Optimising Immunity to Protect against Coronaviruses

The outbreak of a new human form of coronavirus (Wuhan novel coronavirus, 2019-nCoV) in December 2019 in the city of Wuhan in China, is spreading fear and alarm around the world.

Around 56 million people in China have been under lockdown since Chinese New Year, and the Chinese government has just completed the fast-tracked building of the first of two new hospitals in Wuhan, to help cope with a rapidly growing number of cases. As at Monday 3rd February, 20,438 confirmed cases have been reported across all regions in China as human to human transmission occurs, and 425 people have died following infection with the virus, 414 of which were in Hubei province where Wuhan is located. Cases have now been reported in at least 25 other countries, though only one death outside of China has been reported to date.

As with other serious virus outbreaks that have emerged over the past 45 years such as Ebola virus, Bird Flu (H5N1) and Swine Flu (H1N1) virus, this coronavirus seems to have originated in another animal species (probably a bat), and jumped the barrier to be able to replicate itself in humans.

China is now more prepared than it was back in 2002 when the SARS (Sudden Acute Respiratory Syndrome) virus emerged, killing 774 of the 8090 people reportedly infected. Also, while it is relatively early days, indications are that the death rate from 2019-CoV will be less than that of SARS, at around 2-3% of diagnosed cases, versus around 10% for SARS. However, like all viruses 2019-nCoV is likely to continue to mutate rapidly, and new more pathogenic forms are possible.

 

The Coronavirus

Coronaviruses are a fairly large family of viruses that cause illness ranging from the common cold (responsible for 15-30% of cases), to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). They typically infect the respiratory tract, though the gut can also be affected.

Human to human transmission of 2019-nCoV seems to be relatively easy, though we are still learning about the various means through which this can occur. A 7-14-day incubation period seems to occur before symptoms begin to show, although even asymptomatic cases can be infectious,

Most 2019-nCoV patients initially hospitalised in Wuhan had fever at the onset of symptoms, and well as dyspnoea (shortness of breath) and a cough. Myalgia (muscle pain) or fatigue also seem to be common symptoms. The main cause of death is from pneumonia and acute respiratory distress syndrome(1).

 

Treatment Options

There are no proven effective antiviral drug treatments for coronavirus infections, and our biggest protection against this new virus or others that may come our way, relies largely upon the execution of good Public Health measures. Restricting travel, wearing masks, washing hands frequently, the use of sanitising agents and the isolation of those with suspected infections, is the best current approach to help reduce the risk of spread to others.

In considering the nature of the virus and what is known about it so far, there would appear to be a number of possible pharmacotherapy (drug and/or herbal) approaches, namely:

  1. Enhancing immunity to help protect against infection, or if it takes hold, to improve the body’s ability to fight it.
  2. Antiviral actions to specifically inhibit the ability of 2019-nCoV to take hold and replicate.
  3. Lung and respiratory tract protective, healing and anti-inflammatory agents.
  4. Other agents such as febrifuges and systemic anti-inflammatories, to help reduce acute symptoms in some cases.

Since this virus hit the headlines a plethora of articles and social media posts promoting a whole range of natural including herbal treatments has appeared, although the quality of many of these leaves much to be desired.

Just as drug developers have found it challenging to make drugs that have clinically significant antiviral actions, the evidence for herbal remedies having the same, is slim. I am not saying they don’t exist, because I’m sure they do.

However, claiming an antiviral action of a herbal preparation based upon an in vitro antiviral activity shown against a virus completely unrelated to 2019-nCoV, by an individual phytochemical found in relatively low amounts in a whole herb, and usually about which little if anything is known on its bioavailability (ability to be absorbed from the gut after oral administration and distributed to the area in the body where it needs to act), is a very far reach.

A more likely efficacious and evidence-based approach to incorporating plant-based products to help reduce the potential impact of this new virus on human health, is therefore to focus on enhancing immunity. Herbs that help foster greater immunity or that protect or help heal the respiratory tract from the acute inflammation, shortness of breath, pneumonia and respiratory failure that are main causes of serious illness and death, are worthy of consideration.

 

Optimising immunity

As with all infectious diseases, the level of pre-existing immunity to the microbial pathogen, is a key factor known to influence the susceptibility to and severity of an infection, and immunocompromised patients are more vulnerable to viral infections. The largest factor in immunity to influenza and coronaviruses seems to be serum antibodies induced by prior infection or vaccination, which impart a strong and disease specific host resistance to the virus. However, it will take many months or even years to develop a vaccine, and even then, the virus may mutate further by that time.

Plants have much to offer in terms of optimising immunity in humans, and a healthy vegetable and fruit rich diet, is increasingly linked with favourable influences on the gut microbiome and immune function(2). Many plant and mushroom derived preparations have been shown to help enhance human innate immunity (resistance) to different viral and bacterial pathogens, and a full review of these is not possible here. However, I consider Echinacea (Purple coneflower) one of the most promising from both a traditional as well as evidence-based perspective.

 

Echinacea

Echinacea was an important traditional medicinal herb to Native Americans, and different species were used to treat animal bites and a wide range of infectious and inflammatory conditions(3,4). Early European settlers to the Midwest adopted Echinacea purpurea and Echinacea angustifolia as a treatment for wounds and glandular inflammation, and it was a preferred treatment by many clinicians for infections until discovery of penicillin. There are now more than 1200 scientific papers published on it, and its principle application over the last 50 years has largely been as a prophylactic or treatment for colds and influenza.

Several clinical trials have shown beneficial effects of echinacea during the treatment of colds and influenza, although others have had less favourable outcomes. However, evaluation of these is complicated by the use of a diverse range of product types, plant part(s) and doses used.

Immune enhancement and modulation, and anti-inflammatory effects, are principal actions of echinacea, and numerous studies have reported immunological changes associated with echinacea root usage. Key outcomes seem to be increased numbers of circulating white blood cells, monocytes, neutrophils and natural killer (NK) cells, and the abilities of these immune cells to engulf and inactivate harmful microbes or carcinogens. This enhancement of the non-specific immune response, is thought to improve the body’s ability to maintain immunosurveillance against a variety of potential viral or bacterial pathogens or spontaneous-developing tumours.

Canadian researchers found that normal mice given Echinacea purpurea root had significantly prolonged life spans versus non-immunized mice(5). NK cells were also elevated in leukaemic mice receiving echinacea in their diet versus those who didn’t(6). Japanese researchers found Echinacea purpurea to have a suppressive effect on spontaneously occurring leukaemia caused by a murine leukaemia virus, an effect related to enhancement of immune systems(7).

Stress is known to reduce immunity, and echinacea has shown beneficial effects on stress-induced immunosuppression by increasing splenocyte proliferation and NK cell activity, while modulating blood levels of inflammatory cytokines(8).

Secondary or co-existing bacterial infections are also a common cause of pneumonia and death in patients with viral infections of the respiratory tract, and have been reported in approximately 10% of 2019-nCoV hospitalised patients(1). Viral infections can express bacterial adhesion receptors, and the virus-induced inflammatory response can also disturb the integrity of the physical barrier to bacteria. Evidence suggesting echinacea may prevent virus-induced bacterial adhesion to cell membranes, and moderate an excessive inflammatory response (cytokine storm) sometimes seen with pandemic forms of viruses(9,10), may therefore contribute to improved host resistance against pathogenic viral infections.

Alkylamides (alkamides), found in highest concentrations in the root, are now regarded as major bioavailable and active immunomodulatory components in oral forms of echinacea(11). However, microbes known as endophytes that live in close association with echinacea, also exhibit strong antibacterial effects against respiratory pathogenic bacteria such as Klebsiella pneumonia, Burkholderia cepacia and Acinetobacter baumannii(12-14). Recent research also suggests that inulin-type fructans found in echinacea, which are prebiotic compounds that promote a health microbiome, may also contribute to beneficial immunomodulatory effects(15).

