Abstract

Symphytum officinale, commonly known as comfrey, constitutes a traditional medicinal plant with a long-standing therapeutic history, and preparations thereof have been widely used for the treatment of painful muscle and joint complaints, wound and bone healing, and inflammation. Today, its topical use is based on its analgesic and anti-inflammatory effects, which have been substantiated by modern clinical trials. However, the molecular basis of its action remained elusive. Here, we show that a hydroalcoholic extract of comfrey root impairs the development of a pro-inflammatory scenario in primary human endothelial cells in a dose-dependent manner. The extract, and especially its mucilage-depleted fraction, impair the interleukin-1 (IL-1) induced expression of pro-inflammatory markers including E-selectin, VCAM1, ICAM1, and COX-2. Both preparations inhibit the activation of NF-κB, a transcription factor of central importance for the expression of these and other pro-inflammatory genes. Furthermore, our biochemical studies provide evidence that comfrey inhibits NF-κB signaling at two stages: it dampens not only the activation of IKK1/2 and the subsequent IκBα degradation, but also interferes with NF-κB p65 nucleo-cytoplasmatic shuttling and transactivation. These results provide a first mechanistic insight into the mode of action of a century-old popular herbal medicine.

Highlights

  • Symphytum officinale (Boraginaceae), well known as comfrey, represents a plant with an impressive record of medicinal use

  • To investigate if comfrey may act through additional mechanisms, we performed immunofluorescence staining for p65 (RelA) translocation into the nucleus after stimulation with IL-1

  • In comfrey-treated cells, the transcription factor was retained in the nucleus at 90 min, suggesting that the extract interferes with nuclear export (Figure 5A)

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Summary

Introduction

Symphytum officinale (Boraginaceae), well known as comfrey, represents a plant with an impressive record of medicinal use. Native in Europe, it has been used for centuries for the treatment of a variety of painful muscle and joint complaints (Staiger, 2012; Frost et al, 2013). Phenolic compounds have been reported to exert anti-inflammatory effects both in vitro and in vivo (Chen et al, 2018). Comfrey was proven effective for the treatment of, e.g., acute upper and lower back pain, gonarthrosis, or for patients with blunt injuries (Koll et al, 2004; Predel et al, 2005; Grube et al, 2007; Giannetti et al, 2010). Its application is shown to significantly reduce pain and swelling, contribute to tissue regeneration, and result in a more rapid functional improvement. An assessment from the German Commission E resulted in the positive evaluation

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