New Study on Echinacea is Faulty, says Canadian-Based Company

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New Study on Echinacea is Faulty, says Canadian-Based Company JoAnn Guest

Oct 27, 2005 15:21 PDT

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New Study on Echinacea is Faulty, says Canadian-Based Company

Category: Complementary Medicine News

Article 15 Aug 2005

 

 

 

http://www.medicalnewstoday.com/medicalnews.php?newsid=29145

 

A new study which claims that Echinacea products work no better than a

placebo on cold symptoms has been called faulty and inaccurate by the

Canadian-based Company that produces a number of well known

Echinacea-based products for consumers around the world.

 

According to Dr. Michael Murray, the Director of Education for Factors

Group of Nutritional Companies, consumers should certainly not dismiss

Echinacea as a cold remedy based on the results of this study alone.

 

Dr. Murray says that the most recent study, as reported in the New

England Journal of Medicine this week, revealed that the study was

incorrect on several different levels.

 

“What determines the effectiveness of any herbal product is its ability

to deliver an effective dosage of active compounds. The specific

components of Echinacea responsible for its immune-enhancing effects are

the polysaccharides, alkylamides and the cichoric acid,” says Dr.

Murray. “While each of these components is effective alone, the greatest

degree of effectiveness occurs when the three active components are

combined and at a specific ratio.”

 

Dr. Murray says that the current study's researchers made a mistake by

not ensuring that the three active compounds which ensure the efficacy

of any Echinacea product were utilized in an optimum ratio in this

specific study. He says none of the three extracts used on the 399 study

participants actually contained all of the three necessary compounds.

 

Dr. Murray also calls into question the study's dosing of study

participants.

 

“According to the study, the patients were given 1.5 mL three times a

day which represents 300 mg per dose or 900 mg per day. This is not an

effective dose. The standard dosage for dried Echinacea angustifolia

root is normally three grams per day or more and this study used less

than one gram,” says Dr. Murray.

 

Dr. Murray adds that even the National Health Products Directorate of

Health Canada, which is known to be very conservative in the area of

dosing, recommends a minimum dosage of three grams of Echinacea for

therapeutic results.1.

 

Roland Gahler, Executive Chairman of the Factors Group of Nutritional

Companies says, “The real problem is that not all Echinacea products are

equal. As Dr. Murray has so correctly pointed out, it has been clearly

shown time and time again that the single most important aspect in

getting results from an Echinacea product is to make sure that it can

provide sufficient levels of all three classes of the key categories of

active compounds in their proper ratio.”

 

“The benefits of such a preparation have been clinically verified in a

number of studies that the current study's researchers chose to ignore,”

says Mr. Gahler.

 

Factors Group developed its Echinacea-based products following years of

collaboration with researchers at the University of Alberta, University

of British Columbia and Dalhousie University in Canada, as well as

Heinrich-Hein University in Düsseldorf, Germany and Karl-Franzens

University in Graz, Austria. All products were subjected to rigorous

clinical and laboratory testing.

 

Dr. Richard Barton, Department of Biochemistry and Molecular Biology at

the University of British Columbia and co-director of the Company's

human clinical studies, says that there have been a lot of studies with

Echinacea done before but, as usual, none utilize the proper ratio of

active compounds. He says that, as a result, the research continues to

be disappointing.

 

“In contrast, the research that we did on Echinilin® was

triple-standardized (alkylamide, polysaccharide, cichoric acid). And,

the randomized, double-blinded, placebo-controlled human studies showed

it to be consistently effective in fighting off cold and flu viruses. We

saw a sustained increase in natural killer cells (NK cells) in

participants when they were given Echinilin which no doubt contributed

to a more active immune system resulting in the destruction of

virus-infected cells. The end result was a remarkably high reduction in

both severity of symptoms and duration of the infection,” says Dr.

Barton.

 

The Journal of Clinical Pharmacy and Therapeutics published an article

on Dr. Barton's study and described the findings as a breakthrough in

the fight against viral infections such as the common cold and the flu

in February 2004.2.

 

Factors Group of Nutritional Companies includes Factors R & D

Technologies Ltd., which is Canada's leading research organization in

evidence-based phytopharmaceuticals. The Company's science team is

comprised of international experts--some of whom hold positions at the

universities in Alberta, British Columbia, Dalhousie, Toronto and Graz

(Austria). Factors R & D coordinates all research and development of the

500-plus products for the Factors Group. This includes its line of

Med-FoodsTM, as wells as Echinilin® which has demonstrated its

effectiveness as an immune system stimulant against upper respiratory

illnesses in Phase II clinical trials. Research projects include the

agronomy of herbal and other medicinal plants, organic farming methods,

extraction processes, laboratory (in vitro) testing and studies, in vivo

mammalian studies and human clinical trials.