In summary, while the situation in China and elsewhere will continue to evolve rapidly over the coming weeks, given its seriousness and the limitations of drug treatment options at this point, herbal options such as echinacea to help optimise our immune system’s resistance to 2019-nCoV or other viruses that will continue to come our way, should be considered.

 

References:

  1. Huang C et al, Lancet 2020 Jan 24; epub ahead of print.
  2. Tomova A et al, Front Nutr. 2019 Apr 17;6:47.
  3. Felter HW. The Eclectic Materia Medica, Pharmacology and Therapeutics. Eclectic Medical Publications, Oregon, 1922.
  4. Smithsonian National Museum of Natural History, http://www.mnh.si.edu/lewisandclark/index.html?loc=/lewisandclark/home.html
  5. Brouseau M, Miller SC, Biogerontology. 2005;6(3):157-63.
  6. Currier NL, Miller SC, J Altern Complement Med. 2001;7(3):241-51.
  7. Hayashi I et al, Nihon Rinsho Meneki Gakkai Kaishi. 2001;24(1):10-20.
  8. Park S et al, J Med Food. 2018; 21(3):261-268.
  9. Rasmussen PL, Phytotherapy in an Influenza Pandemic: Swine Flu. Phytonews 32, 2009, June. Published by Phytomed Medicinal Herbs Ltd, Auckland, New Zealand. ISSN 1175-0251.
  10. Vimalanathan S et al, Virus Res. 2017; 2(233):51-59.
  11. Mudge E et al, J Agric Food Chem. 2011; 59(15):8086-94.
  12. Haron MH et al, Planta Med 2016; 82(14):1258-1265.
  13. Presta L et al, Res Microbiol 2017; 168(3):293-305.
  14. Chielleni C et al, Microbiol Res. 2017 Mar;196:34-43.
  15. Dobrange E et al, 2019 Oct 16;9(10). pii: E615.

ELECAMPANE, TO PROTECT OUR LUNGS DURING AN ERA OF INCREASING BUSHFIRES

The bushfires in Australia have worsened since I wrote about them a couple of weeks ago. Frequent exposures to hazy skies containing tiny airborne pollutants that are damaging to our lungs, have been incurred by millions of Australians, and also by many New Zealanders due to drift across the Tasman. Smoke from the Australian fires has also travelled to Argentina and across to the Atlantic, a stark reminder of how climatic events in one part of the world can have significant impacts on those living in completely different continents.

In addition to mucilaginous (polysaccharide hydrocolloid rich) and expectorant herbs such as Marshmallow (Althaea officinalis), Mullein (Verbascum thapsus) and the New Zealand native Hoheria (Hoheria populnea), evidence suggests that other herbal medicines can be beneficial for those forced to live or work in environments where exposure to smoke or fine-particulate matter containing and toxic haze from bush or forest fires, is unavoidable. Herbs with protective actions against airborne lung damaging and potentially carcinogenic compounds, are of particular interest.

One of the most promising herbs in this regard, is Elecampane (Inula helenium), the roots of which have long been traditionally used in treatments for coughs, chest infections, asthma and other lung conditions. Elecampane is an anti-inflammatory, antimicrobial and antioxidant herb, and contains various constituents exhibiting lung protective effects.

Research showing in vitro activity by elecampane against various forms of human cancer cell lines was first reported in 2002(1), and several further investigations into anticancer properties of elecampane and other Inula species, have produced favourable results(2-8). While having antitumour activity against cancer cells, no harmful effects have been measured on normal cells(3).

The sesquiterpene lactones alantolactone and isoalantolactone, key sesquiterpene lactone constituents in elecampane roots, undoubtedly contribute to these effects, having inhibitory effects against human lung, breast, prostate, colon and pancreatic cancer cells through a range of different mechanisms(10-13). Alantolactone also increases the sensitivity of lung cancer cells to the effects of the chemotherapy drugs doxorubicin and gemcitabine(9,10), suggesting a possible role as adjunctive therapy.

Isoalantolactone has also been shown to have marked anti-inflammatory effects and to reduce the extent of lung injury following exposure to lung damaging compounds in animal studies. Beneficial effects included suppression of pulmonary pathological changes, neutrophil infiltration, pulmonary permeability, and pro-inflammatory cytokine expression(14).

However, isoalantolactone and alantolactone seem to have low bioavailability when given orally to rats, possibly due to poor stability in gastrointestinal fluids and being subject to significant degradation by the liver after absorption through the so-called “first pass effect”(15,16). As such, alternative means of administration of elecampane apart from the usual oral route, particularly when the lungs are the target organ, are worth considering.

Many traditional applications of herbal medicine including Maori Medicine (Rongoā Māori), Ayurvedic, Chinese and European herbal medicine, utilised inhalation through the lungs as a popular method of administration. This pulmonary route of administration through inhalation or sprays, is also used widely in modern drug-based medicine as a means of treating conditions such as asthma or sore throats, or as a way to deliver drugs to the general blood circulation and treat other systemic conditions. Well-known examples include the pronounced bronchodilatory or anti-inflammatory effects through inhaling bronchodilatory or anti-inflammatory asthma drugs, relaxant and calming effects through inhalation of essential oil-rich preparations such as lavender or chamomile, and the well-known effects through inhaling preparations of plants such as cannabis and tobacco. The high permeability and large absorptive surface area of the lung alveolar epithelium, its good blood supply, the rapid onset of action and capacity for overcoming first-pass metabolism, can provide significant advantages of a pulmonary rather than oral route of administration(17-18).

With increasing evidence that acute or chronic environmental or occupational exposure to airborne carcinogens or lung-damaging compounds can have serious effects on human health, not only in an era of increasing bushfires but also amongst farmers handling pesticides, firefighters, painters and others working in dusty environments, the possible application of chemo-preventive and lung protecting herbs such as elecampane through the pulmonary route as an inhalation or spray, deserves more attention.

inula photo

Refs:

  1. Konishi T et al, Biol Pharm Bull 25(10):1370-1372, 2002.
  2. Spiridonov NA et al, Phytotherapy Res 19(5): 428-432, 2005.
  3. Dorn DC et al, Phytother Res. 2006 Nov;20(11):970-80.
  4. Wang GW et al, Expert Opin Investig Drugs. 2014 Mar;23(3):317-45
  5. Chun J et al, Phytother Res. 2018 Dec;32(12):2501-2509.
  6. Koc K et al, J Cancer Res Ther. 2018 Apr-Jun;14(3):658-661
  7. Zhang B et al, Mol Med Rep. 2018 Apr;17(4):5440-5448.
  8. Bar-Shalom R et al, Front Oncol. 2019 Apr 10;9:227
  9. Wang J, et al. Int J Mol Med. 2019. Sep;44(3):1026-1038
  10. Maryam A et al, Sci Rep. 2017 Jul 24;7(1):6242
  11. He R et al, Toxicol Appl Pharmacol. 2018 Oct 1;356:159-171.
  12. Liu J et al, J Food Biochem. 2019 Sep;43(9):e12972.
  13. Wang J et al, Int J Mol Med. 2019 Sep;44(3):1026-103
  14. Ding YH et al, Acta Pharmacol Sin. 2019 Jan; 40(1): 64–74.
  15. Lee JY, et al. Biopharm Drug Dispos. 2016. Apr;37(3):156-67
  16. Xu R et al, Eur J Drug Metab Pharmacokinet. 2019 Apr;44(2):295-303
  17. Patil JS, Sarasija S.Lung India. 2012 Jan;29(1):44-9.
  18. Gandhimathi C, 2015 et al. J Nanosci Nanotechnol

 

LUNG CARE DURING AN ERA OF INCREASING BUSHFIRES

Bushfires have been burning across many parts of Australia in recent weeks, particularly in the most populated state of New South Wales, and more recently Victoria.  Catastrophic fire conditions have existed, with flames being fanned across the country by high winds, above 40°C temperatures, low humidity and long-term dryness in the bush. These fires are unprecedented and deadly, and many lives and homes have been lost. An area bigger than Belgium has already been burned, despite the warmest summer months not yet arrived.

