Alkaloids and athlete immune function: caffeine, theophylline, gingerol, ephedrine, and their congeners.

Plant alkaloids are found in foods, beverages, and supplements consumed by athletes for daily nutrition, performance enhancement, and immune function improvement. This paper examined possible immunomodulatory roles of alkaloids in exercise contexts, with a focus on human studies. Four representative groups were scrutinized: (a) caffeine (guaranine, mateine); (b) theophylline and its isomers, theobromine and paraxanthine; (c) ginger alkaloids including gingerols and shogaol; and (d) ephedra alkaloids such as ephedrine and pseudoephedrine. Emerging or prospective alkaloid sources (Goji berry, Noni berry, and bloodroot) were also considered. Human in vitro and in vivo studies on alkaloids and immune function were often conflicting. Caffeine may be immunomodulatory in vivo depending on subject characteristics, exercise characteristics, and immune parameters measured. Caffeine may exhibit antioxidant capacities. Ginger may exert in vivo anti-inflammatory effects in certain populations, but it is unclear whether these effects are due to alkaloids or other biochemicals. Evidence for an immunomodulatory role of alkaloids in energy drinks, cocoa, or ephedra products in vivo is weak to nonexistent. For alkaloid sources derived from plants, variability in the reviewed studies may be due to the presence of unrecognized alkaloids or non-alkaloid compounds (which may themselves be immunomodulatory), and pre-experimental factors such as agricultural or manufacturing differences. Athletes should not look to alkaloids or alkaloid-rich sources as a means of improving immune function given their inconsistent activities, safety concerns, and lack of commercial regulation.

Phytochemical and immunomodulatory properties of an Echinacea laevigata (Asteraceae) tincture.

BACKGROUND: Echinacea preparations are consumed for the prevention or treatment of upper respiratory infections. OBJECTIVE: The objective of this study was to provide the first data regarding the in vitro immunomodulatory properties of the American federally endangered species Echinacea laevigata (Asteraceae). METHODS: Human peripheral blood mononuclear cells were cultured with root tinctures from E. laevigata, E. angustifolia, E. pallida, and E. purpurea. Cytokine production (tumor necrosis factor [TNF], interleukin [IL]-2, IL-10) and mononuclear cell proliferation were measured. High-performance liquid chromatography was used to assay levels of known bioactive compounds from all extracts tested to statistically determine whether there were relationships between extract phytochemical content and observed immune effects. RESULTS: E. laevigata extract was most similar to E. pallida extract and able to augment IL-10 and mononuclear cell proliferation, but not TNF or IL-2. Echinacoside, a caffeic acid derivative, correlated most strongly with results. CONCLUSIONS: This species may deserve continued investigation in both experimental and therapeutic contexts.

Effects of Echinacea extracts on macrophage antiviral activities.

Type I interferons are a class of cytokines synthesized by leukocytes such as macrophages that limit viral replication. We hypothesized that one mechanism whereby Echinacea spp. extracts may enhance immunity is through modulating interferon-associated macrophage pathways. We used herpes simplex viral infection in the murine macrophage cell line RAW264.7 and monitored virus-induced cell death, interferon secretion, and two intracellular proteins that indicate activation of interferon pathways. Cells were incubated with control media or extracts from four different species (E. angustifolia, E. purpurea, E. tennesseensis, E. pallida). Cells incubated with extracts prior to infection showed very modest enhancement of viability, and no increase in the secretion of interferons alpha or beta as compared to control cells. Virus-infected macrophages treated with extracts from E. purpurea showed a small (<2-fold) induction of guanylate binding protein (GBP) production, but no effect of extracts from other species was observed. In virus-infected cells, all the extracts increased the amount of inducible nitric oxide synthase (iNOS) protein, and this effect varied by type of extraction preparation. Together, these results suggest that any potential antiviral activities of Echinacea spp. extracts are likely not mediated through large inductions of Type I interferon, but may involve iNOS.

Herbal supplements and athlete immune function--what's proven, disproven, and unproven?

