned the presence of any active ingredients in the product. [41] Other studies have shown better results. [42]
Several reports have been conducted over the past few years regarding the effectiveness of E. purpurea preparations in the treatment and management of upper respiratory infections (URI’s). In the most recent report, sixteen trials with a total of 3396 participants were included. [43] Overall, the results suggested that certain E. purpurea preparations may be better than placebo in the management and treatment of URI’s. Another earlier analysis evaluated 13 trials where E. purpurea was used as a treatment or for the prevention of upper respiratory tract infections (URI’s). [44] The authors of this report concluded that E. purpurea may be beneficial for the early treatment of URI’s, yet there is very little evidence supporting the prolonged use of E. purpurea for the prevention of URI’s. A more recent trial confirmed these findings regarding the treatment of the common cold. Eighty adult patients who were experiencing the first signs of a cold participated in the study evaluating the effect of E. purpurea on the number of days that common cold symptoms were experienced. The group using the Echinacea product experienced 6 days of cold symptoms versus 9 days for the placebo group. [16]
Other studies have demonstrated that E. purpurea is a reported antioxidant. [17] Animal studies have indicated anti-inflammatory properties in the roots of the E. angustifolia plants. Echinacea is reported to have a wide level of antimicrobial activity on bacteria, fungi, and viruses. [18][19]
Poisonous Management
No documentation
Line Drawing
No documentation.
References
- The Plant List. Ver1.1. Echinacea purpurea (L.) Moench. [homepage on the Internet]. c2013 [updated 2012 Feb 11; cited 2016 May 3]. Available from: http://www.theplantlist.org/tpl1.1/record/gcc-135149
- Quattrocchi U. CRC world dictionary of medicinal and poisonous plants: Common names, scientific names, eponyms, synonyms, and etymology. Volume III E-L. Boca Raton, Florida: CRC Press; 2012.
- LIM TK. Edible Medicinal plant and non medicinal plants. Volume 7, flower. Dordrecht, Netherlands: Springer, 2014; p. 340.
- The Kew Science. Plants of the world online. Echinacea purpurea (L.) Moench. [homepage on the Internet]. c2016 [cited 2016 May 3]. Available from: http://www.kew.org/science-conservation/plants-fungi/echinacea-purpurea-eastern-purple-coneflower
- Steinmuller C, Roesler J, Grottrup E, Franke G, Wagner H, Lohmann-Matthes ML. Polysaccharides isolated from plant cell cultures of Echinacea purpurea enhance the resistance of immunosuppressed mice against systemic infections with Candida albicans and Listeria monocytogenes. Int J Immunopharmacol. 1993;15:605-614.
- Woelkart K, Bauer R. The role of alkamides as an active principle of Echinacea. Planta Medica. 2007;73:615-623
- Gruenwald J, Brendler T, Jaenicke C, eds. PDR for herbal medicines. 2nd ed. Montvale, New Jersey: Medical Economics Company; 2000.
- Binns SE, Purgina B, Bergeron C, et al. Light-mediated antifungal activity of Echinacea extracts. Planta Medica. 2000;66:241-244.
- Classen B, Mau SL, Bacic A. The arabinogalactan-proteins from pressed juice of Echinacea purpurea belong to the hybrid class of hydroxyproline-rich glycoproteins. Planta Medica. 2005;71:59-66.
- Barnes J, Anderson LA, Gibbons S, Phillipson JD. Echinacea species (Echinacea angustifolia (DC.) Hell., Echinacea pallida (Nutt.) Nutt., Echinacea purpurea (L.) Moench): A review of their chemistry, pharmacology and clinical properties. J Pharm Pharmacol. 2005;57(8):929-954.
- Burger RA, Torres AR, Warren RP, Caldwell VD, Hughes BG. Echinacea-induced cytokine production by human macrophages. Int J Immunopharmacol. 1997;19:371-379.
- Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: A systematic review. Drug Saf. 2005;28(5):387-400.
- Linde K, Barrett B, Wolkart K, Bauer R, Melchart D. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2006;(1):CD000530.
- Bone K. Echinacea: When should it be used?. Altern Med Rev. 1997;2:451-458.
- Clifford LJ, Nair MG, Rana J, Dewitt, DL. Bioactivity of alkamides isolated from Echinacea purpurea (L.) Moench. Phytomedicine. 2002;9:249-253.
- Luettig B, Steinmuller C, Gifford GE, Wagner H, Lohmann-Matthes ML. Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst.1989;81:669-675.
- Roesler J, Steinmuller C, Kiderlen A, Emmendorffer A, Wagner H, Lohmann-Matthes ML. Application of purified polysaccharides from cell cultures of the plant Echinacea purpurea to mice mediates protection against systemic infections with Listeria monocytogenes and Candida albicans. Int J Immunopharmacol. 1991;13:27-37.