The frequency and severity of bushfires in Australia will continue to increase with global warming, as they also will in New Zealand, California and other parts of the world.

Australian bushfires tend to burn for weeks on end across large areas of land, and this often sends smoke over populated areas. Residents of Sydney have endured smoke for weeks, and when I stood on the tarmac of Sydney airport recently, it was impossible to avoid the smokey smell despite official announcements saying there was nothing to worry about. Also the haze that seemed to envelop the whole city as the plane came in to land, causing poor visibility and making driving a dangerous pursuit.  Millions of people in Sydney and other parts of N.S.W. and Australia, have been blanketed by and frequently exposed to bushfire smoke in recent weeks.

 

Effects on lung health:

Exposure to smoke is obviously not good for human or animal health, and the links between cigarette smoking, lung cancer and emphysema, are well established.

Harmful gases in smoke from burning bush include carbon monoxide, carbon dioxide and nitrogen oxide, all of which are present in cigarette smoke and more prevalent nearer to a fire. However, most danger lies in ultrafine particles known and measured globally as particulate matter PM2.5 (smaller than 2.5 micrometres in diameter). These are invisible to the human eye, cause haziness in the air and can travel vast distances on the wind. They are often coated in toxic chemicals such as lead, and are most worrying because their tiny size means they are able to penetrate deep into the lungs.

Recent PM2.5 readings in Sydney have reported levels as high as 734 micrograms – the equivalent of smoking about 37 cigarettes a day. Firefighters and those living closer to blazes, have been and are being exposed to much higher levels, according to a director of the Fire Centre Research Hub at the University of Tasmania, Prof David Bowman (1).

Australian Paramedics have treated hundreds of people for breathing problems, and there have been increased hospital admissions for asthma and breathing difficulties. Most sensitive are children, the elderly and smokers, while those with asthma, heart and lung problems have experienced increased symptoms such as chest tightness and difficulty breathing. If the smoke lingers, then harmful gases and PM2.5 particles could eventually have the same damaging effects on the lungs as cigarettes.

These types of exposures of millions of people to smoke inhalation from bush or forest fires, is clearly already a major public health concern. However, as with most health concerns, individual action and responsibility, also belongs to each of us.

 

Herbal support:

So what can Australians and anyone else subject to significant or chronic exposure to smoke from bush or industrial fires do to reduce the harmful effects of this to their health, apart from stay indoors with the windows shut, wear masks that experts say do little to prevent fine particle inhalation, or simply panic?

Like most people I am angry and concerned about climate change, and don’t have many answers to offer. However, the impact that these bushfires are having on the Australian people is absolutely enormous, and it is therefore appropriate to review evidence suggesting that certain plant extracts may be usefully taken or inhaled by those forced to incur either acute or longer term ongoing exposure to smoke.

I’ve previously mentioned some of these in my September 2016 and November 2018 blogs in relation to the Haze season in Singapore, and high levels of airborne pollution in downtown Auckland. They include the herbs Marshmallow, Mullein, Elecampane, White horehound, Horseradish, Nasturtium, Ribwort, Hyssop and the New Zealand native plant Hoheria. In this and the next couple of blogs, I will further explore the relevant traditional use and pharmacology of each of these herbs in more detail, as being potentially useful when inhaled or ingested to help protect our lungs and overall health against the numerous damaging effects of bushfire smoke and other airborne pollutants.

 

Expectorants & mucous membrane tonics:

With smokers and others exposed to airborne pollutants on a regular basis, a cough is the body’s natural reflex to expel unwanted substances from the lungs. Critical to the lungs defence system, are the millions of tiny hairlike structures known as cilia lining our lungs, which beat in waves and whose natural function is to expel mucus and potentially harmful particles or gases. In medicine, expectorants are drugs and herbal preparations which have the ability to speed up and enhance this natural elimination and protective process, and their inclusion in most cough medicines, is well known.

Marshmallow (Althaea officinalis) root is no longer included in marshmallow confectionary products sold today, but this plant is still commonly used as an expectorant and for bronchial congestion, by herbal practitioners. Good quality marshmallow root contains at least 5-10% of mucilaginous polysaccharides (known as ‘mucilages’ to most herbalists), which form a protective and soothing layer on inflamed or damaged mucous membranes and human epithelia (2). German researchers have measured an increase in cell viability, cell vitality and proliferation, following treatment of human naso-pharyngeal epithelial cells with marshmallow extract (3).

Another useful mucilaginous herb regarded as a tonic for respiratory tract mucous membranes, is Ribwort (Plantago lanceolata). The leaves of this common plant when harvested and prepared in the optimal way and taken in sufficient doses, support the cilia’s protective barrier effects by nurturing the delicate mucous membranes of the upper nasal passage. Like Marshmallow and leaves or bark of the sweet tasting and mucilaginous New Zealand native plant Hoheria (Hoheria populnea), it has an expectorant and cleansing effect on the upper respiratory tract. These and other herbal expectorants, can thus be helpful, to help facilitate the bodies own natural defence system designed to keep harmful particles and gases, out of our lungs.

sydney haze 20191206_192329_resized

Refs:

  1. Davey Melissa, Australia faces ‘massive’ rethink to prepare for long-term bushfires and air pollution. The Guardian, 15 Dec 2019.
  2. Schmidgall J et al, Int J Biol Macromolecules 10, 217-225, 2002.
  3. Deters A et al, J Ethnopharmacol 127(1):62-69, Jan 8, 2010.

photo sydney haze

NEW ZEALAND’S WOEFUL MENTAL HEALTH STATISTICS FOR YOUNG PEOPLE

The subject of mental health unwellness in children and young people has been prominent in the New Zealand media in recent weeks, with huge cause.

Globally suicide is one of the top three causes of death in young people aged 15-19, globally(1). New Zealand has the highest suicide rate for 10-14 and 15-19 year olds out of 19 developed countries. These alarming figures were revealed in February this year through a study by the British healthcare think tank Nuffield Trust which compared UK’s record on adolescent health and wellbeing to 18 other developed, wealthy countries(2,3).

A 2017 University of Auckland study published in the Australian and New Zealand Journal of Psychiatry, found nearly one in 20 high school students (4.5%) reported attempted suicide, while 7.9% had repeatedly self-harmed over a 12 month period. Students from poor families were nearly three times more likely to try to take their own lives(4). Rates in rainbow youth, and young Māori men, are also higher than for others(5,6).

Reasons for these alarming statistics are multiple, but the fact that millennials and increasingly younger people are living a significant part of their lives online particularly on social networking and gaming, is undoubtedly contributory(7).

We live in a country where our culture and attitudes to depression, have historically been based too much on the ‘buck up and get on with it’ approach. However, these statistics and also the ‘Blam Blam Blam’ song of the same name released in 1981, demonstrate that the comment by former Prime Minister Robert Muldoon ‘There is no Depression in New Zealand’, has long been disproven.

The government is currently looking at how it can improve suicide prevention, and the increased media coverage of this issue is welcome. Early recognition and diagnosis, adults being more open to talking to young people about suicide and depression, and fostering a society where more of a sense of purpose can be gained by young people along their journey through youthhood and into adulthood, are critical needs.

