Echinacea angustifolia DC.

Last updated: 10 Aug 2016

Scientific Name

Echinacea angustifolia DC.

Synonyms

Brauneria angustifolia (DC.) A.Heller, Echinacea angustifolia var. angustifolia, Echinacea angustifolia var. strigosa McGregor, Echinacea pallida var. angustifolia (DC.) Cronquist, Echinacea pallida var. strigosa (R.L. McGregor) Gandhi. [1]

Vernacular Name

English Black samson echinacea, blacksamson, blacksamson echinacea, comb plant, caneflower, mushroom medicine, narrow-leaved purple cone flower, purple cone-flower, whip plant [2]
North America Mika-hi, ikigahai (Omaha-Ponca); ksapi-tahako, saparidu kahts (Pawnee) [2].

Geographical Distributions

Echinacea angustifolia is found primarily in the Great Plains, east of the Rocky Mountains from Texas to Montana and Saskatchewan, to eastern Oklahoma, western Iowa, and western Minnesota. [3]

Botanical Description

E. angustifolia is a member of the Asteraceae family. It is a perennial herb that can grow up to 1.5-6 dm (0.5-2 ft) tall, with a woody taproot. [3]

The plant has one to several rough-hairy stems, mostly unbranched. [3]

The leaves are alternate, simple, and narrowly lance-shaped 5-30cm (2-12 in) long, 1.5-4 cm wide with entire margins. [3]

The flowers look like lavender sunflowers with heads 4-7.5 cm wide (1.5-3 in), at the end of long stalks. The disk flowers are 5-lobed, brownish-purple, and situated among stiff bracts. [3]

The fruits are small, dark, 4-angled achenes. [3]

Cultivation

No documentation.

Chemical Constituent

E. angustifolia roots and aerial parts has been reported to contain isomeric dodeca-2E,4E,8Z,10E/Z-tetraenoic. The roots of E. angustifolia reportedly to contain acetylene amide N-(2-methylpropyl)-2E-undecene-8,10-diynamide, caffeic acid glycosides, caffeic acid esters of quinic acid and of tartaric acid, cynarin and alkylketones. The volatile oil from the aerial parts of E. angustifolia is borneol, bornyl acetate, germacrene D, caryophyllene and other components. The major flavonoid of the aerial parts of E. angustifolia has been identified as patuletin-3-rutinoside. Free phenolic acid including p-coumaric, p- hydroxybenzoic and photocatechuic acids has been isolated from the aerial parts of E. angustifolia. [4]

Plant Part Used

Root and rhizome. [4][5]

Traditional Use

A poultice of smashed roots E. angustifolia were applied as an anesthetic to arms and hands by the Omaha, and a poultice were applied to enlarged glands as a treatment for diseases such as mumps by the Pawnee, Ponca, Dakota, and Winnebago. Purple coneflower was used to increase endurance in the sweat lodge ceremony by the Dakota, Pawnee, Ponca, and Winnebago. The Cheyenne chewed the root to stimulate the flow of saliva, which was especially useful for Sun Dance participants as a thirst preventative. [3]

Preclinical Data

Pharmacology

Phagocytic activity

Hydroethanolic extract from E. angustifolia roots has been reported to exhibit phagocytic activity. The result affirmed the ability of E. angustifolia to enhance cell-mediated immune function through its observed actions on T-lymphocyte proliferation and interferon-gamma production. [6]

In vivo studies have demonstrated that extracts of E. angustifolia possess immune stimulating activity in the murine model. Result obtained show that treatment with extract of E. angustifolia reduced Candida albicans-induced mortality in healthy and cyclosporine-A treated mice. [6]

Equine in vivo studies established E. angustifolia extract as an agent capable of stimulating immunocompetence through modulation of nonspecific cellular immunological parameters. Result obtained show that treatment with E. angustifolia root extract for six weeks increased phagocytic activity, elevated peripheral lymphocyte counts, increased the size and concentration of peripheral red blood cells whilst also increasing hemoglobin concentration in healthy horses. [7]

