In vitro analysis of the herbal compound Essiac.

BACKGROUND: Despite the recommendation of the Task Force on Alternative Therapies of the Canadian Breast Cancer Research Initiative, little research has been published on the widely used herbal compound Essiac. We aimed to address this deficiency by conducting a series of assays to determine some of the purported activities of Essiac in vitro. MATERIALS AND METHODS: The activity of Essiac was measured using established assays to assess anti-oxidant, fibrinolytic, anti-microbial, anti-inflammatory, immune modulation, cell-specific cytotoxicity, and impact on cytochrome P450 (CYP450) enzyme pathways. RESULTS: Essiac exhibited significant antioxidant activity in the ABTS assay. A 20-fold dilution of Essiac also exhibited significant immunomodulatory effects, specifically through stimulation of granulocyte phagocytosis, increases in CD8+ cell activation, and moderately inhibiting inflammatory pathways. Essiac exhibited significant cell-specific cytotoxicity towards ovarian epithelial carcinoma cells (A2780). Importantly, a 20-fold dilution of Essiac showed significant inhibition of several CYP450 enzymes, most notably CYP1A2 (37%) and CYP2C19 (24%). Essiac demonstrated dose-dependent inhibition of clot fibrinolysis. CONCLUSION: In vitro analysis of Essiac indicates significant antioxidant and immunomodulatory properties, as well as neoplastic cell specific cytotoxicity consistent with the historical properties ascribed to this compound. Importantly, significant CYP450 and fibrinolysis inhibition were also observed. This is the first comprehensive investigation of the in vitro effects of Essiac.

An in vivo analysis of the herbal compound essiac.

BACKGROUND: Essiac is a herbal compound that has been in common use with cancer patients in North America for over 80 years. Despite its relatively widespread use, there are no peer-reviewed published reports of in vivo studies regarding the use of this compound. MATERIALS AND METHODS: Essiac was administered orally to test animals prior to all experiments. Standard assays to test protection from ethanol-induced gastric ulceration and carbon tetrachloride-induced hepatic injury were performed on Wistar rats. Assays of postglucose-load serum glucose and cellular and humoral immune modulation were conducted on ICR and BALB/C mice, respectively. RESULTS: Essiac demonstrated a modest gastric protective effect via reduction of ethanol-induced gastric ulceration. However, Essiac did not demonstrate significant hepatoprotective, hypoglycemic or immunomodulatory properties. CONCLUSION: Essiac, administered in established in vivo experimental models, did not significantly demonstrate its purported physiological modifying effects.

Impact of African herbal medicines on antiretroviral metabolism.

We examined the effects of two African herbal medicines recommended for HIV/AIDS patients on antiretroviral metabolism. Extracts from Hypoxis and Sutherlandia showed significant effects on cytochrome P450 3A4 metabolism and activated the pregnane X receptor approximately twofold. P-glycoprotein expression was inhibited, with Hypoxis showing 42-51% and Sutherlandia showing 19-31% of activity compared with verapamil. Initiating policies to provide herbal medicines with antiretroviral agents may put patients at risk of treatment failure, viral resistance or drug toxicity.

Knowledge of safety and herb-drug interations amongst HIV+ individuals: a focus group study.

OBJECTIVE: To determine how HIV+ individuals access safety and knowledge of drug interactions related to complementary and alternative medicine (CAM). METHODS: We conducted two separate focus group sessions with HIV+ users of complementary therapies. A total of 8 men participated at an urban health centre. Focus group sessions were audio taped and transcribed verbatim. Analysis was conducted independently and in duplicate, using thematic analysis. RESULTS: All focus group participants described their use of CAM as very important for their health maintenance, giving them a feeling of empowerment in their health care. Potential side effects and safety issues were indicated as major concerns for treatment decisions, but the participant's knowledge of safety issues involved in CAM care for HIV+ patients was limited. The sources used by the participants to gather information regarding safety and interactions with medications were varied but included: their CAM providers, their physicians, books, resources from AIDS Service Organizations, the internet and health food stores. Participants acknowledged that appraising the quality of such information is difficult. CONCLUSIONS: The participants in this study had a strong trust in CAM and used a wide variety of sources to gather information on CAM safety, though their knowledge base was poor. As the use of CAM grows, further research on how to disseminate reliable information on safety and efficacy to this potentially vulnerable population is required.