Echinacea Group Research Articles

Echinacea as a Potential Force against Coronavirus Infections? A Mini-Review of Randomized Controlled Trials in Adults and Children.

Echinacea purpurea has been shown to broadly inhibit coronaviruses and SARS-CoV-2 in vitro. This review discusses the available clinical evidence from randomized, blinded and controlled human studies. Two RCTs capturing incidence of viral respiratory tract infections during Echinacea preventative treatment were identified including coronavirus infections. Incidence and/or viral loads were measured by RT-PCR and symptom severity was recorded. In a first study, Jawad et al. collected nasopharyngeal swabs from adults (N = 755) over 4 months of continuous prevention. Overall, 24 and 47 enveloped virus infections occurred, including 21 and 33 coronavirus detections (229E; HKU1; OC43) with Echinaforce® extract (2400 mg daily) and placebo, respectively (p = 0.0114). In a separate study, Ogal et al. administered the same extract (1200 mg) or control for 4 months to children (4–12 years) (N = 203). Echinacea reduced the incidence of enveloped virus infections from 47 to 29 (p = 0.0038) whereas 11 and 13 coronavirus detections (229E, OC43, NL63) were counted (p > 0.05). Respiratory symptoms during coronavirus infections were significantly lower with area-under-curve AUC = 75.8 (+/−50.24) versus 27.1 (+/−21.27) score points (p = 0.0036). Importantly, viral loads in nasal secretions were significantly reduced by 98.5% in the Echinacea group, with Ct-values 31.1 [95% CI 26.3; 35.9] versus 25.0 [95% CI 20.5; 29.5] in the control group (p = 0.0479). Results from clinical studies confirm the antiviral activity found for Echinacea in vitro, embracing enveloped respiratory pathogens and therefore coronaviruses as well. Substantiating results from a new, completed study seem to extrapolate these effects to the prevention of SARS-CoV-2 infections. As hypothesized, the established broad antiviral activity of Echinacea extract appears to be inclusive for SARS-CoV-2.

Comparing the Effect of Echinacea and Chlorhexidine Mouthwash on the Microbial Flora of Intubated Patients Admitted to the Intensive Care Unit.

Background:Providing intubated patients admitted to the intensive care units with oral healthcare is one of the main tasks of nurses in order to prevent Ventilator-Associated Pneumonia (VAP). This study aimed at comparing the effects of two mouthwash solutions (echinacea and chlorhexidine) on the oral microbial flora of patients hospitalized in the intensive care units.Materials and Methods:In this clinical trial, 70 patients aged between18 and 65 years undergoing tracheal intubation through the mouth in three hospitals in Arak, were selected using simple random sampling and were randomly divided into two groups: the intervention group and the control group. The oral health checklist was used to collect the data (before and after the intervention). The samples were obtained from the orally intubated patients and were then cultured in selective media. Afterwards, the aerobic microbial growth was investigated in all culture media. The data were analyzed using SPSS software.Results:The microbial flora in the echinacea group significantly decreased after the intervention (p < 0.0001) and it was also the case withmicrobial flora of the patients in the chlorhexidine group (p < 0.001). After 4 days, the oral microbial flora of the patients in the intervention group was lower than that of the patients in the control group (p < 0.001).Conclusions:The results showed that the echinacea solution was more effective in decreasing the oral microbial flora of patients in the intensive care unit. Given the benefits of the components of the herb Echinacea, it can be suggested as a viable alternative to chlorhexidine.

Rabbit dietary supplementation with pale purple coneflower. 1. Effects on the reproductive performance and immune parameters of does

Echinacea pallida (EPAL), also known as pale purple coneflower, is a herbaceous flowering plant with immune-enhancement and antioxidative properties. The effect of EPAL on the reproductive performance, serum biochemistry and haematological parameters of rabbit does has been studied here. A total of 100, 21-week-old Grimaud rabbit does, were randomly assigned to two groups. One group was fed a basal diet supplemented with 3 g EPAL/kg diet (Echinacea group, E), while the other was fed the basal diet without the supplementation (control group, C). The reproductive performance of the does was not affected by the treatment (P>0.05). The haematological parameters of pregnant rabbits showed that there was no interaction between gestation day and treatment. The EPAL supplementation induced a reduction (−47.3%) in the basophil cell rate (0.55% and 0.29%, for the control and treatment groups, respectively; P=0.049). The gestation day significantly affected most of the haematological parameters (P<0.05). The white blood cell counts declined progressively after day 14. The mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red cell distribution width, mean platelet volume and eosinophils increased steadily throughout the study, and reached a maximum value on day 28. The red blood cells, haemoglobin, haematocrit, mean corpuscular volume and neutrophils increased slightly up to day 14, and then subsequently decreased progressively until day 28. The lymphocytes and platelet distribution width decreased until day 14, and then increased to a maximum value on day 28. No significant effect of gestation day or treatment was observed on the blood serum chemistry. As far as the immune parameters are concerned, no significant differences were observed between groups, while a significant effect of gestation day was observed for lysozymes (6.02 v. 7.99 v. 1.91; for 0, 14 and 28 days, respectively; P=0.014). In conclusion, a lack of effect of EPAL has been observed. In fact, no impacts of EPAL have been observed on the reproductive or haematological parameters of the does. The effects of dietary supplementation with EPAL on the performances, bacterial community, blood parameters and immunity in growing rabbits are reported in the second part of this study.