Anti-inflammatory activity

Ethanol extracts of E. angustifolia, E. pallida, and E. purpurea has shown variability between the species with regard to concentrations of hydrophilic caffeic acid derivatives and lipophilic amides. These differences have physiological relevance as the constituent concentration impacts the observed magnitude of an Echinacea-induced biological action. It was found that ethanol extracts of E. angustifolia, E. pallida, and E. purpurea all enhanced interferon-gamma production by mouse splenocytes stimulated in vitro by concanavalin A whilst only E. angustifolia and E. pallida increased interleukin-4 and interleukin-10 in splenocytes by 3 to 4-fold. [8]

E. angustifolia has been shown to increase arginase activity of macrophage cells stimulated with 8-bromo-cAMP whilst suppressing nitric oxide production thereby maintaining biological balance whilst producing an enhancement in nonspecific cellular immune function. Further investigation revealed that the polar fraction of E. angustifolia containing the caffeic acid derivatives produced the enhancement of arginase activity, whilst the lipophilic fraction containing the alkamides suppressed nitric oxide production [9]. This finding is consistent with earlier research that has demonstrated the ability of alkamides isolated from E. angustifolia to mediate anti-inflammatory activity [10].

In vivo studies with mice have shown a polysaccharidic fraction of E. angustifolia to inhibit carrageenan-induced paw edema and croton oil-induced ear edema indicating that the anti-inflammatory effect of E. angustifolia is likely attributable to its multiple constituents. [11]

Immunomodulatory activity

It appears that the immunomodulatory activity associated with Echinacea use is likely attributable to multiple mechanisms of action. Echinacea-induced increases in anti-inflammatory cytokines and the Echinacea-induced decrease in tumour necrosis factor-alpha observed in activated splenocytes indicate that Echinacea may act as an immunomodulatory agent by altering the ratio of anti-inflammatory cytokines to pro-inflammatory cytokines. [8]

In vitro assays with human neuroglioma cells (H4) have demonstrated that E. angustifolia extract suppressed cyclooxygenase-2 dependent prostaglandin-E2 formation at sites of inflammation. Alkamides isolated from E. angustifolia root extract are important constituents for contributing to the Echinacea-induced pharmacological anti-inflammatory effects as they have been shown to interfere with cyclooxygenase-2 activity [12]. As the alkamides have been shown to exhibit affinity for cannabinoid receptors, especially cannabinoid receptor subtype 2, the interactions between alkamides from E. angustifolia, the endocannabinoid system, and its associated cascades, may contribute to the immunomodulatory effects of E. angustifolia [13].

In vivo studies utilizing rats have indicated that E. angustifolia enhanced immune function may be attributable to Echinacea-induced antigen-specific immunoglobulin production as treatment with Echinacea augments rat primary and secondary immunoglobulin-G response in antigen-challenge experiments. [14]

Recent laboratory investigations that have utilized animal models in experimental studies designed to assess immunomodulatory activity have provided support for the use of E. angustifolia and/or its constituents as immunomodulatory agents. The ethanol extract of E. angustifolia has been shown to modulate macrophage function through its ability to attenuate the production of nitric oxide and tumour necrosis factor-alpha in lipopolysaccharide-activated RAW 264.7 murine peritoneal macrophages. [10]

Proliferative activity

The studies completed in ruminants have shown that incubation of a standardized extract of E. angustifolia with bovine peripheral blood mononuclear cells increases proliferation in a dose-dependent manner and extracts of E. angustifolia produce concentration-dependent inhibition of adhesion and superoxide production whilst stimulating production of interleukin-8 in ovine neutrophils. [15][16]

Furthermore, ovine neutrophils pre incubated with E. angustifolia extract have shown E. angustifolia to reduce spontaneous apoptosis, when compared to control apoptotic rates [16]. This finding is of clinical importance with regard to use of Echinacea as an adjunct to chemotherapy. A study investigating concomitant E. angustifolia root extract with doxorubicin chemotherapy demonstrated manifestation of both proliferative and antiproliferative activity in cervical and breast cancer cells dependent upon the specific cell line and treatment with E. angustifolia or its phenolic constituents [17].

