Herbal Alternatives to Cox-2 Inhibitors

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Herbal Alternatives to Cox-2 Inhibitors JoAnn Guest May 29, 2005 17:49 PDT

 

http://www.herbalgram.org/iherb/herbalgram/articleview.asp?a=2153

 

The term Cox-2 inhibitors describes compounds — both the natural

versions and the synthetic — that inhibit an inflammatory enzyme in the

body called cyclooxygenase-2.

 

Cyclooxygenase-2 (Cox-2) inhibitors are fast becoming some of the most

prescribed pharmaceutical drugs on the market, with recent reports that

one of the proprietary Cox-2 drugs has surpassed the anti-impotence

medication Viagra® as the fastest selling prescription drug in history.

 

Celebrex® sold 6.86 million prescriptions during its first six months on

the market, compared with about 5.3 million for Viagra40 (the two

patented Cox-2 medications on the market were both in the top 20

prescribed drugs in 200041).

 

Also, pain relievers (including the non-steroidal anti-inflammatory OTC

medications) are consistently top sellers in the multi-billion dollar

OTC drug market.

 

Individuals using Cox-2 inhibitors include those with chronic and acute

inflammation, people with colon cancer, breast cancer, esophageal

cancer, bladder cancer, skin cancer, and Alzheimer’s disease.

 

Several herbal supplements serve as *alternatives* to synthetic Cox-2

inhibiting drugs.

 

Herbs reported to inhibit Cox-2 in laboratory studies include:

 

capsicum (Capsicum frutescens L., Solanaceae),

turmeric (Curcuma longa L., Zingiberaceae),

white willow (Salix alba L., Salicaceae),

green tea (Camellia sinensis (L.)

Kuntze, Theaceae),

feverfew (Chrysanthemum parthenium (L.) Bernh., Asteraceae),

ginger (Zingiber officinalis Roscoe, Zingiberaceae),

holy basil (Ocimum sanctum L., Lamiaceae),

oregano (Origanum vulgare L., Lamiaceae),

phellodendron (Phellodendron amurense Rupr., Rutaceae), tripterygium

(Tripterygium wilfordii Hook. f. in Benth & Hook. f., Celastraceae),

and resveratrol (from Polygonum cuspidatum Siebold & Zucc.,

Polygonaceae,

and grape skin, Vitis vinifera L., Vitaceae).48-54

 

Two herbs possessing Cox-2 inhibiting properties were discussed at the

conference —

 

devil’s claw secondary tuber (Harpagophytum procumbens (Burch.) DC. ex

Meisn., Pedaliaceae)

and phyllanthus (Phyllanthus amarus Schumach., Euphorbiaceae).

 

Phyllanthus, known as bahupatra or bhuiamla in the Ayurvedic medicine,

has been traditionally used as a medicinal agent in many ethnic cultures

around the world. Usually found in central and southern India, it can

grow to 1–2 feet in height and have blooms with many yellow flowers.

 

Phyllanthus species are found in other countries, including China, the

Philippines, Cuba, Nigeria, and Guam.55 Traditional uses of phyllanthus

leaf include treatment of jaundice, gonorrhea, frequent menstruation,

dysentery and diabetes. It is used topically as a poultice for skin

ulcers, sores, swelling, and itchiness.

 

Most of the current research with phyllanthus species focuses on the use

in viruses, specifically the hepatitis B virus.56,57

 

However, a presentation at the Congress reported a standardized extract

of phyllanthus had inhibiting properties on both Cox-2 and inducible

nitric oxide synthase (iNOS) in laboratory studies.58

 

With these preliminary results, phyllanthus seemingly has the ability

to inhibit two of the pro-inflammatory enzymes (Cox-2 and iNOS), making

it potentially useful in the fight against inflammatory diseases such as

arthritis.

 

Recently, it has been reported that alteration of certain inflammatory

mediators in humans might be involved in the mechanism of action of

devil’s claw herbal supplements.

 

Devil’s claw is native to South Africa and the tuber has historically

been used as an anti-inflammatory agent, reportedly helping with joint

mobility and swelling along with pain reduction.59,60

 

The greatest efficacy of devil’s claw in the management of arthritic

symptoms is reported for chronic rather than acute cases. It was

reported that one of the methods discovered in a laboratory study of the

anti-inflammatory activity of a devil’s claw extract (70 percent

ethanol) was the inhibition of the inflammatory chemical prostaglandin

E2 via Cox-2.61

 

A safety profile of devil’s claw preparations in Europe indicate that

approximately 6 percent of patients taking devil’s claw supplements,

independent of dosage, experience mild gastrointestinal disturbances.62

 

A double blind, randomized multi-center clinical study discussed at the

conference involved a devil’s claw preparation (6 capsules daily, each

containing 435mg of cryo-ground powdered devil’s claw tubers).63

 

The devil’s claw product (Harpadol®, Arkopharma, Carros, France) was

compared to the anti-inflammatory drug diacerhein in 122 patients

suffering from osteoarthritis, in the hip and/or knees for a period of 4

months. Diacerhein is a member of a category of drugs not recognized in

the United States — the so-called slow-acting drugs for osteoarthritis,

or SADOAs.

_________________

JoAnn Guest

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