Immune System Health: A New Understanding Kerry Bone Adjunct Professor New York Chiropractic College
Integria Healthcare Ltd and Standard Process sponsor these webinars to provide healthcare information to practitioners and to provide them the opportunity to hear about the views, recommendations and experiences of other practitioners. Health-related information provided here is not a substitute of medical advice. Neither Integria, Standard Process or the speaker, Kerry Bone have evaluated the legal status of any products, services or recommendations with respect to State or Federal laws, including scope of practice. Integria, Standard Process and Kerry Bone do not and cannot accept responsibility for errors or omissions or for any consequences from applications of the information provided and makes no warranty, expressed or implied, with respect to the information provided. Kerry s recommendations for Standard Process and MediHerb product dosages are sometimes different than the doses that appear on the product labels. Please refer to the product labels or to the product descriptions found in the product catalogs or on the website for Standard Process and MediHerb dosage recommendations. 2
Topics Covered Herbs and cellular support Understanding what makes Echinacea work Proof of the pudding 3
Key Herbs/Phytochemicals with Nrf2/ARE Activity EGCG from Green Tea is very active (in vitro and in vivo - 20 mg/kg, oral) Curcumin from Turmeric is positive in many studies (in vitro and in vivo, oral) Resveratrol shows marked in vitro and in vivo activities and was also positive in a human trial 2006 Kanko Surh YJ, Kundu JK, Na HK. Nrf2 as a master redox switch in turning on the cellular signaling involved in the induction of cytoprotective genes by some chemopreventive phytochemicals. Planta Med 2008; 74(13): 1526-1539 Hur W, Gray NS. Small molecule modulators of antioxidant response pathway. Curr Opin Chem Biol 2011; 15(1): 162-173 4
Key Herbs/Phytochemicals with Nrf2/ARE Activity Carnosol from Rosemary is another well-studied phytochemical Various phytochemicals from Garlic are active in vitro Ginkgo is active and upregulates HO-1 Isothiocyanates from Brassicas are also highly active 2008 Linda N Surh YJ, Kundu JK, Na HK. Nrf2 as a master redox switch in turning on the cellular signaling involved in the induction of cytoprotective genes by some chemopreventive phytochemicals. Planta Med 2008; 74(13): 1526-1539 Hur W, Gray NS. Small molecule modulators of antioxidant response pathway. Curr Opin Chem Biol 2011; 15(1): 162-173 5
SIRT1 or Sirtuin-1 Resveratrol is proven to directly activate SIRT1 Jan Samanek, State Phytosanitary Administration, Czechia Tennen RI, Michishita-Kioi E, Chua KF. Finding a target for resveratrol. Cell 2012; 148(3): 387-389 Hubbard BP, Gomes AP, Dai H et al. Science 2013; 339(6124): 1216-1219 6
Echinacea Root and HSPs In an open-label pilot trial, 11 healthy volunteers were evaluated at baseline (day 1) and on day 15 after consuming 2 Echinacea root tablets/day (standardized to 4.4 mg alkylamides) for 14 days 1 1 Agnew LL et al. J Clin Pharm Ther 2005; 30(4): 363-369 7
Echinacea Root and HSPs Echinacea root markedly enhanced (by about 50%) the increase in white cell heat shock protein (hsp70) expression after mild heat shock (p=0.029) White cell counts were mildly increased (p=0.043) and there was a preventative effect against free radical induced erythrocyte hemolysis (p=0.006) 8
Echinacea Root and HSPs A follow-up open-label trial in 24 healthy volunteers used the same design, except the Echinacea root dose was twice the above 1 While Echinacea did not significantly change basal hsp70 expression in lymphocytes, it increased CD4, CD8 and NK cell stress-induced hsp70 expression 1 Agnew L et al. Planta Med 2010; 76(12): P629, 1354 9
Echinacea Root and HSPs The effect was most marked in NK cells (p<0.05) This implies that Echinacea root may play a role in activating and protecting immune system cells via HSPs when the body encounters a challenge 10
Echinacea Root: Pharmacokinetics Study Design: 11 healthy individuals Age: 18 to 26 years BMI: 19 to 30 Blood samples taken over 12 hours 2006 Waldszenen Dose: 4 Echinacea root tablets as a single dose 11
What Compounds Were Found in Bloodstream No caffeic acid conjugates No caffeic acid conjugate degradation products No alkylamide degradation products No polysaccharides The only compounds identified in human plasma were alkylamides from the Echinacea ingested, at approximately the same ratio as the initial product tested Matthias A, Addison RS, Penman KG, Bone KM et al. Life Sci 2005; 77: 2018-2029 12