Antidepressant drugs have saved countless lives since their inception in the late 1950s, despite some limitations. They don’t always work; adverse effects can be unpleasant and contribute to a very low compliance rate, and without addressing contributory factors, their long-term efficacy is often limited.

Herbal medicines have been used by different cultures for depression since time immemorial, although different terminologies were and still are often applied to this, and a definitive diagnosis according to DSM criteria obviously wasn’t made!

St John’s Wort (Hypericum perforatum) is of course the herb best known to western medical herbalists as an antidepressant, and there are now more than 2,000 peer-reviewed publications on this herb, including more than 30 clinical trials showing it to be as effective as antidepressant drugs for the treatment of mild to moderate depression(8). Its use increased dramatically from 1996 following publication of a favourable meta-analysis of clinical trials published in the British Medical Journal, and while usage reduced at least for a time from 2000 following reports of drug interactions and safety concerns, St John’s wort preparations are widely available ‘over the counter’ in New Zealand and Australia.

While this herb has certainly helped herbal medicine to be taken more seriously by English speaking populations, the self-medication of St John’s Wort in major depression is not necessarily the best approach. There are many more herbs that can also be useful in young people prone to depression, where the complexities of the condition are best suited to an overarching treatment plan overseen by suitably trained health practitioners. This is particularly so given New Zealand’s woeful record in preventing teenage suicide.

Depression frequently coexists with intense anxiety, in addition to those confounding socio-economic and cultural factors, such as poverty and too much online time. The pressure to succeed and worries about the environment and future contribute to an unhealthily high level and type of stress in young people. These factors can manifest as generalised anxiety disorder, sleep issues and over time result in feelings of low self-esteem and depression.

Herbal medicine has much more than St John’s wort to offer for young people with, or prone to, depression. As anxiolytics (anti-anxiety agents), they are much safer interventions than drugs such as benzodiazepines, and there are many herbal adaptogens (stress protectors) that can additionally help insulate young minds against the effects of prolonged or acute stress(9).

An example of how a herbal practitioner-directed treatment approach can help, was shown through a clinical trial undertaken in China between 2009 and 2013. This investigated the effects of individualised treatments with herbal medicine in a group of 146 severely depressed patients admitted to hospital(10). All patients continued to receive treatment with a range of antidepressant and other psychotropic drugs, and half of them took various additional herbal medicines that were individualised to their situation by traditional Chinese medicine practitioners.

Patients who received adjunctive herbal medicines during their average 28 day hospital stay, were 2.1 times more likely to achieve a clinical response (according to the validated Hamilton Rating Scale for Depression), & 5.8 times more likely to achieve remission, than those who received drug treatment only(10). Concomitant Herbal medicine use was also associated with fewer incidences of physical tiredness, headache, palpitation, dry mouth and constipation, although digestive discomfort was more often reported.

Against the background of alarming figures about mental health and particularly teenage suicide, governments should take a serious look at the potential for Herbal Medicine practitioners to help reduce these statistics and save lives. A plethora of natural health products aimed at the management of anxiety and depression are now directly available through pharmacies and health food stores. However, young people experiencing mental health challenges and who are clearly at an unacceptable risk of suicide, warrant a much more personal, integrative and professional approach to their particular situation. Given the seriousness of this issue facing so many of our young people, the need for regulatory and funding systems that support the provision of much greater access to the personalised interventions and individualised treatments that well-trained medical herbalists can provide, is now urgently needed.

 

Refs:

  1. World Health Organization (2014a) ‘Adolescent health epidemiology’.www.who.int/maternal_child_adolescent/epidemiology/adolescence/en.
  1. NZ Herald, Feb 26, 2019, NZ Ranks bottom of developed countries on youth mortality rates.
  2. https://www.nuffieldtrust.org.uk/news-item/sound-the-alarm-we-must-improve-our-young-people-s-health-services.
  3. Chan S et al, Aust N Z J Psychiatry. 2018 Apr;52(4):349-356
  4. https://www.health.govt.nz/our-work/populations/maori-health/tatau-kahukura-maori-health-statistics/nga-mana-hauora-tutohu-health-status-indicators/suicide-and-intentional-self-harm.
  5. NZ Herald, 2 Aug, 2017, Break the silence: Rainbow suicide rate five times higher than mainstream.
  6. NZ Herald, Aug 17, 2019. Anxious millennials reach out for help.
  7. Rasmussen PL, Feb 2018. St Johns Wort: Safety concerns in clinical practice. Practitioner Webinar, Phytomed Medicinal Herbs Ltd, Auckland, NZ.
  8. Rasmussen PL, Feb 3, 2017. Why Herbs should be the first choice of treatment for acute anxiety. http://www.herbblurb.com
  9. Liu LY et al, J Affect Disord 2015; 170:71-77. 

ETHICS, SUSTAINABILITY, AND WHERE OUR HERBS COME FROM

Sustainability. A much used word these days, it is generally defined as living in a way that meets the present generation’s needs without compromising the ability of future generations to meet their’s. The Maori word Kaitiakitanga, is a better term however. Kaitiakitanga is based on the deeper concept that people are all closely connected to and part of the land and nature, and puts the onus of guardianship and protection on all of us to care for all aspects of our environment.

Something that most consumers of natural health products don’t know or think enough about, is where the plants that provide the raw materials for these products, actually come from.

Tea and coffee drinkers increasingly take an interest in the country of origin, the plantation business model (profit-sharing or not), Fairtrade and organic or non-organic status of the leaves or beans that produce their daily drinks. This is because more of us are now making the connections between sustainability, ethics, quality and health. Not just our own health, but that of other people and the environment.

What few people realise is that global medicinal herb trading is similar to that for other commodities, in that most medicinal herbs procured globally come from people living in rural communities in countries where wage expectations are relatively low. As with commodity crops such as tea, coffee, cocoa and cotton, the international herb and spice trade and supply chain is driven largely by the abilities of those in the final rather than earlier stages of the supply chain to make a profit.

As a teenager, I was emotionally moved and became resolved to try and help make the world a better place, after reading “How the Other Half Dies”, by Susan George. Susan’s 1976 book, provided startling information about Third World poverty, underdevelopment and debt, and the contribution of corporate greed and politics to a world in which the gap between wealthy and poor countries, is far too wide.

The issues raised in the book are even more pertinent today, with the additional onset of Climate Change due to human practices, beginning to majorly impact our ability to produce enough food and ensure people – particularly in poorer countries – have access to healthy food and medicines.

Plants are used as the primary form of medicine by around 80% of the world’s population, but the over-influence of price on procurement practices adopted by most companies, means that quality and Kaitiakitanga are all too often compromised. This affects the likelihood that natural health products consumed by end users are in fact therapeutic, rather than subtherapeutic or contaminated.

Product parameters such as the plant part and extract type, the amount used and dose recommendations made, obviously have a significant impact on why some herbal medicines work and others don’t. However, where plants come from and how they are handled along the way, can also have significant impacts on finished product quality and efficacy.

There are numerous variables and stages involved in medicinal herb supply chains, and all of these are important. If the processes in place for these are good, in that people are receiving a living wage and paying a high level of care and attention to each stage (including growing, harvesting, washing, drying or storing the raw plant materials), the finished product will more likely be good.

Unfortunately there are a lot of unscrupulous practices that sometimes take place within the herb industry–some of it intentional, some of it not. These include adulteration, incorrect species identification, whether workers have washed their hands or have access to clean water, what the collection bags were previously used for, whether the plants were harvested in the rain or sun, and processed quickly or left in a pile in a tarp for a few days until workers had time to process them. Programmes to control use of agrichemicals are also either limited or non-existent in most poorer countries.