Rabbit dietary supplementation with pale purple coneflower. 2. Effects on the performances, bacterial community, blood parameters and immunity of growing rabbits

Echinacea pallida (EPAL), a herbaceous flowering plant with immunomodulatory properties, has been chosen to determine the pre- and post-supplementary effects on the growth performances, bacterial community, blood parameters and immunity of growing rabbits. The same Grimaud does (14-week-old) from the studied in the first part of this study were randomly divided into two groups (n=50/group). The first group was fed a basal diet without supplementation (Control group, C) while the another group was fed a basal diet supplemented with 3 g EPAL/kg diet (Echinacea group, E). From the second parturition, 80 weaned kits (40 from the C does and 40 from the E does) were randomly assigned to four groups of 20 animals each and were fed a growing commercial diet supplemented with or without a 3 g EPAL/kg diet: the CC group (rabbits from the C does fed the control diet), CE group (rabbits from the C does fed the supplemented diet), EC (rabbits from the E does fed the control diet) and EE group (rabbits from the E does fed the supplemented diet). The dietary EPAL treatment did not affect the growth performance. Ten fattening rabbits from each group were selected to evaluate the bacterial community and blood parameters, while the remaining rabbits (n=10/group) were used to study phagocytosis and the humoral immune response. The variability was evaluated from hard faeces at 35, 49 and 89 days, and the caecal content at 89 days. The variability of the bacterial community of the EE group was higher than that of the other groups. The phagocytic activity was higher in the CE and EE groups than in the CC and EC ones (30.9 and 29.7 v. 21.2 and 21.8%; P<0.05), whereas no statistically significant difference was observed for the blood parameters or humoral immune response against vaccination (rabbit haemorrhagic disease virus) at 95 days old which the serum was collected at 88, 102, 109, 116 and 123 days old. In conclusion, no impact of EPAL dietary supplementation has been observed on the growth performances, bacterial community, blood parameters or humoral immune responses in growing rabbits, except for an increase in phagocytic activities.

Interaction of Ceftriaxone with Echinacea

Ceftriaxone is a third-generation cephalosporin with a broad-spectrum activity against Gram-positive and Gram-negative bacteria . Ceftriaxone induced lipid peroxidation which generated the peroxidases and hydro peroxidases. The aforementioned substances caused an immune suppression. Echinacea is a popular herbal product in North America and Europe, used as an immune-­modulatory product. The objectives of this study was to evaluate the effects of Echinacea, ceftriaxone and their combination on some immunological parameters in vaccinated rabbits, moreover to investigate the effect of Echinacea to ameliorate the side effect and immune-suppression of ceftriaxone. The experiment was carried out on twenty-five male New Zealand white rabbits .They were divided into 5 equal groups, each consisting of five rabbits (control, vaccinated with formalized killed P.multocida vaccine, vaccinated and treated with 50 mg/Kg BW Ceftriaxone I/M once daily for 5 days, vaccinated and treated with 50 mg/Kg BW Echinacea orally once daily for 5 days and vaccinated and treated with Ceftriaxone and Echinacea). Some immunological parameters had been estimated (Nitric Oxide, Lysosomal activity, Lymphocyte transformation and fractionation of serum protein. The Echinacea group was the best in all estimated parameters, while the Ceftriaxone group was the worst. Both Echinacea and ceftriaxone in a combination improved the immunological parameters. In ceftriaxone group, serum nitric oxide and serum lysozyme activity were 6.73±0.32um/ml and 139.60±2.29Ugm/ml; 6.62±0.21um/ml and 136.00±1.14Ugm/ml; 6.33±0.23um/ml and 130.80±1.02Ugm/ml at the 1 st , 2 nd and 3 rd day post vaccination, respectively. The immunological parameters were better in the combined group (14.78±0.15 γ-globulin, 14.62±0.16 β-globulin, 11.96±0.10 α-globulin, 62.09±0.05 albumin and 0.89±0.03 Lymphocyte Transformation index) when compared with the ceftriaxone group (10.22±0.17 γ-globulin, 13.13±0.16 β-globulin, 10.04±0.39 α-globulin, 60.55±0.53 albumin and 0.59±0.02 Lymphocyte Transformation index). Therefore, the current study concluded that combination of both ceftriaxone and Echinacea have a promising protective action and improving rabbit immunity, through ameliorating the obvious immune-suppression of the Ceftriaxone alone.