What Do Echinacea Alkylamides Do? Some bind strongly to cannabinoid receptors causing subtle modulation of immune system function Others may inhibit breakdown of endogenous cannabinoids Possibly upregulate dendritic cell maturation Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine. 2 nd Edition, Elsevier, UK. 2013 13
What Do Echinacea Alkylamides Do? Possibly responsible for positive effects on natural killer (NK) cell function and numbers and increased white cell phagocytic activity seen in several in vivo studies Possibly responsible for effects on heat shock proteins seen in human studies Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine. 2 nd Edition, Elsevier, UK. 2013 14
Echinacea: A Miracle Herb? In an extraordinarily paper Canadian scientist Dr Sandra Miller reviewed her research on Echinacea, specifically Echinacea purpurea root 1 In healthy young adult mice, oral doses of Echinacea purpurea root (0.45 mg per 25 g body weight, similar to human dose rates) stimulated NK cell production by bone marrow which resulted in significantly higher levels (around 25% more) of NK cells in the spleen by 2 weeks 2 1 Miller SC. ecam 2005; 2(3): 309-314 2 Sun LZ-Y, Currier NL, Miller SC. J Altern Complement Med 1999; 5: 437-446 15
Echinacea Boosts NK Cells In addition, the helper or accessory cells for NK cells, the monocytes, were also increased by 25% The Echinacea treatment influenced no other white blood cell counts Polysaccharides, even by injection, were not responsible for this effect Currier NL, Lejtenyi D, Miller SC. Phytomedicine 2003; 10: 145-153 16
Echinacea Boosts NK Cells Dr Miller feels that alkylamides are largely responsible for the effect (personal communication) This research tends to shift the focus for Echinacea to innate immune system response Currier NL, Lejtenyi D, Miller SC. Phytomedicine 2003; 10: 145-153 17
Echinacea Reverses Aging of Innate Immune System Response NK cells decline in number and function with age and this is thought to be one factor behind the increase of various age related challenges Experiments in healthy, elderly mice found that 2 weeks of oral doses of Echinacea root returned NK cell numbers and function to levels in young adults 1 1. Currier NL, Miller SC. Exp Gerontol 2000; 35: 627-639 18
Echinacea Reverses Aging of Innate Immune System Response In addition for mice fed Echinacea purpurea root from 7 weeks of age to 13 months lifespan was significantly extended compared to controls 2 2. Brousseau M, Miller SC. Biogerontology 2005; 6: 157-163 1992 Janet Stephens 19
Good Preparation is Better Than Intervention In a study presented by the late Dr Anna Macintosh at the 1999 Convention of the American Association of Naturopathic Physicians, an Echinacea root formulation was compared against a herbal adaptogenic formulation and a placebo in over a 90-day period 1 1. McIntosh A et al. AANP Convention, Coeur d Arlene, 1999. 20
Good Preparation is Better Than Intervention The trial recruited 260 medical students who were under stress from their studies The placebo group averaged 10%, whereas this dropped to as low as 2% by day 70 (p=0.013) in the Echinacea group 2007 Leonid Mamchenkov 21
Echinacea and Long-haul Flights A randomized, double blind, placebo-controlled clinical trial was undertaken with 175 participants traveling return from Australia to North America, Europe or Africa for 1 to 5 weeks Active tablets each contained extract from 1.275 g Echinacea root (4.4 mg alkylamides) 2010 Qantas_Boeing_747-400ER_VH-OEI_at_LAX.jpg: Aero Icarus from Zürich, Switzerland 22
Echinacea and Long-haul Flights Priming dose was 2/day, travel dose was 4/day and dose when ill was 6/day The placebo group exhibited significantly higher average score (around double) compared with the Echinacea group (p<0.05) after return from travel 23
Echinacea Root and Air Travelers Tiralongo E et al. Evid Based Complement Alternat Med 2012; 2012: 417267 24
Echinacea Premium Suggested use: 1 tablet twice daily or 2 tablets 2 to 3 times daily 25
Cellular Support Vitanox : 1 tablet 1-2 times daily HerbaVital: 1 tablet 2 to 4 times daily Echinacea Premium: 1 tablet 2 to 4 times daily 26
But it s February! Andrographis Complex 1 tablet 2 4 times daily 2 tablets 3 4 times daily Broncafect 2 tablets 2 4 times daily Euphrasia Complex 1 tablet 3 4 times daily 2 tablets 3 4 times daily 27
Questions 28