Small-scale farmers and workers involved in the majority of medicinal herb production are amongst the most marginalized groups globally. Through Fairtrade people can lift themselves out of poverty to maintain successful livelihoods. Also, by getting more of the herbs we use grown locally, and supporting communities and companies who are trying to build capabilities and provide meaningful jobs in this sector to our own lower socio-economic communities, is a powerful ethical and quality-driven approach, which promotes Kaitiakitanga.

Quality and Ethics are intrinsically linked, just as Quality and Efficacy are. Through prioritisation of ethical behaviours, all of the people involved in supply become motivated and concerned with quality. And the natural health products we take, are then more likely to genuinely promote both personal wellness, and that of the planet and its future.

 

WHY NEW ZEALAND GROWN HERBS ARE BEST!

New Zealand plants are unique, and amongst the best in the world. As an island nation situated a long way away from most other places, in the 55 million years since New Zealand separated from Gondwanaland, its native plants had a long time to evolve before humans arrived, and it’s therefore not surprising that many have some special properties.

Aside from indigenous species, numerous other plants also seem to have special characteristics when grown in the New Zealand environment, and we are fortunate to live in a country where such a wide variety of plants can be grown relatively easily.

Reasons for this are many, but probably include the relative youth of our landmass, the richness of our soils carved from volcanoes, rainforests and other inputs from nature, and our diverse geography and microclimates. There are few countries in the world where one can be sunbathing on the beach in the morning, and skiing in cold alpine temperatures a few hour’s drive away, in the afternoon.

The bioactive and medicinally active compounds in plants, are known in plant physiology and phyto-pharmacology as secondary metabolites. These include many different classes of chemical compounds such as alkaloids, flavonoids, essential oils and phenolic acids, whose functions within the plant are mainly to protect it against harmful influences or predators.

Plants growing in a stressful drought environment will produce higher levels of secondary metabolites than plants which are less stressed. Next time you are out in the bush, look out for kawakawa plants and you may notice that many of the heart shaped leaves contain lots of holes, courtesy of the kawakawa looper moth caterpiller. This is a good example of a plant thought to have greater medicinal properties from secondary metabolites, produced as a defense mechanism against the caterpillars.

One reason why so many plants grow so quickly and well in New Zealand, is thought to be attributable to the hole in the ozone layer in the atmosphere above us. In response to high UV-B light, New Zealand plants have to put greater energies into producing secondary metabolite compounds to protect themselves, many of which have medicinal properties.

New Zealand is also fortunate to have a reasonably strong biosecurity system, together with a relative abundance of water by world standards. Water supplies as well as soil health are critical parameters in producing healthy plants, both for food and for medicines.

New Zealand’s fruit and vegetables are widely known to have a great taste and high quality. This superior raw material quality has contributed significantly to our growing reputation as a country with some of the best cuisine in the world. The kiwifruit, hops, wine and berry industries have flourished and performed well for New Zealand in recent decades, all fundamentally due to their high quality characteristics. Thanks to a great deal of trial and error, hard work, investment of scientific knowhow and money, and most of all a whole lot of Mother Nature. These plant-based products are highly sought after in export markets, and as consumers we are privileged to have a wide selection of excellent quality foods and beverages available to us!

Medicinal plants (herbs) have also shown excellent quality parameters when grown in the New Zealand environment, and some examples of these follow.

Korean and American ginseng (Panax ginseng and Panax quinquefolium), seem to like it here, as very high levels of active ginsenosides have been achieved in ginseng roots. Thanks to work by the former Crop & Food Research (now Plant & Food Research) and a small number of dedicated growers (it takes many years and significant investment to establish and grow ginseng commercially), much has been learnt about ideal growing and harvesting methods, including how to grow it within Pinus radiata forests.

Leaves of ginkgo (Ginkgo biloba) are best known to help prevent dementia and other age-related disorders, as well as improve memory in healthy individuals. Levels of the active ginkgo flavone glycosides and terpenoids in New Zealand grown material are higher than those produced by trees grown in China, where most of the world’s ginkgo is sourced. This enables therapeutic levels to be achieved with a lower dose.

As with ginseng, golden seal (Hydrastis canadensis) is slow-growing and endangered in its natural habitat, yet global demand is high due to research validating its use as an antibacterial agent. This valuable medicinal plant was grown commercially by a couple of growers in New Zealand in the 1990’s, again with agronomy research support from Crop & Food Research. Much was learnt about how to grow it under local conditions, and laboratory tests showed the rhizomes contained very high levels of the active compounds hydrastine and berberine.

Many other medicinal herbs grown in New Zealand have been found by research studies or routine tests by manufacturing companies, to have very high levels of active phytochemicals. These include echinacea (alkylamide levels in the roots), arnica (another increasingly endangered species but New Zealand grown flowers containing high concentrations of sesquiterpene lactones), green tea (high epigallocatechin gallate and theanine levels), and valerian (high valerenic acid levels in the root and rhizome). The New Zealand blackcurrant industry has also grown rapidly over the past 20 years, catalysed by research showing significantly higher levels of antioxidant anthocyanidins in NZ berries than those grown in other countries, and anti-aging and cognitive-enhancing actions. Superior flavour profiles, and higher levels of vitamin C, have also been reported.

In summary, an appraisal of the performance of these “new” and more established medicinal plant crops in our New Zealand environment, shows that in all cases key quality parameters are significantly above average and in some cases are at the top of their field, when compared to the same species grown offshore.

New Zealand grown herbs are amongst the best in the world. Best for the health of ourselves, our pets and animals, our economy, our soils and waterways.

Kaitiakitanga in Māori, is about ensuring an intergenerational stewardship of the land, sea and waterways. Encouraging the growing of more both native and non-native medicinal plants in our own country rather than relying on cheap-labour countries to supply the bulk of our increasing needs, makes good sense.

 

Phil Rasmussen

STATUTORY REGULATION OF MEDICAL HERBALISTS AND NATUROPATHS: AN ESSENTIAL STEP TOWARDS A MORE COST AND OUTCOME BENEFICIAL FUTURE HEALTHCARE SYSTEM

With aging populations, the costs of drugs and institutionalised healthcare continually rising, and government drug funding agencies such as Pharmac always under the pump, it’s time to take a look at just what our taxpayer dollars are funding, and whether the current paradigm is working.

Total expenditure by New Zealand District Health Boards (Pharmac) on Drugs to the year ending 30 June 2018, was $870 million(1).

Health economists and policy advisers know it is unrealistic and unsustainable for governments to continue spending more and more of the GDP on the healthcare budget, and that shifting some of the growing burden of responsibility onto the population to take better care of their own health and wellness (‘self-care’), is a good strategy. However, the increasingly wide gap between those who can and can not afford the best available modern healthcare treatments and interventions, is very worrying. A ‘two tier’ health service in which the quality of state-funded services declines, as more and more pressure mounts on it, is inherently and morally wrong.

Primary care health services are not just those provided by General Practitioners, but also include a wide array of other inputs such as those by Pharmacists, Nurse Practitioners, Social Workers, Occupational Therapists and Drug Counsellors. These are aimed at disease prevention, health education and screening, and avoiding the need for hospital based care. A strong primary health care system is critical to improve the health of all New Zealanders, and reduce health inequalities between different groups(2).

However, the current primary health care system is neither keeping pace with nor adequately addressing the health needs of our population. Increasing challenges and treatment deficits are emerging particularly in areas such as mental health, substance dependency, diabetes prevention, disability services, dementia and infectious disease management. Too many New Zealanders are falling through the gaps or requiring repeated treatments, for recurring health problems(3,4), and health care staff stress levels and recruitment challenges, are worsening.