The purpose of this paper is to critically evaluate current immunological and clinical literature regarding the effects of herbal preparations on athlete immune function. First, we review rates of herbal supplement use by athletes. Second, we use ginseng (Panax ginseng) and coneflower (Echinacea spp.) as models for examining how herbal supplements may influence immune function within the contexts of exercise and sport, while briefly considering several other popular herbal products. Third, we proffer several evidence-based hypotheses to explain apparent discrepancies among the cumulative data, concomitantly advancing a novel conceptual framework which may be useful to understanding herbal supplements and athlete immune function using Echinacea supplements as a model. Fourth, we apply the proposed framework to some prospective data regarding the effects of Echinacea pallida and Echinacea simulata on in vitro cytokine production and cell proliferation in peripheral blood mononuclear cells collected from male collegiate wrestlers and soccer players during training. Fifth and finally, we evaluate the current knowledge on herbal supplements and athlete immune function, identify gaps and limitations in knowledge, and advance several possible options for future research.

Human blood mononuclear cell in vitro cytokine response before and after two different strenuous exercise bouts in the presence of bloodroot and Echinacea extracts.

The purpose of this multidisciplinary investigation was to characterize cytokine production by human blood mononuclear cells after 2 contrasting exercise bouts (a maximal graded oxygen consumption [VO(2)max] test and 90 min of cycling at 85% of ventilatory threshold [VT]) when stimulated in vitro with extracts from bloodroot (Sanguinaria canadensis), coneflower (Echinacea tennesseensis), or solvent vehicle controls. Blood was sampled pre- and post-exercise. Production of TNF, IL-1beta, and IL-10 were measured at 24, 48, and 72 h, respectively. In the VO(2)max test there was a main effect of exercise such that exercise increased cytokine synthesis and a main effect of stimulant such that bloodroot extracts significantly increased cytokine production compared to other stimulants or controls. In the 90-min bout, there was a main effect of exercise for TNF and IL-1beta (but not IL-10) such that exercise decreased cytokine synthesis and a main effect of stimulant such that bloodroot extracts significantly increased cytokine production compared to other stimulants or controls, with exercisexstimulant interactions for both IL-1beta and IL-10. A similar though weaker effect was seen with Echinacea extracts; subsequent biochemical analyses suggested this was related to alkamide decay during 3 years undisturbed storage at ultralow (-80 degrees C) temperature. In this study, the VO(2)max test was associated with enhanced cytokine production whereas the 90-min cycling at 85% VT was associated with suppressed cytokine production. Bloodroot extracts were able to increase cytokine production in both contexts. Herbal extracts purported to offset exercise-associated effects on immune activity warrant continued investigation.

Echinacea tennesseensis ethanol tinctures harbor cytokine- and proliferation-enhancing capacities.

BACKGROUND: Members of the genus Echinacea are used medicinally to treat upper respiratory infections such as colds and influenza. The aim of the present investigation was to characterize the phytomedicinal properties of the American federally endangered species Echinacea tennesseensis. METHODS: Fifty-percent ethanol tinctures were prepared from roots, stems, leaves, and flowers and tested separately for their ability to influence production of IL-1beta, IL-2, IL-10, and TNF-alpha as well as proliferation by young human adult peripheral blood mononuclear cells (PMBC) in vitro. Tincture aliquots were stored at three different temperatures (4, -20, and -80 degrees C) for 21h before testing. At 1-month post-extraction, tinctures stored at -20 degrees C were tested again for cytokine modulation. Phytochemical analyses were performed using HPLC. RESULTS: Fresh root, leaf, and flower tinctures stimulated PBMC proliferation. Fresh root tinctures alone stimulated IL-1beta, IL-10, and TNF-alpha production. No tinctures modulated IL-2 production. Stem tinctures showed no activity. Storage temperature did not influence any outcomes. Root tinctures maintained their ability to modulate IL-1beta, IL-10, and TNF-alpha production after 1month of storage at -20 degrees C. CONCLUSIONS: These results suggest E. tennesseensis harbors phytomedicinal properties that vary by plant organ, with roots demonstrating the strongest activities.

Bloodroot (Sanguinaria canadensis L., Papaveraceae) Enhances Proliferation and Cytokine Production by Human Peripheral Blood Mononuclear Cells in an In Vitro Model.