- Roesler J, Emmendorffer A, Steinmuller C, Luettig B, Wagner H, Lohmann-Matthes ML. Application of purified polysaccharides from cell cultures of the plant Echinacea purpurea to test subjects mediates activation of the phagocyte system. Int J Immunopharmacol. 1991;13:931-941.
- Rininger JA, Kickner S, Chigurupati P, McLean A, Franck Z. Immunopharmacological activity of Echinacea preparations following simulated digestion on murine macrophages and human peripheral blood mononuclear cells. J Leukoc Biol. 2000;68:503-510.
- Sun LZ, Currier NL, Miller SC. The American coneflower: a prophylactic role involving nonspecific immunity. J Altern Complement Med. 1999;5:437-446.
- Sasagawa M, Cech NB, Gray DE, Elmer GW, Wenner CA. Echinacea alkylamides inhibit interleukin-2 production by Jurkat T cells. Int Immunopharmacol. 2006;6:1214-1221.
- Raduner S, Maiewska A, Chen JZ, et al. Alkylamides from Echinacea are a new class of cannabinomimetics. Cannabinoid type 2 receptor-dependent and –independent immunomodulatory effects. J Biol Chem. 2006;281:14192-14206.
- Carlisle SJ, Marciano-Cabrai F, Staab A, Ludwick C, Cabral GA. Differential expression of the CB2 cannabinoid receptor by rodent macrophages and macrophage-like cells in relation to cell activation. Int Immunopharmacol. 2002;2:69-82.
- De Petrocellis L, Cascio MG, Di Marzo V. The endocannabinoid system: A general view and latest additions. B J Pharmacol. 2004;141:765-774.
- Goel V, Chang C, Slama JV, et al. Alkylamides of Echinacea purpurea stimulate alveolar macrophage function in normal rats. Int Immunopharmacol. 2002;2:381-387.
- Classen B, Thude S, Blaschek W, Wack M, Bodinet C. Immunomodulatory effects of arabinogalactan-proteins from Baptisia and Echinacea. Phytomedicine. 2006;13:688-694.
- Hu C, Kitts DD. Studies on the antioxidant activity of Echinacea root extract. J Agric Food Chem. 2000;48:1466-1472.
- Grimm W, Muller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections. Am J Med. 1999;106(2):138-143.
- Schoop R, Klein P, Suter A, Johnston SL. Echinacea in the prevention of induced rhinovirus colds: A meta-analysis. Clin Ther. 2006;28:174-183.
- Roxas M, Jurenka J. Colds and influenza: A review of diagnosis and conventional, botanical, and nutritional considerations. Altern Med Rev. 2007;12:25-48.
- Melchart D, Linde K, Worku F, et al. Results of five randomized studies on the immunomodulatory activity of preparations of Echinacea. J Altern Complement Med. 1995;1:145-160.
- Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust. 1998;168:170-171.
- Mullins RJ, Heddle R. Adverse reactions associated with Echinacea: The Australian experience. Ann Allergy Asthma Immunol. 2002;88:42-51.
- Rakel. Conn’s current therapy. 53rd ed. US: W. B. Saunders Co., 2001; p. 1267.
- Ernst E. Herbal medicinal products during pregnancy?. Phytomedicine. 2002;9:352-354.
- Ondrizek RR, Chan PJ, Patton WC, King A. An alternative medicine study of herbal effects on the penetration of zona-free hamster oocytes and the integrity of sperm deoxyribonucleic acid. Fertil Steril. 1999;71(3):517-522.
- Parnham MJ. Benefit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral immunostimulation. Phytomedicine. 1996;3:95-102.
- Bauer VR, Jurcic K, Puhlmann J, et al. immunologic in vivo and in vitro studies on Echinacea extracts. Arzneimittelforschung. 1988;38(2):276-281.
- Wildfeuer A, et al. Unterschung des einflusses von phytopraparaten auf zellulare funktionen der korpereigenen abwehr. Arzneim-Forsch/Drug Res. 1994;44(1):361-366.
- Gaisbauer M, Schleich T, Stickl HA, et al. The effect of Echinacea purpurea moench on phagocytosis in granulocytes measured by chemiluminescence. Arzneimittelforschung. 1990;40(5):594-598.
- Turner RB, Riker DK, Gangemi JD. Ineffectiveness of Echinacea for prevention of experimental rhinovirus colds. Antimicrob Agents Chemother. 2000;44(6):1708-1709.
- Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized Echinacea preparation (Echinilin) for the treatment of the common cold: A randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther. 2004;29(1):75-83.
- Melchart D, Linde K, Fischer P, et al. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2000;(2):CD000530.Clifford LJ, Nair MG, Rana J, Dewitt, DL. Bioactivity of alkamides isolated from Echinacea purpurea (L.) Moench. Phytomedicine. 2002;9:249-253.