In New Zealand, most Medical herbalists and Naturopaths have undergone a 3 or 4 year course of study to the level of a degree. Apart from their high level of expertise in the use of specific plant-based medicines to help optimise health and overcome many illnesses, their training in nutrition and herb-drug interactions, and ability to take a ‘wholistic’, more integrative and preventive approach to an individual’s health, means they are well suited to advise and educate, on self-care and wellness interventions.

The estimated cost of a day’s hospital care in New Zealand during an influenza pandemic was put at $2,595 per patient in 2009(18), and current costs are probably in the range of $3,000 to $5,000, depending on the treatment required.  Compare this to the approximate $1,200 per year cost of a daily herbal tonic tailor-made to the patient’s needs and often focussed on prophylaxis. Even if it takes 3 years of such treatment to prevent a single night’s stay in hospital, it is a more cost-effective intervention, and with additional benefits.

Well-educated, higher socio-economic income bracketed and very sick people currently make up the bulk of patients seen by Medical Herbalists and Naturopaths in New Zealand. Meanwhile those on lower incomes who may benefit the most from its numerous inputs, are often unable to afford any non-subsidised treatment, and are effectively being excluded from having natural health as an option available to them.

Despite many holding the view that the benefits of natural health interventions are unproven, there is now compelling evidence from good quality scientific studies, supporting the use of specific herbal medicines when taken as adjuncts to drug medications being used for cancer, diabetes, heart failure, alcohol or drug dependency, and schizophrenia(5-16). There are several potential benefits of herbal medicine when appropriately prescribed to patients receiving conventional treatment for these and other conditions. They include improved patient outcomes, a reduction in the need for drug-based or other expensive medical care options, and thus a lower frequency of drug-related side effects and overall costs(17). Savings in the current drug budget alone, would enable an improved ability to fund new drugs or other healthcare interventions, including more emphasis on the most cost-effective approach, of disease prevention rather than treatment.

New Zealand’s commitment as a signatory to the World Health Organisation “Traditional Medicine Strategy, 2017-2023”(19), puts an obligation on the government to both further research into the area of traditional and plant-based medicines, and to progress statutory regulation of complementary medicine practitioners. There is an urgent need for more research into this area, and for political and funding support to enable the introduction of some such treatments in a regulated manner, into clinical practice.

However, in the case of Medical Herbalists, since 2005, successive New Zealand governments have rebuffed efforts to achieve statutory regulation as a profession under the Health Practitioners Competence Assurance (HPCA) Act. Despite a high level of professionalism shown by their national association, and comprehensive degree level courses being provided by training institutions, there seems little willingness on the part of the state to validate this profession, or ensure appropriate standards are in place to protect public safety, by progressing its latest application for statutory regulation lodged in 2016.

With the government’s so-called ‘Wellness Budget’ soon to be announced, it would be nice to know that more thought is being applied to preventing unwellness, and identifying ways to take some of the pressure off existing healthcare services. By finally recognising the untapped potential of well-trained and professionally registered Medical Herbalists and Naturopaths to make a greater contribution to future NZ healthcare options, we would at last see signs of a genuine commitment to the WHO Traditional Medicine Strategy, and a comprehensive health and wellness strategy for New Zealanders.

 

References:

  1. Pharmac. Pharmaceutical Management Agency Annual Report for the year ended 30 June 2018, 2018.
  2. https://www.health.govt.nz/our-work/primary-health-care
  3. New Zealand Herald 17 Feb, 2016. Fears Canterbury mental health services may be slashed amid budget cutbacks.
  4. New Zealand Herald, 21 April 2019. Limited showers, no meal prep: ‘Ruthless’ plans to cut disabled care revealed.
  5. Rasmussen PL, Eur. J. Herbal Med. 3(1):11-21, 1997
  6. Rasmussen PL, Eur. J. Herbal Med. 3(2):13-19, 1997
  7. Pittler MH et al, Am J Med 2003; 114(8): 665-674.
  8. Doruk A et al. A placebo-controlled study of extract of ginkgo biloba added to clozapine in patients with treatment-resistant schizophrenia. Int Clin Psychopharmacol. 2008 Jul;23(4):223-7.
  9. Barton DL et al, Support Care Cancer 2010; 18(2):179-187.
  10. Barton DL et al, J Natl Cancer Inst 2013; 105(16):1230-1238.
  11. Biswal BM et al, Integr Cancer Ther 2013; 12(4):312-322.
  12. Chen EYH et al, Phytother Res 2012; 26:1166-1172.
  13. Zhang XY et al, J Clin Psychiatry 2001; 62(11):878-883
  14. Zhang XY et al, Psychopharmacology 2006; 188(1):12-17;
  15. Atmaca M et al, Psychiatry Clin Neurosci 2005; 59(6):652-6.
  16. Li J et al, Wuzhi Tablet (Schisandra sphenanthera Extract) is a Promising Tacrolimus-Sparing Agent for Renal Transplant Recipients Who are CYP3A5 Expressers: a Two-Phase Prospective Study. Drug Metab Dispos. 2017 Nov;45(11):1114-1119
  17. Rasmussen PL, Potentially beneficial herb-drug interactions. Practitioner Seminar, July 2016, Phytomed Medicinal Herbs Ltd, Auckland, New Zealand
  18. Wilson N et al, NZMJ 9 November 2012, Vol 125 No 1365; ISSN 1175 8716
  19. WHO Traditional Medicine Strategy: 2014-2023.http://www.who.int/medicines/publications/traditional/trm_strategy14_23/en

 

 

EFFECTS OF HUMAN POLLUTANTS ON PLANTS: THE CASE OF RIBWORT

ribwortRibwort (narrow leaved plantain) is commonly seen in pastures, lawns and street verges, and once positively identified, is rarely forgotten. One of the most useful and endemic “weeds”, its young fresh leaves have been used for centuries as a healing ointment and treatment for slow healing wounds, bites and haemorrhoids, by people from many different parts of the world.

Seed husks of its botanical relative Plantago ovata (commonly known as Psyllium seed), are used as a bulking laxative and for digestive health.

The other main application of Ribwort leaves, is to improve the health and function of the mucous membranes in the respiratory tract. A particular characteristic of this plant, when harvested and prepared in the optimal way, and applied or taken in sufficient doses, is its gentle nurturing and nutritive, but also protective barrier effects on delicate mucous membranes of the nasal passage and other sensitive skin areas of the body. These mucous membranes help protect the sinuses and bronchial tract from invading micro-organisms and other insults, and foods and herbs that optimise their function, can help protect against and manage a wide range of upper respiratory tract conditions.

The diverse phytochemistry of ribwort, which includes polysaccharide hydrocolloids (mucilaginous compounds), phenylethinoid glycosides, flavonoids, coumarins, cinnamic and other phenolic acids, contributes to its anti-inflammatory, antioxidant and antimicrobial activities. This combination of herbal actions makes it a valuable addition to the treatment of inflamed sinuses, catarrh or blocked noses. Research has also found ribwort in large doses to be comparable or superior to the drugs ranitidine and misopristol, in an animal model of peptic ulcer (1).

 

Human influences on the health of this plant

As a common and fairly fast growing plant, ribwort is one of a number of plant species being studied by plant and environmental scientists, for the effects of pollutants on its health and physiology. Recent studies have found ribwort grown near mines, smelting plants and other contaminated areas, accumulates high levels of cadmium, lead and other heavy metals(2-4). Heavy metal contamination of ribwort, dandelion and birch growing in urban areas of Poland with considerable air and soil pollution, has also been shown to be high(5).