Previous studies have suggested that phytomedicinal preparations from bloodroot (Sanguinaria canadensis L.) may harbor immunomodulatory properties. The purpose of this investigation was to determine the effects of alcohol tinctures and water infusions generated from bloodroot flowers, leaves, rhizomes, and roots on human peripheral blood mononuclear cell (PBMC) cytokine production and proliferation in vitro. PBMCs were collected from 16 healthy young adults and cultured with bloodroot extracts or respective controls for interleukins-1ß, -2, -8, -10, interferon-γ, and tumor necrosis factor. Proliferative capabilities of both PBMCs and K562 cells (an immortalized human myelogenous leukemia cell line) following extract treatment were determined. High-pressure liquid chromatography was used to quantify berberine, chelerythrine, and sanguinarine in the extracts and to correlate extract composition with observed effects. Overall, infusions demonstrated greater immunomodulatory capabilities than tinctures, and flower- and root-based extracts showed greater immunomodulatory properties than leaf- or rhizome-based extracts (some effects seen with root-based extracts may be due to endotoxin). Several extracts were able to augment PBMC proliferation and diminish K562 proliferation, suggesting a selective anti-carcinogenic activity. The rhizome alcohol tincture had a markedly stronger effect against K562 cells than other extracts. Chelerythrine, sanguinarine, and endotoxin (but not berberine) sometimes correlated with observed effects. The in vitro activities demonstrated here suggest bloodroot extracts may have potential as therapeutic immunomodulators.

Enhancement of innate and adaptive immune functions by multiple Echinacea species.

Echinacea preparations are commonly used as nonspecific immunomodulatory agents. Alcohol extracts from three widely used Echinacea species, Echinacea angustifolia, Echinacea pallida, and Echinacea purpurea, were investigated for immunomodulating properties. The three Echinacea species demonstrated a broad difference in concentrations of individual lipophilic amides and hydrophilic caffeic acid derivatives. Mice were gavaged once a day (for 7 days) with one of the Echinacea extracts (130 mg/kg) or vehicle and immunized with sheep red blood cells (sRBC) 4 days prior to collection of immune cells for multiple immunological assays. The three herb extracts induced similar, but differential, changes in the percentage of immune cell populations and their biological functions, including increased percentages of CD49+ and CD19+ lymphocytes in spleen and natural killer cell cytotoxicity. Antibody response to sRBC was significantly increased equally by extracts of all three Echinacea species. Concanavalin A-stimulated splenocytes from E. angustifolia- and E. pallida-treated mice demonstrated significantly higher T cell proliferation. In addition, the Echinacea treatment significantly altered the cytokine production by mitogen-stimulated splenic cells. The three herbal extracts significantly increased interferon-alpha production, but inhibited the release of tumor necrosis factor-gamma and interleukin (IL)-1beta. Only E. angustifolia- and E. pallida-treated mice demonstrated significantly higher production of IL-4 and increased IL-10 production. Taken together, these findings demonstrated that Echinacea is a wide-spectrum immunomodulator that modulates both innate and adaptive immune responses. In particular, E. angustifolia or E. pallida may have more anti-inflammatory potential.

Cytokine- and interferon-modulating properties of Echinacea spp. root tinctures stored at -20 degrees C for 2 years.

Echinacea spp. phytomedicines are popular for treating upper respiratory infections. The purpose of this investigation was to examine the immunomodulatory properties of Echinacea tinctures from seven species after being stored at -20 degrees C for 2 years. Two experimental techniques were employed using human peripheral blood mononuclear cells (PBMC). In the first set of experiments, PBMCs were stimulated in vitro with tinctures alone and assayed for proliferation and production of interleukin-10 (IL-10), IL-12, and tumor necrosis factor-alpha (TNF-alpha). In the second set of experiments, subjects were immunized with influenza vaccine. PBMCs from vaccinated individuals were stimulated in vitro with Echinacea tinctures and influenza virus; cytokine production (IL-2, IL-10, and interferon-gamma [IFN-gamma]) was compared prevaccination and postvaccination. In the first experiments, (1) tinctures from E. angustifolia, E. pallida, E. paradoxa, and E. tennesseensis stimulated proliferation and tended to increase IL-10, (2) E. sanguinea and E. simulata stimulated only proliferation, (3) E. purpurea stimulated only IL-10, and (4) none of the extracts influenced IL-12 or TNF-alpha. In the second experiments, (1) tinctures from E. pallida, E. paradoxa, E. sanguinea, and E. simulata diminished influenza-specific IL-2, and (2) none of the extracts influenced influenza-specific IL-10 or IFN-gamma. For in vitro models using Echinacea, immune response may vary based on stimulus (Echinacea alone vs. Echinacea + recall stimulation with virus).