Cytotoxic activity

E. angustifolia extract has been shown to be cytotoxic in human pancreatic and colon cancer cell lines (MIA PaCa-2 and COLO320, respectively) thereby providing additional support for the use of Echinacea in oncology. [18]

Murine and bovine (HC11 and BME-UV, respectively) cell lines have also been employed to assess the biological effect of E. angustifolia treatment upon normal cell viability and differentiation. The results indicate that treatment with E. angustifolia produces an enhancement in cell viability. The further experiments indicate that the proposed mechanisms by which the stimulation of mammary epithelial cell physiology occurs may be through increased MAPK and AKT activation or through the dose-dependent reduction of caspase 3 activities that ensures following E. angustifolia treatment. Taken together, the effects of E. angustifolia may have therapeutic implications in the treatment of inflammation-related pathologies, oncology and autoimmune disorders. [19]

Wound healing activity

Echinacoside isolated from E. angustifolia has been investigated for its role in the wound healing properties. One such study utilized unilateral vocal fold stripping to induce porcine vocal fold injury with the uninjured vocal fold serving as control. A standardized extract of E. angustifolia was employed to evaluate the effects of echinacoside and its established anti-hyaluronidase properties on wound healing by topically applying the extract to the injured vocal fold; when compared to control, topical application of the standardized extract of E. angustifolia improved vocal economy and phonation threshold pressure. [20]

Immunostimulatory activity

The preclinical studies provide support for the immunostimulatory effects associated with Echinacea use; clinical trials assessing Echinacea preparations in the prophylaxis and treatment of upper respiratory infections have demonstrated favorable differences in the treatment versus control groups [21][22]. The conflicting conclusions of these studies may be attributable to varying factors within the experimental designs, such as the use of different doses and/or preparations of Echinacea, different animal models employed, and/or differing parameters measured to evaluate outcome in patients. The discrepancy in findings may also be due to failure of Echinacea products to meet recognized pharmaceutical quality standards [21].

The immunostimulatory activity of Echinacea preparations has been found to vary significantly by preparation and even raw material obtained from the same supplier varied greatly by lot when examined for immunostimulatory activity [22]. This occurrence may explain why some studies have shown immunostimulatory activity to be specific to Echinacea herb and root powder preparations whilst others have demonstrated that the extracts display immunostimulatory activity [22][23].

Indeed, product variation with regard to species of Echinacea and formulation utilized was found to vary greatly between ten commercially available preparations of E. angustifolia or Echinacea purpurea when assessed by phytochemical analysis. These variations produced differences in constituent content; E. angustifolia products derived from ethanolic extracts displayed a low polysaccharide profile and high levels of alkamides, echinacoside, and cynarin. This constituent profile was consistent amongst ethanol-derived preparations of Echinacea and associated with high antiviral activity but limited immunostimulatory activity. On the contrary, products derived from aqueous extractions displayed high levels of polysaccharides, low levels of other constituents, and immunostimulatory activity in a mouse macrophage model. [24]

Toxicity

No documentation.

Clinical Data

Clinical findings

A human study assessing an E. angustifolia intravenous homeopathic complex preparation demonstrated an enhancement in the phagocytic activity of polymorphonuclear neutrophil granulocytes when compared to placebo and adverse effects could not be detected. [8]

Precautions

No documentation.

Side effects

Patients possessing allergies to members of the Asteraceae family (e.g. sunflower, safflower, ragweed, chamomile and mugwort) should use E. angustifolia with caution due to an established cross-reactivity between members within this family. Allergic reactions have been documented in individuals with sensitivities to other members of the Asteraceae family following use of Echinacea; following exposure to Echinacea, allergic patients present with symptoms that range in severity from localized symptoms (rhinitis and/or urticaria) to acute asthma attack to generalized, life-threatening anaphylaxis [21][25][26][27]. As with all allergies, incidence of allergic reactions is higher in patient populations where asthma or atopy are already present and patients should consult their medical practitioner/seek medical attention if allergic symptoms manifest [25][26].