 

Kate Jobling

Media & Public Relations

Factors R & D Technologies Ltd.

Direct: 604-415-4181

Email: kjob-

factorstechnologies.com

 

1. http://www.hc-sc.gc.ca/hpfb-dgpsa/nhpd-dpsn/mono_echinacea_e.html

 

2. V. Goel, et al., ‘Efficacy of a standardized Echinacea preparation

(Echinilin®) for the treatment of the common cold: a randomized,

double-blind, placebo-controlled trial', published in the Journal of

Clinical and Pharmaceutical Therapeutics (2004), 29, 75-83

=================================================================Posted:

Thu Oct 27, 2005 2:00 pm

Post subject: Echinacea - medicinal uses

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http://www.ncarboretum.org/Superb_Herbs/echinacea_a.html

 

E. angustifolia has a long tradition of use among the native people of

North America. It continues to be the most widely used herbal remedy in

native cultures. In modern cultures of North America and Europe, E.

angustifolia is primarily used in medicines believed to stimulate the

immune system. Of the three Echinacea species used for medicinal

purposes (E. purpurea, E. angustifolia, and E. pallida), E. angustifolia

is regarded as the most chemically active possessing anti-bacterial,

anti-viral and anti-fungal properties. Traditional/folk uses include a

blood purifier, fevers, acne, and to treat infections and sores.

 

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Efficacy of echinacea for upper respiratory tract infections in

children

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Sunita Vohra MD FRCPC1, Michael Rieder MD PhD FRCPC FAAP FRCP (Glasgow)2

 

http://www.pulsus.com/Paeds/10_04/vohr_ed.htm

 

A mother in your practice asks about using echinacea for the prevention

of upper respiratory tract infections (URTIs) for her children, aged two

and five years, who are otherwise healthy children. She is very pleasant

and has been compliant with therapy in the past.

 

What do you recommend?

 

Complimentary and alternative medicine treatments are commonly used by

Canadian patients and by parents for their children. In the context of

chronic illness, this appears to be the rule rather than the exception.

Echinacea is consistently one of the most commonly used herbal

medications in North America, frequently used by patients for the

prevention and therapy of URTIs.

 

Does it work?

 

Echinacea, or the purple cone flower, is a plant of which three species

are used medicinally. The constituents are known to vary between the

three species. A variety of preparations, including extracts, roots,

aerial parts and rhizomes, have been used for prophylaxis and therapy.

 

Although the impression is that there is little research in

complimentary and alternative medicine, there are two recent large

reviews on echinacea (1,2). Barrett et al (1) reviewed 13 trials that

used echinacea for URTIs – nine that used echinacea as therapy and four

prevention trials. There were considerable differences among the trials

in terms of products used and outcome measures, and, consequently, it

was not possible to conduct a meta-analysis. Eight of the nine treatment

trials reported benefit from echinacea therapy, and two of the

prevention trials reported benefit while two did not (1). The Cochrane

review by Melchart et al (2) analyzed the results of 16 trials using

echinacea – eight as therapy for URTIs and eight for prevention – with a

total of 3396 subjects studied. The prevention studies suggested that

any beneficial effects of echinacea were small at best, with a maximum

estimated risk reduction of 15% to 20%. In contrast, there was stronger

evidence for benefit in the treatment trials (2).

 

In applying these data, one major consideration is that the majority of

subjects studied were adults. Among the subjects reported in the trials

evaluated in the Cochrane review, there were 1100 subjects aged one to

13 years (2). Unfortunately, these trials included the use of other

natural health products, and the contribution of echinacea to the

overall benefit demonstrated is difficult to evaluate. The treatment

trials suggest that the benefits of echinacea in the context of URTIs in

children are probably confined to treatment and not prevention.

Echinacea appears to show benefits in the treatment of URTIs when it is

given early, and this is related to the reduced progression of symptoms.

An estimate of the number of children needed to treat to produce a

benefit is five. This means that, on average, five children must be

treated to see improvement in one child.

 

Is it safe?