In animal farming, anthelmintics (anti-worming drugs) are regularly applied to control gastrointestinal nematodes, and these are excreted from animals into pastures and the wider environment. Along with other drugs such as antibiotics, anthelmintics have become one of a new class of micro-pollutants that disturb the environment. The anthelmintic drugs albenazole, flubendazole and flenbendazole for example, widely used in conventional animal farming, are taken up by and metabolised by ribwort. However, they also produce, in the plant, a significant increase in concentrations of proline (a well-known stress marker), and activities of several antioxidant enzymes. This suggests a possible risk of oxidative damage in this and other plants influenced by these drugs, and is a growing cause of concern(6,7).

Anthelmintic drugs excreted into pastures and taken up by plants also have the potential to impede seed germination negatively, thus affecting affect the regeneration of ribwort and other plants(8).

These studies reinforce the sensitivity of ribwort and other plants to environmental contaminants as a result of human activity, in this case mining, city air pollution, and conventional animal farming. As we are only beginning to discover such delicate links between environmental pollutants and plant health, the importance of growing this plant (and probably numerous others) in certified organic soil as opposed to purchasing it from non-organic, so-called ‘wildcrafted’ or trade broker sources, is highlighted.

Refs:

  1. Melese E et al. Evaluation of the antipeptic ulcer activity of the leaf extract of Plantago lanceolata L. in rodents. Phytother Res. 2011 Aug;25(8):1174-80. doi: 10.1002/ptr.3411. Epub 2011 Feb 7.
  2. Tamás J, Kovács A.Vegetation pattern and heavy metal accumulation at a mine tailing at Gyöngyösoroszi, hungary. Z Naturforsch C. 2005 Mar-Apr;60(3-4):362-7.
  3. Tinkov AA et al. Comparative Analysis of the Trace Element Content of the Leaves and Roots of Three Plantago Species. Biol Trace Elem Res. 2016 Sep;173(1):225-30.
  4. Drava G et al.Trace elements in Plantago lanceolata L., a plant used for herbal and food preparations: new data and literature review. Environ Sci Pollut Res Int. 2019 Jan;26(3):2305-2313.
  5. Nadgórska-Socha A. Air pollution tolerance index and heavy metal bioaccumulation in selected plant species from urban biotopes. Chemosphere. 2017 Sep;183:471-482.
  6. Stuchlíková Raisová L et al. Evaluation of drug uptake and deactivation in plant: Fate of albendazole in ribwort plantain (Plantago lanceolata) cells and regenerants. Ecotoxicol Environ Saf. 2017 Jul;141:37-42.
  7. Stuchlíková LR et al, Biotransformation of flubendazole and fenbendazole and their effects in the ribwort plantain (Plantago lanceolata). Ecotoxicol Environ Saf. 2018 Jan;147:681-687.
  8. Eichberg C et al. The Anthelmintic Ingredient Moxidectin Negatively Affects Seed Germination of Three Temperate Grassland Species. PLoS One. 2016 Nov 15;11(11): e0166366. doi: 10.1371/journal.pone.0166366. eCollection 2016.

Honeysuckle and other useful weeds surrounding us

In taking my usual summer holiday in rural New Zealand this year, I noticed that over the past year, certain ‘noxious weeds’ seem to have grown more prolific.
While perhaps I shouldn’t focus on such observations when I’m meant to be resting and indulging in leisure pursuits, I’m frequently alarmed at the disconnect between people and plants in their environment. This is especially obvious at this time of year, for two highly medicinal particular species, Chinese Privet (Ligustrum lucidum) and Japanese Honeysuckle (Lonicera japonica).

In January and February the distinctive creamy-white flowers of Chinese Privet trees make their presence obvious in many towns and rural locations and increasingly in areas of native bush. While the flowers are attractive and from a distance somewhat similar to the European Elder (Sambucus nigra), the berries produced are a delicacy to birds, who have successfully spread it throughout the land to make it the most noxious tree in the country. Similarly the smaller but scented flowers of the vigorous climber Japanese Honeysuckle, which open white then turn lemon-yellow, draw my attention to how successful this plant has been in establishing itself in more rural, native bush and farm environments.

Our avian relatives seem to have more incentives than simply having a feed for finding the berries and seeds of these two plants so desirable, as in traditional Chinese and Asian medicine both plants have been common medicines for centuries.

In Asia, Japanese Honeysuckle is traditionally used for febrile illnesses featuring fever, headache, coughs, thirst & sore throat. It is also widely used as an anti-bacterial, anti-inflammatory, antiviral and anti-diabetic agent, and is used topically for skin infections and sores, ulcers, carbuncles, swollen joints and rheumatic conditions.

A recent study found that unripe fruit from Japanese honeysuckle has strong antioxidant properties which contribute to animal health(1). Another study found that extracts improved age-related physiological functions and extended the life expectancy of worms by 22%(2).

Bacteriostatic (antibacterial) effects have been shown against Staphylococcus aureus and Escherichia coli for an ethanolic extract of Japanese honeysuckle leaves(3). In mice with sepsis (a serious bacterial infection of the blood), an ethanol extract of Japanese honeysuckle flower buds enhanced bacterial clearance, reduced the level of sepsis and risk of multiple organ failure, resulting in a lower rate of sepsis-induced mortality (4). This suggests potential applications as a good adjunct with or alternative to antibiotics. With growing concerns around antibiotic resistance, these findings should enhance our interest in this plant, now endemic throughout New Zealand.

Diabetes is another traditional use of Japanese honeysuckle, and researchers in Taiwan have found an ethanol extract of flowering aerial parts to reduce diabetic nephropathy in rats. Japanese honeysuckle treatment to diabetic rats for 8 weeks reversed three key abnormalities associated with renal dysfunction – including reduced creatinine clearance, increased blood urea and proteinuria, and an elevated ratio of kidney weight to body weight(5).

Anti neurodegenerative compounds with monoamine oxidase B receptor affinity (identified as isochlorogenic acid A and isochlorogenic acid), have also recently been detected in Japanese honeysuckle flowers(6). In Korean traditional medicine this plant has been used for cancer management, and anticancer activities on human lung cancer cells have recently been documented for polyphenol compounds extracted from it(7).

I’ve discussed the many medicinal benefits of Chinese Privet fruits in my March 2016 blog, particularly in relation to their potential prophylactic and treatment benefits for degenerative bone and joint conditions such as osteoporosis and arthritis(8). Again, a great deal of research has validated these and other therapeutic actions. Other recent findings include possible benefits of a combination of Chinese Privet and Siberian ginseng (Eleutherococcus (Acanthopanax) senticosus), to protect against bone marrow suppression induced by chemotherapy in mice(9). Inhibitory effects against the influenza A virus have also been reported for secoiridoid components of Privet fruits(10), and compounds with neuraminidase inhibitory activity (a key mechanism of action of anti-influenza drugs), have been isolated from its leaves(11).

Knowledge of these many useful potential medicinal applications for these two plants, should be of great interest both to those wanting cost-effective local solutions to increasing health concerns, as well as those concerned at the damaging effects that they are starting to have as invasive species, on our ecosystem and native species habitats.
The effect of invasive plants on natural ecosystems can be disastrous, firstly for the competition with indigenous species, and secondly, because they limit the stability and availability of natural resources to the whole native species community. They constitute a global environmental, economic, and social change driver as they can dramatically alter the composition of ecosystems and lead to losses in biodiversity, agriculture productivity, and human health. These negative effects of invasive plant species are likely to be exacerbated by climate change, which will foster their further spread especially in valuable fertile areas.
Identifying innovative ways for communities to transform invasive plants from ‘problems to resources’, represents an important challenge for modern societies and policy makers. Bioprospecting and investigating both Lonicera japonica and Ligustrum lucidum to identify and develop new phytomedicines and compounds to promote human health in the future, is surely worth further exploration and research.