Parental administration of Echinacea preparations has produced adverse reactions, including but not limited to urticaria, pyrexia and muscle weakness [28]. Patients suffering from kidney, liver, immunosuppressive or chronic diseases should not begin any medicinal therapy without a consultation with their medical practitioner. Echinacea is theoretically contraindicated in patients suffering from autoimmune diseases although there is a paucity of scientific evidence available to support this theory [29][30]. Echinacea preparations have produced transient lymphopenia in patients afflicted with infections of various etiologies and so should not be used in patients with active infections [28].

Pregnancy/Breast Feeding

Patients planning to become pregnant, who are pregnant or breastfeeding should not use Echinacea supplements without first consulting their medical practitioner due to the lack of information concerning the use of supplements during pregnancy and lactation [31]. A review of available literature assessing information regarding the safety and efficacy of Echinacea species supplements during pregnancy and lactation concluded that oral consumption of Echinacea during the first trimester did not appear to increase the risk for major malformations but preparations should be used with caution during lactation due to insufficient information [32][33].

Age limitation

E. angustifolia supplements should not be used in pediatric patients without first consulting a medical practitioner due to the insufficiency of scientific studies specific to the pediatric population. Echinacea (purpurea) treatment demonstrated no difference in duration of URI, severity of URI symptoms, or number of days where fever was present during the URI for pediatric patients aged 2-11 when compared to placebo. Importantly, the investigation found an increased incidence of rash in the pediatric patients treated with Echinacea (purpurea) when compared to those receiving placebo; therefore, caution is recommended if using Echinacea supplements in a pediatric patient. [34]

Adverse reaction

A clinical study that showed continuous therapy with Echinacea produced greater immune reactivity with longer duration of use, i.e. immune reactivity was greatest after 10 weeks of use when compared to levels at 2 weeks of use, has been cited in support of increased immune reactivity with longer durations of use [30][35]. A double-blind, placebo-controlled randomized trial assessed the use of E. angustifolia extract over a period of 12 weeks and concluded that oral administration of Echinacea for a period up to but not exceeding 12 weeks produced no significant increase in adverse effects when compared to the number of adverse effects reported by the placebo group [36].

Similarly, there was no difference in the number of reported adverse events between E. angustifolia treatment groups and placebo during a 7-day prophylaxis or 5-day treatment study employing challenge with rhinovirus type 39. The long term use of Echinacea, i.e. durations of use that exceed 12 weeks, has not been evaluated to date and clinical studies that have assessed E. angustifolia are few in number. [37]

Oral preparations of Echinacea are generally regarded as safe due to the minimal calculated risk short-term use of quality products pose to consumers when factors such as the number of patients using Echinacea and the number of doses consumed annually are compared to the low numbers of reported adverse events. [29][38][39]

Interaction & Depletion

Interaction with drug

Studies have reported that Echinacea stimulates our immune system, which may alter the effects of corticosteroid and immunosuppressive medications and possibly the dose needed for treatment. Use with caution. [40][41][42]

These drugs include azathioprine, basiliximab, cyclosporine, daclizumab, glatiramer, muromonab-cd3, mycophenolate mofetil, tacrolimus (FK506), sirolimus, methotrexate, prednisone, hydrocortisone, methylprednisolone, prednisolone, betamethasone, budesonide, triamcinolone, dexamethasone, cortisone, beclomethasone, flunisolide, fluticasone fludrocortisone and mometasone. [39][40][41]