 

There has been extensive evaluation of echinacea in murine models, and

it appears that the lethal dose when expressed as the median lethal dose

(LD50) is many times the usual human dose (3). Echinacea is known to

have the potential to generate an immune response, and allergic

reactions have been reported. However, allergic reactions appear to be

infrequent, with the Australian adverse events reporting system

reporting 51 cases and the World Health Organization database reporting

76 cases over 19 years, with 10 hypersensitivity reactions and eight

cases of anaphylaxis (4,5). The Australian data suggest a higher risk

among atopic individuals (a known risk factor for adverse reactions to

other drugs such as antibiotics). Fever has been reported with

parenteral administration of echinacea, but the data to date suggest

that oral administration of echinacea is unlikely to be associated with

a significant risk for serious adverse events.

 

An important caveat applies. The data to date are largely based on

otherwise healthy adults and children, and the possible adverse effects

of echinacea in children with an altered immune system (eg, autoimmune

disease or HIV) are not known. Because the reduced rate of progression

of symptoms in the context of URTIs is presumably related to immune

modulation, caution is recommended when planning to use echinacea in

children who are not otherwise healthy.

 

Returning to our case, what do we recommend to the mother of the two

children? The evidence to date does not support the use of echinacea in

the prevention of URTIs and you should share this information with the

mother of your patients. The evidence does suggest the potential that

echinacea may reduce the severity of symptoms among children who have a

URTI. The two provisos that apply are that therapy appears only to be

effective if given early and that the data to date have come primarily

from otherwise healthy children.

 

Acknowledgements: Dr Rieder holds the GSK-CIHR Chair in Paediatric

Clinical Pharmacology at the University of Western Ontario. Dr Rieder’s

research is supported by the Canadian Institutes of Health Research, the

Robarts Research Institute and the Children’s Health Research Institute.

 

 

REFERENCES

 

1. Barrett B, Vohmann M, Calabrese C. Echinacea for upper respiratory

infection.

J Fam Pract 1999;48:628-35.

 

2. Melchart D, Linde K, Fischer P, Kaesmayr J. Echinacea for preventing

and treating the common cold. Cochrane Database Syst Rev

2000;(2):CD000530.

 

3. Mengs U, Clare CB, Poiley JA. Toxicity of Echinacea purpurea. Acute,

subacute and genotoxicity studies. Arzneimittelforschung

1991;41:1076-81.

 

4. Mullins RJ, Heddle R. Adverse reactions associated with echinacea:

The Australian experience. Ann Allergy Asthma Immunol 2002;88:42-51.

 

5. Farah MH, Edwards R, Lindquist M, Leon C, Shaw D. International

monitoring of adverse health effects associated with herbal medicines.

Pharmacoepidemiol Drug Saf 2000;9:105-12.

 

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The following is a review of the positive research findings on Echinacea

 

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Laboratory studies

A series of studies in animals has shown that various echinacea

preparations increase phagocytosis, chemotaxis and oxidative burst by

neutrophils and macrophages (Percival). These are all part of the body's

generic or nonspecific response to injury or illness.

 

Fresh herb and root powders of E. purpurea stimulated cytokine release

by macrophages (Rininger et. al.). Macrophages are a type of white blood

cell, and cytokines are weapons in the nonspecific immune system.

 

In mice treated with echinacea, macrophages were able to kill cells

infected with parasites and yeast, as well as certain tumor cells

(Pervival). Again, this is part of the nonspecific immune response.

 

E. angustifolia root extract enhanced the primary and secondary IgG

response to antigen exposure. Rats treated with echinacea produced

antibodies sigWhat It Doesnificantly faster than the controls, although

the total amount of antibody did not change between the two groups

(Rehman et. al.). Antibodies are part of the acquired or specific branch

of the immune system. They are produced in response to specific

invaders, such as viruses or bacteria. Other studies have not been able

to duplicate these effects on acquired immunity.

 

 

Studies in Humans

 

Seven German studies involving 910 subjects looked at the effect of

echinacea on the severity and duration of cold and flu symptoms. All

seven studies showed significant benefits due to echinacea (Percival).

When white blood cells were taken from humans and treated with echinacea

extract, cytokine production improved and activity against

staphylococcal bacteria was increased (Percival).

Injecting echinacea extract in humans increased the C-reactive protein

level and erythrocyte sedimentation rate. Both of these tests can

indicate an increase in nonspecific immune activity (Percival).

Injection of E. angustifolia improved phagocytic (toxin-killing)

activity. E. purpurea root in ethanol had the same result, but similar

studies with other echinacea preparations had no effect (Percival).

