CHAPTER 20 Veterinary Herbal Medicine: A Systems-Based Approach
This chapter reviews traditional and scientific approaches to the use of herbal medicine in treating an array of conditions by system.
Clinically, it is common to find more than one system affected, so it is important to consider the whole patient and not just the diagnosis or system. In this section formulas are offered as starting points; however, it is intended that they should be modified to match the needs of the individual patient wherever possible (see Chapter 19).
HERBS FOR BLOOD AND IMMUNOLOGIC DISORDERS
Mechanisms of Interest
Adaptogens
ASIAN GINSENG (PANAX GINSENG):
Hundreds of scientific papers have established that Panax ginseng has numerous clinical effects. In laboratory animals, these include central nervous system (CNS) stimulation; protection against exogenous damage from radiation, toxins, and infection; protection from physical and psychological stress; and an influence on carbohydrate and lipid metabolism and immune stimulation. All of these may bear on an animal’s response to stress. Recently, investigators have developed rat models of stress that have resulted in measurable physical and chemical changes. In these studies, pretreatment with ginseng attenuated the stress-induced rise in corticosterone, hyperglycemia, immune suppression, increased adrenal gland weight, gastric ulceration, and other signs of chronic stress (Rai, 2003b; Kim, 2003). The dose in rats used in one study was 100 mg/kg of ginseng root powder (Rai, 2003b). The saponin-rich fraction of ginseng also reduced the secretion of catecholamines from bovine adrenal medullary chromaffin cells (Tachikawa, 2004).
BACOPA (BACOPA MONNIERI):
Rai and colleagues (2003a) showed that a dose of 40 mg/kg of a standardized extract reversed stress-induced ulcer development, and higher doses (80 mg/kg) additionally prevented increases in adrenal gland weight in rats.
ELEUTHERO (ELEUTHEROCOCCUS SENTICOSIS):
Water extracts high in isofraxidin and eleutherosides B and E (especially E) reduced corticosterone levels in stressed mice (Kimura, 2004). On the contrary, in human athletes, Eleuthero slightly worsened a hormonal indicator of stress after 6 weeks of training. The athletes were administered 8 mL daily of a 33% hydroethanolic extract (Gaffney, 2001).
CORDYCEPS (CORDYCEPS SINENSIS):
This herb is not a well known adaptogen; nonetheless, one laboratory animal study suggests that it may have antistress properties. A hot water extract was administered to stressed rats (150 mg/kg daily), and investigators found that stress-induced changes in adrenal and thyroid gland weights, as well as changes in cholesterol and alkaline phosphatase, were suppressed (Koh, 2003).
ASHWAGANDHA (WITHANIA SOMNIFERA):
A standardized extract given to rats at 25 mg/kg and 50 mg/kg suppressed stress-induced changes in blood glucose levels, glucose intolerance, corticosterone levels, gastric ulceration, immunosuppression, and mental depression (Bhattacharya, 2003). A single withanolide, as well as a withanolide-free fraction, has shown adaptogenic activity in stress models (Kaur, 2003; Singh, 2003a).
RHODIOLA (RHODIOLA ROSEA):
Russian studies have long suggested that the root of this plant has adaptogenic activity. Two double-blind, placebo-controlled human clinical trials used an extract of Rhodiola and found significant improvements in cognitive functions, fatigue, and “neuromotoric tests” (Spasov, 2000; Darbinyan, 2000).
Blood Tonics
DANG GUI, DONG QUAI (ANGELICA SINENSIS):
This is a traditional Chinese herb that is used to tonify as well as “invigorate” the blood. A case report in a human kidney patient with anemia who was resistant to erythropoietin treatment indicated that treatment with this herb improved hematologic measures (Bradley, 1999). Wang (2001) found that dang gui improved measures of erythrocyte deformability and fragility.