Interaction with other Herbs

No documentation

Contraindications

No documentation

Dosage

No documentation

Poisonous Management

No documentation

Line drawing

No documentation

References

  1. The Plant List. Ver1.1. Echinacea angustifolia DC. [homepage on the Internet]. c2013 [updated 2012 Feb 11; cited 2016 Aug 10]. Available from: http://www.theplantlist.org/tpl1.1/record/gcc-140068.
  2. Quattrocchi U. CRC world dictionary of medicinal and poisonous plants: Common names, scientific names, eponyms, synonyms, and etymology. Volume III E-L. Boca Raton, Florida: CRC Press, 2012; p. 2.
  3. USDA. Plant Guide Purple Coneflower Echinacea angustifolia DC. United States: United States Department of Agriculture Natural Resources Conservation Service; 2006.
  4. Barnes J, Anderson LA, Phillipson JD. Herbal medicines. 3rd ed. London, United Kingdom: The Pharmaceutical Press, 2007; p. 218.
  5. Gruenwald J, Brendler T, Jaenicke C, editors. PDR for herbal medicines. 2nd ed. Montvale, New Jersey: Medical Economics Company, 2000; p. 261-266.
  6. Morazzoni P, Cristoni A, Di Pierro F, et al. In vitro and in vivo immune stimulating effects of a new standardized Echinacea angustifolia root extract (Polinacea). Fitoterapia. 2005;76(5):401-411.
  7. O’Neill W, McKee S, Clarke AF. Immunological and haematinic consequences of feeding a standardized Echinacea (Echinacea angustifolia) extract to healthy horses. Equine Vet J. 2002;34(3):222-227.
  8. Zhai Z, Liu Y, Wu L, et al. Enhancement of innate and adaptive immune functions by multiple Echinacea species. J Med Food. 2007;10(3):423-434.
  9. Zhai Z, Solco A, Wu L, et al. Echinacea increases arginase activity and has anti-inflammatory properties in RAW 264.7 macrophage cells, indicative of alternative macrophage activation. J Ethnopharmacol. 2009;122(1):76-85.
  10. Chen Y, Fu, T, Tao T, et al. Macrophage activating effects of new alkamides from the roots of Echinacea species. J Nat Prod. 2005;68(5):773-776.
  11. Tubaro A, Tragni E, Del Negro P, Galli CL, Della Loggia R. Anti-inflammatory activity of a polysaccharidic fraction of Echinacea angustifolia. J Pharm Pharmacol. 1987;39(7):567-569.
  12. Hinz B, Woelkart K, Bauer R. Alkamides from Echinacea inhibits cyclooxygenase-2 activity in human neuroglioma cells. Biochem Biophys Res Commun. 2007;360(2):441-446.
  13. Woelkart K, Xu W, Pei Y, Makriyannis A, Picone RP, Bauer R. The endocannabinoid system as a target for alkamides from Echinacea angustifolia roots. Planta Med. 2005;71(8):701-705.
  14. Rehman J, Dillow JM, Carter SM, Chou J, Le B, Maisel AS. Increased production of antigen-specific immunoglobulins G and M following in vivo treatment with the medicinal plants Echinacea angustifolia and Hydrastis canadensis. 1999;68(2-3):391-395.
  15. Wu J, Nardone A, Lacetera N. Effects of a standardized purified dry extract from Echinacea angustifolia on proliferation and interferon gamma secretion of peripheral blood mononuclear cells in dairy heifers. Res Vet Sci. 2009;87(3):396-398.
  16. Farinacci M, Colitti M, Stefanon B. Modulation of ovine neutrophil function and apoptosis by standardized extracts of Echinacea angustifolia, Butea frondosa and Curcuma longa. Vet Immunol Immunopathol. 2009;128(4):366-373.
  17. Huntimer ED, Halaweish FT, Chase CC. Proliferative activity of Echinacea angustifolia root extracts on cancer cells: interference with doxorubicin cytotoxicity. Chem Biodivers. 2006;3(6):695-703.
  18. Chicca A, Adinolfi B, Martinotti E, et al. Cytotoxic effects of Echinacea root hexanic extracts on human cancer cell lines. J Ethnopharmacol. 2007;110(1):148-153.
  19. Starvaggi Cucuzza L, Motta M, Accornero P, Baratta M. Effect of Echinacea angustifolia extract on cell viability and differentiation in mammary epithelial cells. Phytomedicine. 2008;15(8):555-562