SONY DSC

ligustrum jan19
Ligustrum lucidum Jan19

 

1. Guzzetti L et al, Scientific Reports 7:13799, 2017.
2. Yang ZZ Free Radic Biol Med. 2018 Dec;129:310-322.
3. Xiong J et al, Food Chem. 2013 May 1;138(1):327-33
4. Kim SJ et al, J Ethnopharmacol. 2015 Aug 2;171:231-9.
5. Tzeng TF et al, Planta Med. 2014 Feb;80(2-3):121-9.
6. Wu GF et al. J Sep Sci. 2019 Jan 17. doi: 10.1002/jssc.201801255. [Epub ahead of print].
7. Park C, Phytother Res. 2018 Mar;32(3):504-513.
8. Chen B et al, 2017 Molecules. 2017 Sep 5;22(9).
9. Wang C et al, Biomed Pharmacother 2019 Jan;109:2062-2069.
10. Pang X et al, Bioorg Med Chem Lett 2018 May 15;28(9):1516-1519
11. Zhang Y et al, J Chromatogr B Analyt Technol Biomed Life Sci 2018 Apr 15;1083:102-109.

 

CARING FOR OUR LUNGS IN AUCKLAND’S POLLUTION

New Zealand is often seen as a ‘clean and green’ country with levels of pollution much lower than those in the rest of the world, but recent research by Auckland Council has revealed that levels of air pollution in Queen Street (Auckland’s main street) are in fact rising. According to the research, Queen Street levels of black carbon, which are ultra-fine carbon particles emitted to the air and formed through the incomplete combustion of fossil fuels, biofuels and biomass, are more than three times higher than in Canadian cities and two times higher than concentrations in major cities in Europe and the U.S.(1).

Like other forms of fine airborne particulate matter (PM10 particles), black carbon can enter deep into the lungs, and travel into the bloodstream to become deposited into tissues such as the brain or heart. Both short- and long-term exposure is linked with serious health effects. Epidemiological studies have shown an increase in morbidity and mortality rates from chronic obstructive pulmonary disease after exposure to elevated levels of air pollution, and associations between lung cancer and cardiovascular diseases are well established(2, 3). Exposure to traffic related particulate matter is also increasingly associated with an increased risk of birth defects, and Alzheimer’s disease and other dementias in later life(4, 5).

Black carbon also contributes to a warming effect on our climate(6, 7), and to the melting of snow and glaciers(8). Genotoxic and other damaging effects on plants, are also evident as a result of particulate matter pollutants(9).

The biggest source of high levels of black carbon in the council Queen St study was identified as diesel emissions from older buses, trucks, ferries and ships. While replacing diesel buses with electric buses, introducing modern electric trams and pedestrianising Queen Street in the future would reduce black carbon, the currently very high levels of exposure to pedestrians and others working in or visiting the area or similar inner city locations in other cities, are of concern. Similarly high black carbon levels in other New Zealand cities, towns and locations, have been shown to be unacceptably high(10-11).

In Asian cities it is a common sight to see locals wearing a mask to protect their lungs against the damaging effects of vehicle, smoke or factory pollution and so-called toxic smog. Good quality masks provide some form of a physical barrier to filter out some of these harmful airborne particles, but wearing them can be cumbersome.

It is appropriate also, to consider the potential support that certain medicinal plants can provide to lung health, when there is exposure to a high level of airborne pollution. In cities such as Beijing, Delhi and Mexico City, high levels of air pollution have increased demand for herbal products that enhance lung function, and may help protect against some of the numerous damaging health effects that particulate matter and other airborne pollutants can have.

As written about in February 2016 after my visit to Singapore, there are many herbs traditionally used for lung conditions and upper respiratory tract infections, which seem to work at least partially through gently encouraging the natural expectoration process of the millions of cilia cells lining our bronchial trees. The role of these is to remove excess mucus and potentially harmful substances such as particulate matter or unwanted allergens, so enhancing their ability to fulfill this protective function, can be useful. Mucilaginous (polysaccharide hydrocolloid rich) and expectorant herbs such as marshmallow (Althaea officinalis), mullein (Verbascum thapsus) and the NZ native hoheria (Hoheria populnea), seem to work in this manner. Other traditional lung herbs such as elecampane (Inula helenium), white horehound (Marrubium vulgare) and horseradish (Armoracia rusticana), can also be helpful.

In Britain the root of elecampane was traditionally prepared into a candy as a protection against ‘bad air’, and research now suggests this volatile oil and sesquiterpene lactone rich plant may help protect against some of the more serious potential outcomes of exposure to high levels of airborne pollutants.

Increasing data is emerging on potential cancer protective effects of elecampane, and separate research teams have found it to inhibit the growth of a range of different types of human cancer cell lines in vitro, yet not damage normal cells(12, 13). Potential antitumour activity for elecampane extracts against certain forms of brain cancer, has also been reported(14).

Horseradish is a popular European plant whose root has been used not only to make a hot sauce, but also as a traditionally used warming expectorant and lung tonic. It contains phytochemicals which are well absorbed orally and have established chemo-preventive effects. Anti-mutagenic properties and protective effects against DNA damage shown by horseradish(15) are also of interest, as DNA damage prevention is an important mechanism involved in cancer prevention by dietary compounds.

To summarise, efforts should continue to reduce the sources of black carbon and other forms of airborne pollution. However, chemo-preventive or protective effects shown by various herbal extracts against cellular damage and carcinogenicity may be helpful when exposure to air pollution is unavoidable. Inhalation or ingestion of these in appropriate concentrations at or soon after the time of exposure, may impart short term resistance against the many damaging effects of airborne pollutants, and should be further explored.

Refs:
1. ‘Toxic Air Threat’. New Zealand Herald, Nov 7 2018. http://www.nzherald.co.nz
World Health Organisation, Health risks of particulate matter from long-range transboundary
air pollution, 2006. http://www.euro.who.int/__data/assets/pdf_file/0006/78657/E88189.pdf
2. Segersson D et al, Int J Environ Res Public Health. 2017 Jul; 14(7): 742. Published online 2017 Jul 7.
3. Kilian J, Kitazawa M, Biomed J. 2018 Jun;41(3):141-162. doi: 10.1016/j.bj.2018.06.001. Epub 2018 Jul 17.
4. Wang L et al, J Public Health (Oxf). 2018 Aug 18. doi: 10.1093/pubmed/fdy137. [Epub ahead of print]
5. Bond TC, Sun H. Environ Sci Technol. 2005 Aug 15;39(16):5921-6.
6. Ramanathan V et al, Nature. 2007 Aug 2;448(7153):575-8.
7. Painter TH et al, Proc Natl Acad Sci U S A. 2013 Sep 17;110(38):15216-21
Rai PK, Ecotoxicol Environ Saf. 2016 Jul;129:120-36
8. Davy PK, & Trompetter WJ (2018a). Black carbon in New Zealand. GNS Science, Lower Hutt.
9. Davy, PK, & Trompetter, WJ (2018b). Heavy metals, black carbon and natural sources of particulate matter in New Zealand. GNS Science, Lower Hutt.
12. Dorn DC et al, Phytotherapy Res, Aug 16 (epub ahead of print), 2006.
13. Spiridonov NA et al, Phytotherapy Res 19(5): 428-432, 2005.
14. Koc K et al, J Cancer Res Ther. 2018 Apr-Jun;14(3):658-661
15. Gafrikova M et al, Molecules. 2014 Mar 14;19( 3):3160-72.

Horseradish