REHMANNIA (REHMANNIA GLUTINOSA):
In traditional Chinese medicine, this herb is used to “cool” the Blood and is an important herb in treating Yin deficiency, which is seen, for example, in patients with diabetes. However, one Chinese study suggested that in people with chronic aplastic anemia, Rehmannia root could improve symptoms and recovery (Yuan, 1998). In anemic mice, the root appeared to enhance replication of certain bone marrow progenitor cells (Yuan, 1992).
RHODIOLA (RHODIOLA ROSACEA):
This is a European and Asian plant that has been used traditionally to treat anemia. In vitro studies have suggested that it protects human erythrocytes from damage caused by glutathione depletion and hemolysis that occurs via oxidation (De Sanctis, 2004). An extract appeared to stimulate replication of mouse bone marrow cells in vitro as well (Udintsev, 1991).
Immune Modulators
A Medline search on “immune” and “herbal” would suggest that a legion of plants may stimulate some aspect of immune function. The problem here is that most studies have been conducted in vitro or at best in experimental animals and most of these plants have not been used traditionally for immune support. The herbs described below give researchers plenty to explore and are those that are deemed most useful by herbalists. Immune stimulant herbs have been implicated in reactivation or worsening of autoimmune disease, and they should be used with caution in these patients (Lee, 2004c).
MEDICINAL FUNGI:
These are very likely to work in similar ways. Individual fungi are listed here:
All these fungi contain polysaccharide complexes and sterols that appear to enhance cell-mediated immune function and that may have antitumor activity as well (Ooi, 2000; Wasser, 1999; Zhu, 1998b). Still, structural differences have been noted in some of the primary constituents, and it is possible that their activities in vivo are somewhat different. As a rule, polysaccharide complexes such as those found in medicinal fungi are more likely to be completely extracted in aqueous or dried preparations than in alcohol extracts.
ECHINACEA (ECHINACEA SPP):
Extracts have been shown to increase phagocytic activity in human peripheral monocytic cells, to promote production of various cytokines, and to enhance natural killer cell function, all of which involve the innate immune system as opposed to specific, adaptive processes. Most clinical studies in humans have involved upper respiratory infection and, in fact, Echinacea may shorten the duration of the common cold (Percival, 2000), depending on the form administered. Echinacea is often recommended for chronic recurrent viral upper respiratory infection in cats, and some practitioners use Echinacea to treat patients with retroviral infection. Although some practitioners caution against the long-term use of Echinacea because toxicity or autoimmune conditions may result, this concern has not been well documented. However, immunostimulants are probably best used as pulsed treatments if they are administered on a long-term basis, because full response to treatment is probably reached in a few weeks and does not continue to increase. In a 4-day observational study conducted at the Ohio Eclectic College in 1935, students were administered Echinacea before meals and at bedtime. Leukocyte counts increased 24 to 48 hours after initiation of treatment. Short-term (2- to 4-week), on-off administration is most sensible. The Echinacea monograph (see Chapter 24) describes studies in swine and horses that suggest immune modulating effects in these species.
ASTRAGALUS (ASTRAGALUS MEMBRANACEUS):
This traditional Chinese herb has been shown to increase T cell–mediated immune function in vitro in mice, as well as in uncontrolled trials in humans (Zhao, 1990; Sun, 1983; Yoshida, 1997).
GINSENG POLYSACCHARIDES AND SAPONINS:
These have shown immunostimulating capacity in vitro and in animal models (Kitts, 2000). In one study, rats with chronic Pseudomonas aeruginosa lung infection were administered extracts of Panax ginseng; the treated group exhibited higher bacterial clearance and lower serum immunoglobulin levels than did the untreated group, which suggests enhancement of cell-mediated immunity (Song, 1998).
THUNDER GOD VINE (TRIPTERYGIUM WILFORDII):
This herb appears to be a true immune suppressant. Extracts of this plant have been investigated in human clinical trials for the treatment of rheumatoid arthritis, myasthenia gravis, lupus erythematosus, graft rejection, asthma, and other immune-mediated problems, generally with positive results (Tao, 2000; Tao, 2002). Various trials have shown reductions in interleukin (IL)-6, IL-5, IL-2, NF-kappaB, and CD 4+ levels, caused by an extract or by single constituents such as triptolide. In one trial, it was effective for rheumatoid arthritis when applied topically (Cibere, 2003). The plant has some toxicity, most notably causing infertility in both males and females.