Year-and-a-half old, dried Echinacea roots retain cytokine-modulating capabilities in an in vitro human older adult model of influenza vaccination.

Alcohol tinctures prepared from aged Echinacea roots are typically taken for preventing or treating upper respiratory infections, as they are purported to stimulate immunity in this context. The effects of long-term (> 1 year) dry storage on the capabilities of Echinacea spp. roots from mature individuals to modulate cytokine production are unknown. Using an older human adult model of influenza vaccination, we collected peripheral blood mononuclear cells from subjects 6 months post-vaccination and stimulated them in vitro with the two Type A influenza viruses contained in the trivalent 2004-2005 vaccine with a 50 % alcohol tincture prepared from the roots of one of seven Echinacea species: E. angustifolia, E. pallida, E. paradoxa, E. purpurea, E. sanguinea, E. simulata, and E. tennesseensis. Before being processed into extracts, all roots had been stored under dry conditions for sixteen months. Cells were cultured for 48 hours; following incubation, supernatants were collected and assayed for interleukin-2, interleukin-10, and interferon-gamma production, cytokines important in the immune response to viral infection. Four species ( E. angustifolia, E. purpurea, E. simulata, E. tennesseensis) augmented IL-10 production, diminished IL-2 production, and had no effect on IFN-gamma production. Echinacea pallida suppressed production of all cytokines; E. paradoxa and E. sanguinea behaved similarly, although to a lesser extent. The results from these in vitro bioactivity assays indicate that dried Echinacea roots stored for sixteen months maintain cytokine-modulating capacities. Our data support and extend previous research and indicate that tinctures from different Echinacea species have different patterns of immune modulation; further, they indicate that certain species may be efficacious in the immune response to viral infection.

Changes in immunomodulatory properties of Echinacea spp. root infusions and tinctures stored at 4 degrees C for four days.

BACKGROUND: Phytomedicinal preparations from members of the genus Echinacea are popular worldwide and frequently used to treat upper respiratory infections. With the increasing popularity of herbal medicines, many people are making their own Echinacea extracts at home and storing them at refrigerator (4 degrees C) temperatures. We tested the hypothesis that Echinacea extracts made using homemade methods change in immunomodulatory efficacy with storage at 4 degrees C over a 4-day period. METHODS: Three extract types (50% ethanol tincture, cold water infusion, hot water infusion) from 5 different species (Echinacea angustifolia, E. pallida, E. purpurea, E. sanguinea, E. tennesseensis) were prepared. Four in vitro immune assays (monocyte secretion of TNF-alpha, IL-10, and IL-12; and peripheral blood mononuclear cell proliferation) using human blood were used to test extract efficacy at Days 1 and 4 post-extraction. Two statistical analyses, traditional ANOVA and several statistical models that account for endotoxin effects, were used. RESULTS: Endotoxin was found to significantly impact immune outcomes only in 4-day old cold water infusions and not in all assays. Extracts showed the greatest stimulation in TNF-alpha assays. By extract type, 50% ethanol tinctures produced the most immune stimulation. By species, extracts from E. angustifolia extracts were the most efficacious in our assays; extracts from E. sanguinea showed the least activity overall. CONCLUSIONS: Taken together, these results suggest that: (1) homemade Echinacea extracts are efficacious in modulating immune cell activity in vitro but that their properties change with time during storage at 4 degrees C; and (2) endotoxin effects from extracts may be important considerations in the analysis of immunobiological data.