Randomised, Double Blind, Placebo-Controlled Trial ofEchinaceaSupplementation in Air Travellers

Objective. To identify whether a standardised Echinacea formulation is effective in the prevention of respiratory and other symptoms associated with long-haul flights. Methods. 175 adults participated in a randomised, double-blind placebo-controlled trial travelling back from Australia to America, Europe, or Africa for a period of 1–5 weeks on commercial flights via economy class. Participants took Echinacea (root extract, standardised to 4.4 mg alkylamides) or placebo tablets. Participants were surveyed before, immediately after travel, and at 4 weeks after travel regarding upper respiratory symptoms and travel-related quality of life. Results. Respiratory symptoms for both groups increased significantly during travel (P < 0.0005). However, the Echinacea group had borderline significantly lower respiratory symptom scores compared to placebo (P = 0.05) during travel. Conclusions. Supplementation with standardised Echinacea tablets, if taken before and during travel, may have preventive effects against the development of respiratory symptoms during travel involving long-haul flights.

Echinacea for Treating the Common Cold

Echinacea is widely used to treat the common cold. To assess the potential benefits of echinacea as a treatment of common cold. Randomized, controlled trial. (ClinicalTrials.gov registration number: NCT00065715) Dane County, Wisconsin. 719 patients, aged 12 to 80 years, with new-onset common cold. Patients were assigned to 1 of 4 parallel groups: no pills, placebo pills (blinded), echinacea pills (blinded), or echinacea pills (unblinded, open-label). Echinacea groups received the equivalent of 10.2 g of dried echinacea root during the first 24 hours and 5.1 g during each of the next 4 days. Indistinguishable placebo tablets contained only inert ingredients. The primary outcome was the area under the curve for global severity, with severity assessed twice daily by self-report using the Wisconsin Upper Respiratory Symptom Survey, short version. Secondary outcomes included interleukin-8 levels and neutrophil counts from nasal wash, assessed at intake and 2 days later. Of the 719 patients enrolled, 713 completed the protocol. Mean age was 33.7 years, 64% were female, and 88% were white. Mean global severity was 236 and 258 for the blinded and unblinded echinacea groups, respectively; 264 for the blinded placebo group; and 286 for the no-pill group. A comparison of the 2 blinded groups showed a 28-point trend (95% CI, -69 to 13 points) toward benefit for echinacea (P = 0.089). Mean illness duration in the blinded and unblinded echinacea groups was 6.34 and 6.76 days, respectively, compared with 6.87 days in the blinded placebo group and 7.03 days in the no-pill group. A comparison of the blinded groups showed a nonsignificant 0.53-day (CI, -1.25 to 0.19 days) benefit (P = 0.075). Median change in interleukin-8 levels and neutrophil counts were also not statistically significant (30 ng/L and 1 cell/high-power field [hpf] in the no-pill group, 39 ng/L and 1 cell/hpf in the blinded placebo group, 58 ng/L and 2 cells/hpf in the blinded echinacea group, and 70 ng/L and 1 cell/hpf in the open-label echinacea group). Higher-than-expected variability limited power to detect small benefits. Illness duration and severity were not statistically significant with echinacea compared with placebo. These results do not support the ability of this dose of the echinacea formulation to substantively change the course of the common cold. National Center for Complementary and Alternative Medicine, National Institutes of Health.

The effectiveness of a standardised Echinacea preparation in preventing colds, flus and other respiratory disorders for air-travellers