OTHER HERBS:
Hemidesmus indicus and Tylophora indica may also have immune suppressant activity. The effect of an ethanolic extract of each herb was studied on delayed-type hypersensitivity, humoral response to sheep red blood cells, skin allograft rejection, and phagocytic activity of the reticuloendothelial system in mice. Tylophora indica appeared to stimulate phagocytic function while inhibiting the humoral component of the immune system. Hemidesmus indicus suppressed both cell-mediated and humoral components of the immune system (Atal, 1986).
Antihyperlipidemics
GARLIC (ALLIUM SATIVUM):
This herb has shown modest efficacy in lowering cholesterol and triglyceride levels in laboratory animals and people (Ackermann, 2001). Garlic has the potential for causing Heinz body anemia in dogs and especially in cats. Many veterinarians, however, use garlic for their patients and monitor blood parameters.
RED YEAST RICE (MONASCUS PURPUREUS):
This is a natural statin that has been shown to reduce cholesterol and triacylglycerol concentrations in controlled trials in humans (Heber, 1999). Similar to other statins, it may cause rhabdomyolysis. This author (SW) has observed a case of rhabdomyolysis in a dog who was being treated with both red yeast rice and gemfibrozil.
GUGULIPID (COMMIPHORA MUKUL):
This herb contains resins that have been shown to have cholesterol- and triglyceride-lowering activity in humans (Singh, 1994) and laboratory animals. However, the overall effect is mild to moderate compared with cholesterol-lowering drugs used in people (Caron, 2001).
GLOBE ARTICHOKE (CYNARA SCOLYMUS):
This herb has been shown in human clinical trials to lower cholesterol and triglycerides, at doses ranging from 900 to 1920 mg per day. Globe artichoke leaf extract not only increases choleresis and, therefore, cholesterol elimination, but it also has been shown to inhibit cholesterol biosynthesis (Kraft, 1997b). It is suggested that a possible mechanism of action might be the indirect inhibition of hydroxymethylglutaryl–CoA reductase (HMG-CoA) (Gebhardt, 1998). In vitro studies have documented a concentration-dependent inhibition of de novo cholesterol biosynthesis in cultured rat and human hepatocytes for globe artichoke leaf extract given at 0.03 to 0.1 mg/mL (Petrowicz, 1997).
Hemostatics
YUNNAN PAI YAO (WHITE MEDICINE FROM YUNNAN PROVINCE):
This is the most popular Chinese herbal formula in veterinary medicine for the control of hemorrhage. The formula contains San qi (Panax notoginseng), an herb that has a reputation for being able to stop bleeding anywhere in the body. Other herbs in the formula (according to the label on a box purchased in 2005) are Ajuga patantha, Dioscorea opposita, Dioscorea nipponica, Erodium stephanianum, Alpinia officinarum, and Dryobalanops aromatica (or Blumea balsamifera). The formula is often guarded, and labels don’t always provide an ingredient list, but it always contains pseudoginseng (San Qi or Tienchi) Panax pseudoginseng, and variously Chinese yam (Dioscorea opposita), yam rhizome (Dioscorea hypolglauca), sweet geranium (Erodium stephanianum) and galangal rhizome (Alpinia officinarum) (Polesuk, 1973). Yunnan bai yao has been shown to decrease both clotting times and prothrombin times (Ogle, 1977) and to initiate platelet release (Chew, 1977).
OTHER HERBS:
A Chinese herbal formula, Wen-She decoction (WSD), resolved acute upper digestive tract hemorrhage in an open sequential controlled trial. It was concluded that WSD was an excellent treatment for hemorrhage of the upper digestive tract. WSD consists of Codonopsis pilosa, Atractylodes macrocephala, Poria cocos, Glycyrrhiza uralensis, Zingiber officinale, Os sepia, Halloysitum rubrum, and Astragalus membranaceus (Gong, 1989).