  20. Rousseau B, Tateya I, Lim X, Munoz-del-Rio A, Bless DM. Investigation of anti-hyaluronidase treatment on vocal fold wound healing. J Voice. 2006;20(3):443-451.
  21. Barnes J, Anderson LA, Gibbons S, Phillipson JD. Echinacea species (Echinacea angustifolia (DC.) Hell., Echinacea pallida (Nutt.) Nutt., Echinacea purpurea (L.) Moench): A review of their chemistry, pharmacology and clinical properties. J Pharm Pharmacol. 2005;57(8):929-954.
  22. Rininger JA, Kickner S, Chigurupati P, McLean A, Franck Z. Immunopharmacological activity of Echinacea preparations following simulated digestion on murine macrophages and human peripheral blood mononuclear cells. J Leukoc Biol. 2000;68(4):503-510.
  23. Melchart D, Linde K, Worku F, et al. Results of five randomized studies on the immunomodulatory activity of preparations of Echinacea. J Altern Complement Med. 1995;1(2):145-160.
  24. Vohra S, Adams D, Hudson JB, et al. Selection of natural health products for clinical trials: a preclinical template. Can J Physiol Pharmacol. 2009;87(5):371-378.
  25. Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf. 2005;28(5):387-400.
  26. Mullins RJ. Echinacea-associated anaphylaxis. Medical J Aust. 1998;168(4):170-171.
  27. Mullins RJ, Heddle R. Adverse reactions associated with Echinacea: the Australian experience. Ann Allergy Asthma Immunol. 2002;88(1):42-51.
  28. Parnham MJ. Benefit-risk assessment of the squeezed sap of the purple coneflower (Echinacea purpurea) for long-term oral stimulation. Phytomedicine. 1996;3:95-102.
  29. Barrett B. Medicinal properties of Echinacea: A critical review. Phytomedicine. 2003;10(1):66-86.
  30. Bone K. Long term use of Echinacea. Medical Herbalism. 1995;7:23,451-458
  31. Ernst E. Herbal medicinal products during pregnancy? Phytomedicine. 2002;9:352-354
  32. Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf. 2005;28(5):387-400.
  33. Perri D, Dugoua JJ, Mills E, Koren G. Safety and efficacy of Echinacea (Echinacea angustifolia, E. purpurea, and E. pallida) during pregnancy and lactation. Can J Clin Pharmacol. 2006;13(3):262-267.
  34. Taylor JA, Weber W, Standish L, et al. Efficacy and safety of Echinacea in treating upper respiratory tract infections in children: A randomized controlled trial. JAMA. 2003;290(21):2824-2830.
  35. Coeugniet E, Kuhnast R. Adjuvante Immuntherapie mit verschiedenen Echinacin®-Darreichungsformen [Recurrent candidasis: Adjuvant immunotherapy with different formulations of Echinacin®. Translated by D. Wirth]. Therapiewoche. 1986;36:1-19.
  36. Melchart D, Walther E, Linde K, Brandmaier R, Lersch C. Echinacea root extracts for the prevention of upper respiratory tract infections: a double-blind, placebo-controlled randomized trial. Arch Fam Med. 1998;7(6):541-545.
  37. Turner RB, Bauer R, Woelkart K, Hulsey TC, Gangemi JD. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. New Engl J Medicine. 2005;353(4):341-348.
  38. Heinrich M, Modarai M, Kortenkamp A. Herbal extracts used for upper respiratory tract infections: are there clinically relevant interactions with the cytochrome P450 enzyme system? Planta Med. 2008;74(6):657-660.
  39. Huntley AL, Thompson Coon J, Ernst E. The safety of herbal medicinal products derived from Echinacea species: a systematic review. Drug Saf. 2005;28(5):387-400.
  40. Vomel VT. [The effect of a nonspecific immunostimulant on the phagocytosis of erythrocytes and ink by the reticulohistiocyte system in the isolated, perfused liver of rats of various ages]. Arzneim Forsch/Drug Res. 1984;34(6):691-695. German.
  41. See DM, Broumand N, Sahl L, Tilles JG. In vitro effects of Echinacea and Ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients. Immunopharmacol. 1997;35(3):229-235.
  42. Bauer R. Echinacea drugs-effects and active ingredients. Z Arztl Fortbild. (Jena). 1996;90(2):111-115.