Air travel, especially on intercontinental flights can be stressful. Studies have shown that passengers' well-being is influenced by the cabin environment such as quality of cabin air, oxygen pressure in the cabin, motion or vibration and oil additives used in aircraft engines [1, 2]. Various studies have reported and investigated the occurrence of nasal dryness [3] and the increased risk of developing upper respiratory disorders such as allergic rhinitis [4] and attracting virus or bacteria induced respiratory infections [5, 6]. Studies have shown that Echinacea, one of the most widely used herbal medicines worldwide, can decrease the severity of cold symptoms and improve quality of life if used as early treatment [7-9]. Some studies also suggest positive effects for the prevention of the common cold when using Echinacea [8]. Here we report on a randomised, double-blind placebo controlled clinical trial with 183 participants who were travelling return from Australia to America, Europe or Africa for a period of 1-5 weeks on non-stop commercial flights via economy class. Participants were using coated Echinacea (standardised to 4.42mg alkylamides) or placebo tablets, and trial dosing consisted of three protocols (priming, travel and sick), depending on the phase of travel of the participants and their health status. Outcomes were assessed using a survey which included questions about upper respiratory symptoms (based on WURSS-44), quality of life (based on SF-36) and the occurrence of additional air travel related symptoms. Each participant completed this survey before travel (baseline), after travel (return) and at 4 weeks after return from travel (follow-up). Preliminary results so far indicate that at follow-up a significantly lower number of participants reported respiratory illness in the Echinacea treated group compared to placebo (P=0.02) and a significantly higher number of participants treated with Echinacea reported a 䧯od quality of life compared to placebo (P=0.005). Moreover, a significantly higher number of participants in the placebo group compared to the Echinacea group reported respiratory illness at follow-up compared to baseline (P=0.044) suggesting that the placebo group had not returned to the pre-travel level in terms of respiratory illness.

Effects of echinacea on the frequency of upper respiratory tract symptoms: a randomized, double-blind, placebo-controlled trial

BackgroundUpper respiratory tract infection symptoms are a common cause of morbidity. Herbal preparations of the plant Echinacea purpurea have immune-enhancing properties.ObjectiveTo compare the frequency of upper respiratory tract symptoms in individuals receiving E purpurea capsules and those receiving placebo to evaluate the preventive efficacy of echinacea.MethodsIn a randomized, double-blind clinical trial, 90 volunteers recruited from hospital personnel were randomly assigned to receive 3 capsules twice daily of either placebo (parsley) or E purpurea for 8 weeks during the winter months. Upper respiratory tract symptoms were reported weekly during this period.ResultsFifty-eight individuals were included in the final data analysis: 28 in the echinacea group and 30 in the placebo group. Individuals in the echinacea group reported 9 sick days per person during the 8-week period, whereas the placebo group reported 14 sick days (z = −0.42; P = .67). Mild adverse effects were noted by 8% of the echinacea group and 7% of the placebo group (P = .24).ConclusionProphylactic treatment with commercially available E purpurea capsules did not significantly alter the frequency of upper respiratory tract symptoms compared with placebo use.

A proprietary extract from the echinacea plant (Echinacea purpurea) enhances systemic immune response during a common cold

In a previous paper, it was reported that Echinilin (Factors R & D Technologies, Burnaby, British Columbia, Canada) a formulation prepared from freshly harvested Echinacea purpurea plants and standardized on the basis of three known active components (alkamides, cichoric acid and polysaccharides) is effective for the treatment of a naturally acquired common cold. However, the mechanism by which this effect is achieved remains unknown. In the present study, Echinilin or placebo were administered to volunteers at the onset of their cold for a period of 7 days, with eight doses (5 mL/dose) on day 1 and three doses on subsequent days. Fasting blood samples were obtained before and during their colds. The decrease in total daily symptomatic score was more evident in the echinacea group than in the placebo group. These effects of echinacea were associated with a significant and sustained increase in the number of circulating total white blood cells, monocytes, neutrophils and NK cells. In the later part of the cold, the echinacea treatment suppressed the cold-related increase in superoxide production by the neutrophils. These results suggest that Echinilin, by enhancing the non-specific immune response and eliciting free radical scavenging properties, may have led to a faster resolution of the cold symptoms.

Efficiency of Echinacea purpurea on performance and immune status in pigs

The aim of the present investigation was to examine the inclusion of the dried herb Echinacea purpurea (L.) MOENCH as feed additive in diets of sows, piglets, and grower/finisher pigs on growth performance, blood picture, plasma enzymes including proliferation of lymphocytes, antibody status, and protein and immune globulin content of colostrum. The control groups were supplemented with alfalfa meal. The sows (total 36) received 0%, 1.2%, or 3.6% Echinacea cobs in the diet from day 85 to day 110 of gestation and 0%, 0.5%, or 1.5% Echinacea cobs up to day 28 of lactation. No significant differences were found for growth performance, weight loss, blood picture, plasma enzymes, and colostrum composition. Performance of the sucking piglets was not impaired either during lactation or during a 4 week observation period after weaning. The health status was similar in all treatment groups. In a second experiment, lasting 6 weeks, with 36 piglets (5.8-22.1 kg body weight), 1.8% Echinacea cobs, or 20 mg/kg feed Flavomycin were supplemented. No significant differences were found for the recorded parameters. Feed conversion ratio (kg feed/kg gain) of the Echinacea group was slightly (4%) increased (1.54 vs. 1.60). In a third trial, 48 grower/finisher pigs were used during a 9-week experimental period with two supplementation phases (weeks 1-3 and weeks 7-9). The experimental groups received 0%, 1.5% cobs or 4-6 ml pressed juice (commercial standard) per day respectively. Vaccination with Swine erysipelas was implemented in weeks 1 and 5 to determine the specific immune response. Growth performance and blood picture for all groups were similar, however, feed conversion of both Echinacea supplemented groups was significantly (p < 0.03) better than of the unsupplemented control group (2.44 vs. 2.51). In addition, the Swine erysipelas antibodies showed a marked significance (p < 0.05) in regard of altitude in both supplemented groups. It is concluded, that E. purpurea might be used as a feed additive to achieve immune stimulating efficiency in pig production and increase feed-to-gain-conversion. The efficiency of cobs is comparable to a commercial juice product.