REVIEW OF SPECIFIC HEMATOLOGIC AND IMMUNOLOGIC CONDITIONS
Anemia, General
Therapeutic rationale
A prescription for anemia might include the following:
Dang gui | 33% (circulatory stimulant, anti-inflammatory, vasodilator, antiallergic, warming) |
Rhodiola | 33% (immune modulating, adaptogen) |
System- or organ-specific herb | 33% (such as an astringent for gastrointestinal tract bleeding) |
Autoimmune Disorders, General
Therapeutic rationale
Aside from Thunder God Vine, which has significant toxicity and is not widely available, few herbs address autoimmune disorders as a general class of medicine. Hemidesmus indicus, Tylophora indica, and Stephania tetrandra are immune suppressants that must be used very carefully by experienced herbalists. Ideally, the prescription addresses the underlying or perpetuating factors that contribute to the pathophysiology. Autoimmune disease may be precipitated by viral infection, so antiviral herbs may need to be used. Prescriptions generally include anti-inflammatory herbs, as well as those that address specific organ involvement and “leaky gut” (see later section on dermatologic herbs for more information). Herbs that enhance elimination should also be included. Immune-modulating herbs described earlier as immune stimulant are not always inappropriate but should be chosen with special attention to all of their purported effects. Focusing on maintaining systemic health rather than on suppressing the immune system is a worthwhile strategy, and herbal medicine is particularly useful when combined with the conventional treatment of autoimmune disease.
A prescription for autoimmune disease support follows:
Rehmannia | 40% |
Bupleurum | 20% |
Milk thistle | 20% |
Bilberry | 20% |
Hyperlipidemia
Therapeutic rationale
A prescription for hyperlipidemia (1) follows:
Garlic | 5% |
Guggul | 30% |
Reishi | 25% |
Dandelion | 15% |
Calamus | 15% |
Prickly ash | 10% |
A prescription for hyperlipidemia (2) is presented here:
Globe artichoke | 60% |
Dandelion root | 30% |
Garlic | 10% |
Nonspecific Sign | Herb |
---|---|
Bleeding gums | Bilberry, Witch hazel |
Hematemesis | Cranesbill, Yunnan pai yao |
Hematuria | Yunnan pai yao, Rehmannia, Trillium |
Hemoptysis | Bugleweed, Yunnan pai yao, Cinnamon |
Gastric hemorrhage | Yarrow, Atractylodes, Agrimony, Plantain, Shepherd’s purse, Cranesbill |
Immune Deficiency or Suppression
Therapeutic rationale
Patients with poor immunity should be prescribed herbs from three main groups:
Echinacea and Astragalus are two of the most popular “immune” herbs in human herbal medicine. Echinacea improves phagocytosis and generally enhances immune surveillance. It must be used in high doses during acute infections, such as infected wounds or viral infections. In humans, doses of 20 to 30 mL per day can be taken; it takes about 3 days for phagocytic activity to peak. Many studies that detract from the benefits of Echinacea are flawed by incorrect dosing and improper extract type. Echinacea can be used for chronic bacterial and viral infections, postviral syndromes, acquired immunodeficiency syndrome resulting from feline leukemia virus (FAIDS), in the appropriate formulas, autoimmune disease and long-term allergies and intolerances. It can be used during chemotherapy or pneumonia, and for chronic purulent or pyodermic skin infection—at relatively high doses in all cases (in humans, 15 mL per day for serious chronic states of immune deficiency). Doses as high as 40 mL on the first day followed by 16 mL daily were used in one positive clinical trial (Goel, 2004). Astragalus, on the other hand, is more appropriately used as a preventive measure during disease outbreaks or for chronic immune incompetence and autoimmune disease (especially nephritis). The dose in humans is between 20 and 40 mL per week. High dosing in the case of Echinacea is an important consideration because it does influence efficacy.
