Immune-modifier Herbs

Summary

Immune-modifier Herbs

introduction: Numerous medicinal herbs from the Western and Asian materia medicas affect immunological function. Pharmacological studies, even on well known immuno-active herbs, such as Echinacea spp. (Echinacea), are only beginning to reveal the complexity of herb actions on the immune system. The terms immuno-stimulant and immuno-depressant are too narrow to account for the complexity either of immune system functions or the range of activities exhibited by many immuno-active herbs, particularly since some herbs may depress some aspects of immune function while enhancing others. The preferred term is immunomodulator or immune-modifier.

Immuno-polysaccharides.
• mechanism: The largest group of immuno-active compounds are the immuno-stimulating polysaccharides, of which over 200 have been discovered, most abundantly among the Fungi. They fall into three general categories, activators of the reticulo-endothelial system in general, antitumor compounds, and complement system interactors. An important point but often overlooked point regarding immuno-polysaccharides is their water solubility; this implies that alcohol extracts, for example of Echinacea, designed to extract active isobutylamides would fail to capture the polysaccharide fraction.

overview of interactions:
• herb group potentially affecting drug class performance: Chemotherapy

• herb group potentially affecting drug class performance: Cyclophosphamide

• herb group possibly affecting drug class performance: Corticosteroids

• general herbal concern: Autoimmune conditions and Echinacea



Herbs

herb group potentially affecting drug class performance: Chemotherapy and Cyclophosphamide

• mechanisms: While many immuno-polysaccharides are antitumor, their interactions with chemotherapy remain largely speculative. At least one study, by Lersch et al, suggests a possible synergy between Echinacea and cyclophosphamide, but animal studies suggest that Astragalus F3 polysaccharide fractions, and Rehmannia may counter the immuno-suppressive activity of cyclophosphamide. Chinese clinical studies have reportedly shown that combination therapies of radiotherapy, chemotherapy and an Astragalus and Panax ginseng combination inreased survival times and maintained white blood cell counts during the immunosuppressive therapy.
(Bone K. 1996.)

• herbal concern: The use of immuno-modifiers during chemotherapy should be undertaken with collaboration and approval, or at least awareness, between physician, oncologist, and naturopathic or herbal practitioner, with appropriate monitoring of tumor markers and other indices of treatment progress as deemed necessary.
(Bone K. 1996, 15; Lersch C, et al. Cancer Invest 1992;10(5):343-348.)

herb group possibly affecting drug class performance: Corticosteroids

• mechanism: there is some pharmacological evidence that Rehmannia glutinosa (Chinese foxglove), Angelica sinensis (Dong Quai) and Astragalus can prevent the suppressive effects of corticosteroid therapy on endogenous corticosteroid levels. Human studies are lacking and interaction remains speculative.

• herbal concern: Immune modifier herbs should be used with caution during corticosteroid therapy.

general herbal concern: Autoimmune conditions.

• Various sources have suggested, largely following the Commission E position on Echinacea, that autoimmune conditions are a contraindication for the use of immune-modulating herbs. This is controversial, unsupported, and a rather dogmatic assertion that has recently gained vogue. The issue is discussed more fully under herbs: Echinacea.

Immune-modifier herbs:
• Andrographis paniculata (Kirata)
• Angelica sinensis (Dong Quai)
• Arnica spp. (Arnica)
• Astragalus membranaceus (Astragalus)
• Baptisia tinctoria (Wild Indigo)
• Coriolus versicolor (Turkey Tail)
• Echinacea spp. (Echinacea)
• Eleutherococcus senticosus (Siberian Ginseng)
• Ganoderma applenatum (Artist's Conk)
• Ganoderma lucidum (Reishi)
• Grifola frondosa (Maitake)
• Lentinus eloides (Shiitake)
• Matricaria recutita (German Chamomile)
• Panax ginseng (Korean Ginseng, Chinese Ginseng)
• Rehmannia glutinosa (Chinese Foxglove)
• Salvia miltiorrhiza (Dan Shen)
• Stephania tetandra (Stephania)

Predominantly immuno-suppressive herbs:
• Artemisia annua (Chinese Wormwood)
• Hemidesmus indicus (Indian Sarsaparilla)
• Tylophora indica (Indian Ipecac)

Please read the disclaimer concerning the intent and limitations of the information provided here.
Do not rely solely on the information in this article.

The information presented in Interactions is for informational and educational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, case reports, and/or traditional usage with sources as cited in each topic. The results reported may not necessarily occur in all individuals and different individuals with the same medical conditions with the same symptoms will often require differing treatments. For many of the conditions discussed, treatment with conventional medical therapies, including prescription drugs or over-the-counter medications, is also available. Consult your physician, an appropriately trained healthcare practitioner, and/or pharmacist for any health concern or medical problem before using any herbal products or nutritional supplements or before making any changes in prescribed medications and/or before attempting to independently treat a medical condition using supplements, herbs, remedies, or other forms of self-care.


References

Bone K. Clinical Applications of Ayurvedic and Chinese Herbs. Queensland, Australia: Phytotherapy Press, 1996.

Blumenthal M, Gruenwald J, Hall T, & Riggins CW, (eds.) German Commission E Monographs: Therapeutic Monographs on Medicinal Plants for Human Use. Austin, TX: American Botanical Council, 1998.

Hoffmann D. Phytochemistry . (Forthcoming title, in press 1999, publisher to be confirmed).

Lersch C, Zeuner M, Bauer A, Siemens M, Hart R, Drescher M, Fink U, Dancygier H, Classen M. Nonspecific immunostimulation with low doses of cyclophosphamide (LDCY), thymostimulin, and Echinacea purpurea extracts (echinacin) in patients with far advanced colorectal cancers: preliminary results. Cancer Invest 1992;10(5):343-348.
Abstract: Outpatients (n = 15) with metastasizing far advanced colorectal cancers received immunotherapy consisting of low-dose cyclophosphamide (LDCY) 300 mg/m2 every 28 days i.v., thymostimulin 30 mg/m2, days 3-10 after low-dose cyclophosphamide i.m. once daily, then twice a week, and echinacin 60 mg/m2 together with thymostimulin i.m. All patients had had previous surgery and/or chemotherapy and had progressive disease upon entering the study. Two months after onset of therapy a partial tumor regression was documented in one and a stable disease in 6 other patients by abdominal ultrasonography, decrease of the tumor markers carcinoembryonic antigen (CEA), CA 19-9, CA 15-3, and/or chest roentgenography, which may also be attributed to the natural course of disease. Mean survival time was 4 months, 2 patients survived for more than 8 months. Immunotherapy was well tolerated by all patients without side effects.