Efficacy of a standardized echinacea preparation (EchinilinTM) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial

Recently, echinacea has regained popularity as one of the treatments chosen most commonly by consumers with the expectation that it will reduce the severity and duration of the common cold. However, the results from a limited number of clinical trials for this application have thus far been inconclusive. This incongruity may be the result of investigators utilizing poorly standardized echinacea products, likely devoid of sufficient quantities of active constituents necessary to exert a definitive clinical effect. Therefore, a formulation containing alkamides, cichoric acid, and polysaccharides at concentrations of 0.25, 2.5, and 25 mg/mL, respectively, was prepared from freshly harvested Echinacea purpurea plants (commercially available as Echinilin, Natural Factors Nutritional Products, Inc., Vancouver, BC, Canada). The objective of this study was to test the efficacy of this highly standardized formulation in reducing the severity and duration of symptoms of a naturally acquired common cold. In a randomized, double-blind, placebo-controlled trial, 282 subjects aged 18-65 years with a history of two or more colds in the previous year, but otherwise in good health, were recruited. The subjects were randomized to receive either echinacea or placebo. They were instructed to start the echinacea or placebo at the onset of the first symptom related to a cold, consuming 10 doses the first day and four doses per day on subsequent days for 7 days. Severity of symptoms (10-point scale: 0, minimum; 9, maximum) and dosing were recorded daily. A nurse examined the subjects on the mornings of days 3 and 8 of their cold. A total of 128 subjects contracted a common cold (59 echinacea, 69 placebo). The total daily symptom scores were found to be 23.1% lower in the echinacea group than in placebo in those who followed all elements of the study protocol (P<0.01). Throughout the treatment period, the response rate to treatments was greater in the echinacea group. A few adverse event profiles were observed in both groups. Early intervention with a standardized formulation of echinacea resulted in reduced symptom severity in subjects with naturally acquired upper respiratory tract infection. Further studies with larger patient populations appear to be warranted.

A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory infections

Purpose: Fluid extracts of Echinacea purpurea are widely used for the prevention and treatment of colds and respiratory infections, although the clinical efficacy of this agent has not been proven. Patients and Methods: A total of 109 patients with a history of more than 3 colds or respiratory infections in the preceding year were randomly assigned to receive 4 mL fluid extract of Echinacea purpurea or 4 mL placebo-juice twice a day in a double-blind manner. (One patient withdrew his consent before taking the first dose of the allocated medication; thus, only 108 patients were included for analysis.) The incidence and severity of colds and respiratory infections were determined during 8 weeks of follow-up, based on patient reported symptoms together with findings on physical exam. The severity of each infection was graded by the investigators. Relative risks (RR) and 95% confidence intervals (CI) were estimated. Results: During the 8-week treatment period, 35 (65%) of 54 patients in the Echinacea group and 40 (74%) of 54 patients in the placebo group had at least one cold or respiratory infection [RR = 0.88; 95% CI (0.60, 1.22)]. The average number of colds and respiratory infections per patient was 0.78 in the Echinacea group, and 0.93 in the placebo group [difference = 0.15; 95% CI (−0.12, 0.41), P = 0.33]. Median duration of colds and respiratory infections was 4.5 days in the Echinacea group and 6.5 days in the placebo group (95% CI: −1, +3 days; P = 0.45). There were no significant differences between treatment groups in the number of infections in each category of severity. Side effects were observed in 11 patients (20%) of the Echinacea group and in seven patients (13%) of the placebo group ( P = 0.44). Conclusion: Treatment with fluid extract of Echinacea purpurea did not significantly decrease the incidence, duration or severity of colds and respiratory infections compared to placebo.