A prescription for general immune support follows:
Echinacea | 40% |
Oregon grape root | 20% |
Astragalus | 20% |
Licorice | 20% |
Infection
Herbal management of infections should include the following:
Thrombocytopenia
Sheng xue ling
One formula that may be useful in treating idiopathic thrombocytopenic purpura is Sheng xue ling (SXL). In an open study in China, 86 human cases of ITP were divided randomly into two groups. A total of 56 patients were treated with SXL, and 30 patients were administered prednisone, each for 3 months. In the SXL group, the “total effective rate” at 3 months was 85.71%, similar to prednisone (83.33%), but at 6 months, efficacy for SXL was greater (91.07%) than that of the prednisone group (53.33%), without adverse reactions. Bleeding was alleviated; blood platelet count was increased; platelet-associated immunoglobulin and IL-4 dropped; natural killer cell activity increased; and T lymphocyte subsets gradually returned to normal level. All differences described here were statistically significant. The mechanism by which the formula might work was not identified (Zhou 2005).
HERBS FOR CANCER
General Considerations
Many chemotherapeutic drugs currently in use in medicine were first identified in plants, including taxol, vinblastine and vincristine, and etoposide and teniposide (Boik, 1996). Herbs offer a rational potential in the treatment of cancer in animals; however, it is important to note that herbs may be used for purposes other than direct antitumor activity. On the other hand, just about any selection of herbs prescribed to treat a patient will more than likely have some anticancer activity because of the presence of widely occurring anticancer constituents like flavonoids.
Although little research has been conducted in cats and dogs specifically, a plethora of research pertains to rats, mice, hamsters, and guinea pigs. At least pocket pets are amply catered to if they are diagnosed with cancer! Herbs can be used to help manage the effects of chemotherapy; to assist in recuperation after chemotherapy, radiation, or surgery; to complement conventional cancer treatment; to provide an alternative to conventional treatment in some cases; to assist in cancer prevention; and to support various systems that are affected by cancer. One of the approaches used by veterinary herbalists is to treat cancer as a chronic disease, with emphasis on improving the health of the whole body, regardless of the presence of cancer. Anecdotal evidence from veterinary herbalists indicates that herbs offer improved quality of life and may support remission in some cases.
The rational use of herbal medicine for the treatment of patients with cancer depends on a growing understanding of the biological mechanisms by which cancer cells proliferate, maintain life, and die. These include differentiation (the maturation process of cells), angiogenesis (the growth of new blood vessels into tumors), apoptosis (programmed cell death), invasion (the spread of the tumor mass into adjacent tissue), metastasis (the spread of tumor cells to distant locations), mitosis (the proliferation of cells), and evasion of the immune system. As these mechanisms have become elucidated, their weak points have been identified and have become the targets of research that is both conventional and complementary (Boik, 1996). The selection of several herbs that have different mechanisms of action provides a broad spectrum of anticancer activity. A holistic strategy that incorporates all elements discussed here is proposed under “Review of Strategies for Cancer Prescriptions” at the end of this section.
Adaptogens
ASTRAGALUS (ASTRAGALUS MEMBRANACEUS):
Astragalus induces cell differentiation and cell death in vitro (Cheng, 2004) and exerts anticarcinogenic effects through activation of cytotoxic activity and the production of cytokines in mice (Kurashige, 1999).
ASHWAGANDHA (WITHANIA SOMNIFERA):
The antitumor and radiosensitizing effects of Withania have been studied. Growth of carcinoma in mice was inhibited and survival increased with Withania treatment, especially when it was combined with radiation (Sharada, 1996). When given before irradiation, it synergistically increased survival, even in mice with advanced tumors (Devi, 1995). Complete regression of sarcoma in mice caused by Withania root extract was observed (Devi, 1992).