Double-blind randomized, placebo-controlled trial to test efficacy as a

treatment for children (2 to 11 years old) with the common cold. The

results indicated no statistically significant differences between the

echinacea and placebo groups in any primary outcome. There was an

increase in rash (1 in 22) among those taking echinacea and also the

frequency of a second cold was lower in the echinacea group (12%

absolute reduction in risk of next cold).

 

German Commission E and Expanded Commission E Reports:

 

Commission E is a committee of health care experts formed by the German

government in 1978 to examine the safety and effectiveness of herbal

medications. Its monographs have become one of the most comprehensive

resources in use today. An expanded version of the monographs with

updated research is also available in the United States. In 1992,

Commission E published four monographs on echinacea. E. pallida root was

approved for treatment of influenza-like symptoms.

E. purpurea herb (above-ground part) was approved for respiratory

infections, colds, urinary tract infections and topical treatment of

non-healing skin wounds.

They also released two negative monographs on E. purpurea root and E.

angustifolia root due to lack of clinical trials at the time of

publication.

 

According to the expanded report, pharmacological evidence supports use

of the root of all three echinacea species.

The expanded report sited a study in which E. purpurea juice was given

to patients with initial symptoms of a cold. They found that fewer

patients developed full-blown illness (40% versus 60% placebo), and

recovery was quicker (4days versus 8 days).

Another study showed possible benefits of E. purpurea leaf juice in

recurrent yeast infections. Women who were treated with a common

anti-yeast medication alone had a 60.5% recurrence rate, while those who

took the echinacea had a lower recurrence rate of 16.7%.

The World Health Organization conducted a review of literature on E.

angustifolia root and concluded that it can be used as supportive

therapy for colds and other respiratory infections, as well as urinary

tract infections.

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Post subject: MEDICINAL VALUE OF ECHINACEA

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http://www.hort.purdue.edu/newcrop/proceedings1999/v4-490.html

 

Three Echinacea species (E. purpurea, E. angustifolia, and E. pallida)

have medical properties (Schulthess et al. 1991), and are commercially

traded as medicinal plants.

 

Native Americans used echinacea extensively for the treatment of snake

and other venomous bites, rabies, toothaches, coughs, soremouth, throat,

dyspepsia, colds, colic, headache, and stomach cramps (Hobbs 1989;

Kindscher 1989; Foster 1991).

 

European settlers first used echinacea around the beginning of 19th

century. By 1921, echinacea preparations were among the most widely sold

medicines extracted from an American plant (Flannery 1998).

 

Echinacea appears to have strong anti-inflammatory activity,

wound-healing action, stimulates the immune system, and may be effective

against some viral and bacterial infections (Bauer et al. 1990;

Schulthess et al. 1991; Leung and Foster 1996; Burger et al. 1997; Cox

1998).

 

Scaglione and Lund (1995) observed that an anti-cold remedy including

E. purpurea was effective for the treatment of common cold and it

shortened the healing time.

 

Echinacin, a product made from the juice of fresh plant tops, has been

produced for 50 years and subjected to more than 150 clinical studies in

Germany (Hobbs 1989).

 

Echinacea products are medically prescribed in Germany (Blumenthal 1998;

Hobbs 1989; Leslie 1995, 1996). In the US, many health remedies or

dietary supplements include echinacea in the form of dry root, capsules,

tablets, crude extracts, tinctures, and are mainly from E. purpurea and

E. angustifolia (Leung and Foster 1996; Li 1998).

 

Injectable preparations using echinacea extracts are available only in

Germany (Li 1998). Echinacea products can also be found combined with

other medicinal herbs yet in the US, but the product label is not

allowed to have specific therapeutic claims (Li 1998).

 

McCaleb (1998) reported that the squeezed sap of Echinacea purpurea L.

(Echinacinâ, Madaus AG, Cologne, Germany) is well tolerated and

appropriate for long term-oral use, with no adverse reaction observed

other than aversion to the taste during oral use for up to 12 weeks.

 

Even injections were found to be safe for both adults and infants.

Some rare side effects were observed such as headache and fever during

injection treatment. Mengs et al. (1991) reported no evidence of any

toxicity using E. purpurea in rats or mice during a 4-week application

of single oral or intravenous doses, amounting to many times the human

therapeutic dose. Tyler (1993) and Scaglione and Lund (1995) conclude

that the use of echinacea is safe.

_________________

 

 

 

JoAnn Guest

mrsjo-

www.geocities.com/mrsjoguest/Diets

 

 

 

 

AIM Barleygreen

" Wisdom of the Past, Food of the Future "

 

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