ELEUTHERO (ELEUTHEROCOCCUS SENTICOSIS):
This herb was able to inhibit tumor growth and prolong survival time in tumor-bearing mice; these effects were significantly related to enhanced immune response (Xie, 1989). Siberian ginseng appeared to reduce the quantity of conventional antimetabolites that were needed to attain antiproliferative effects on tumor cells in vitro (Hacker, 1984).
Immune Modulators
Anticancer Mechanism of Selected Herbs and Constituents
Apoptosis Inducers
Inhibitors of Angiogenesis
Inhibitors of Local Invasion
CORDYCEPS (CORDYCEPS SINENSIS):
Controlled, open-label clinical studies have found that Cordyceps appeared to restore immune cell function in patients with advanced cancer who were given conventional cancer therapies (Zhou, 1995; Zhu, 1998b). Of 59 patients with advanced lung cancer, 95% were able to complete chemotherapy and radiotherapy with the use of Cordyceps compared with 64% of controls. More than 85% of Cordyceps-treated patients showed more normal blood cell counts versus 59% of controls (Zhu, 1998b). A study in patients with various types of tumors found that a cultured mycelium extract of Cordyceps (6 g/d for over 2 months) improved subjective symptoms in most patients. White blood cell counts were maintained at <3000/mm3, and tumor size was significantly reduced in approximately half of patients (Zhu, 1998b).
ECHINACEA (ECHINACEA PURPUREA):
Mice who received dietary Echinacea daily throughout life, from youth until late middle age, demonstrated significant longevity/survival differences, as well as differences in various populations of immune/hematopoietic cells. Key immune cells, acting as the first line of defense against developing neoplasms and natural killer (NK) cells, were significantly elevated in absolute number in their bone marrow production site, as well as in the spleen. Cells of the myeloid/granulocyte lineages remained at control levels in the bone marrow and the spleen in Echinacea-consuming mice. Thus, it appears that regular intake of Echinacea may indeed be beneficial or prophylactic because it maintains elevated levels of NK cells, which are elements in immunosurveillance against spontaneously developing tumors (Brousseau, 2005).
ASTRAGALUS (ASTRAGALUS MEMBRANACEUS):
The efficacy of this herb in enhancing quality of life and reducing the toxicity of chemotherapy in human patients with malignant tumors was investigated. Astragalus (by injection) supplemented by chemotherapy was noted to inhibit the development of tumors, decrease the toxic or adverse effects of chemotherapy, elevate immune function, and improve quality of life in treated patients (Duan, 2002).
ASHWAGANDHA (WITHANIA SOMNIFERA):
This herb demonstrates antitumor properties in mice and protects against induced carcinogenic effects. It also reverses the adverse effects of a carcinogen (urethane) on total leukocyte count, lymphocyte count, body weight, and mortality (Singh, 1986). Significant increases in hemoglobin; red blood cell, white blood cell, and platelet count; and body weight were observed in cyclophosphamide-, azathioprine-, and prednisolone-treated mice that were given Withania versus controls (Ziauddin, 1996).
OTHER HERBS
Alteratives
Alteratives include the herbs listed here:
BURDOCK (ARTICUM LAPPA):
Differentiation-inducing activities have been demonstrated against mouse myeloid leukemia cells. The most active derivative induced more than half of leukemia cells to become phagocytic cells (Umehara, 1996).
DANDELION ROOT (TARAXACUM OFFICINALE):
In vitro antitumor activity has been documented for an aqueous extract of dandelion. The mechanism of action was thought to be similar to that of tumor polysaccharides such as lentinan (Baba, 1981).
SHEEP SORREL (RUMEX ACETOSELLA):
One study found that Rumex acetosella polysaccharide displayed antitumor activity in mice that were implanted with sarcoma (180 solid tumors) (Ito, 1986).
OREGON GRAPE (MAHONIA AQUIFOLIUM):
Berberine has anticancer activity and exhibits the ability to induce apoptosis in leukemia cells (Kuo, 1995; Yang, 1996). In addition, some protoberberines are highly effective as cytotoxic agents against several carcinoma lines; berberine consistently showed the highest cytotoxicity among the alkaloids tested (Cernakova, 2002).
Antioxidants
GREEN TEA (CAMELLIA SINENSIS):
Green tea polyphenols in mice increased antioxidant levels and glutathione peroxidase, catalase, and quinine reductase in skin, small bowel, liver, and lungs. These combined activities make green tea an effective chemopreventive agent against the initiation, promotion, and progression of multistage carcinogenesis (Katiyar, 1997). Human clinical trials suggest that the concentrated extract EGCG (epigallocatechin gallate), dosed at approximately 200 mg daily, is most efficient at improving blood antioxidant levels.
REDGRAPE (VITIS VINIFERA):
Resveratrol, a phytoalexin found in red wine, inhibits the metabolic activation of carcinogens, has antioxidant and anti-inflammatory properties, decreases cell proliferation, and induces apoptosis (Bianchini, 2003; Granados-Soto, 2003). Oligomeric proanthocyanidins (OPCs) increased NK cell cytotoxicity, modulated levels of interleukins from immune compromised mice (including those infected with retrovirus) (Cheshier, 1996), and demonstrated antimutagenic activity in vitro (Seo, 2001).
HAWTHORN (CRATAEGUS SPP):
Crataegus contains OPCs, and much of what is known about grape seed extract applies to Crataegus.
MILK THISTLE (SILYBUM MARIANUM):
Silymarin and silibinin (silybin) are antioxidants that react with free radicals, transforming them into more stable, less reactive compounds (Morazzoni, 1995). The cancer chemoprevention and anticarcinogenic effects of silymarin have been shown to be caused by its major constituent, silibinin (Bhatia, 1999). Its antitumor effect occurs primarily at stage I tumor promotion; silymarin may act by inhibiting COX-2 and IL-1α (Zhao, 1999). Such effects may involve inhibition of promoter-induced edema, hyperplasia, the proliferation index, and the oxidant state (Lahiri-Chatterjee, 1999). Silibinin may also have anti-angiogenic effects (Yang, 2005; Singh, 2005).
TURMERIC (CURCUMA LONGA):
The abilities of turmeric to scavenge radicals, reduce iron complex, and inhibit peroxidation may explain the possible mechanisms by which turmeric exhibits its beneficial effects in medicine (Tilak, 2004). The anticancer properties of curcumin have been demonstrated in cultured cells and animal studies. Curcumin inhibits lipoxygenase activity and is a specific inhibitor of COX-2 expression. It halts carcinogenesis by inhibiting cytochrome P450 enzyme activity and increasing levels of glutathione-S-transferase (Chauhan, 2002).
DAN SHEN (SALVIA MILTIORRHIZA):
Dan shen is a potent antioxidant that demonstrates free radical scavenging activity (Xia, 2003). Recent studies showed that one of its tanshinone constituents possesses cytotoxic activity against many kinds of human carcinoma cell lines, induces differentiation and apoptosis, and inhibits invasion and metastasis of cancer cells. Its mechanisms are believed to be inhibition of DNA synthesis and proliferation of cancer cells; regulation of the expression of genes related to proliferation, differentiation, and apoptosis; inhibition of the telomerase activity of cancer cells; and change in the expression of cellular surface antigen (Yuan, 2003).
BILBERRY (VACCINIUM MYRTILLUS):
The anthocyanosides in bilberry inhibit protein and lipid oxidation (Morazzoni, 1995). Components of bilberry have been reported to exhibit potential anticarcinogenic activity in vitro, as demonstrated by inhibition of the induction of ornithine decarboxylase (ODC) by the tumor promoter phorbol 12-myristate 13–acetate (TPA) (Bomser, 1996).
SCHISANDRA (SCHISANDRA CHINENSIS):
Schisandra lignans act as free radical scavengers and inhibit iron-induced lipid peroxidation and superoxide anion production (Lu, 1992). Geranylgeranoic acid, a constituent of Schisandra, has been shown to induce apoptosis in a human hepatoma–derived cell line (Shidoji, 2004).
GINKGO (GINKGO BILOBA):
This leaf extract has significant antioxidant activity because of its flavonoid and terpenoid components. Recent studies with various models show that the anticancer properties of Ginkgo are related to antioxidant, antiangiogenic, and gene-regulatory actions. Antiangiogenic activity may involve antioxidant activity and the ability to inhibit both inducible and endothelial forms of nitric oxide synthase. Exposure of human breast cancer cells to a Ginkgo extract altered expression of the genes involved in the regulation of cell proliferation, cell differentiation, or apoptosis. Exposure of human bladder cancer cells to a Ginkgo extract produces an adaptive transcriptional response that augments antioxidant status and inhibits DNA damage. Flavonoid and terpenoid constituents of Ginkgo extracts may act in a complementary manner to inhibit several carcinogenesis-related processes; therefore, the total extracts may be required for optimal effects (DeFeudis, 2003).
GINGER (ZINGIBER OFFICINALE):
Some pungent constituents in ginger and other zingiberaceous plants such as gingerol have potent antioxidant and anti-inflammatory effects, and some of them exhibit antitumor promotional activity in experimental carcinogenesis (Surh, 1998). The chemopreventive effects are probably associated with antioxidative and anti-inflammatory activities (Surh, 1998).
ROSEMARY (ROSMARINUS OFFICINALIS):
Several extracts and constituents of rosemary have exhibited antioxidant activity (ESCP, 1999). The volatile oil was reported to be toxic to leukemia cells (Ilarionova, 1992). Topical administration of a methanol extract 5 minutes before application of carcinogens to the dorsal surface of mice reduced the irritation and promotion of tumors. Application of rosemary extract before carcinogen application reduced the formation of metabolite–DNA adducts by 30% and 54%, respectively (Huang, 1994). In rats, dietary supplementation with 1% rosemary extract for 21 weeks reduced the development of induced mammary carcinoma in the treated group, compared with the control group (40% vs 75%, respectively) (Singletary, 1991).
Anticachectic Activity
COPTIS (COPTIS CHINENSIS):
This herb was investigated in mice bearing colon carcinoma cells that cause IL-6–related cachexia after cell injection. Coptis significantly attenuated weight loss in tumor-bearing mice compared with controls, without changing food intake or tumor growth. It was therefore shown to exert an anticachectic effect associated with tumor IL-6 production, and it was suggested that this effect might be due to berberine (Iizuka, 2002).
Anticancer Action by Organ/System
Respiratory system: small cell lung carcinoma
GRAPE SEED (VITIS VINIFERA):
Oral administration of grapeseed extract reduced the number of metastatic nodules induced in mice by 26.07% compared with a control group treated with ethanol (Martinez 2005).
GREEN TEA AND BLACK TEA (CAMELLIA SINENSIS):
Consumption of tea (Camellia sinensis) has been suggested to prevent cancer, heart disease and other diseases. Animal studies have shown that tea and tea constituents inhibit carcinogenesis of the skin, lung, oral cavity, esophagus, stomach, liver, prostate and other organs (Lambert 2003). For example, mice were given decaffeinated green or decaffeinated black tea in their drinking water before, during, and after treatment with a carcinogen. Mice that received 0.63% or 1.25% green tea, or 1.25% black tea, exhibited a reduction in liver tumor numbers of 54%, 50%, and 63%, and a decrease in the mean number of lung tumors of 40%, 46%, and 34%, respectively, compared with controls (Cao 1996). In some experiments, reduction in tumor number and size has been observed in the tea-treated groups; in other experiments, decreased tumor incidence has also been observed (Yang 2005). Black tea preparations have been shown to reduce the incidence and number of spontaneously generated lung adenocarcinomas and rhabdomyosarcomas in mice; they also were noted to inhibit the progression of lung adenoma to adenocarcinoma. In many of these experiments, tea consumption resulted in reduced body fat and body weight; these factors may also contribute to the inhibition of tumorigenesis (Yang, 2005).