In August of 1996 at the 212th National Meeting of the American Chemical Society in Orlando, a special satellite symposium was held on Phytomedicines of Europe. Amidst the plethora of herb-related conferences held in the United States over the past couple of years, many with the same cadre of speakers offering the same comments to one audience after another, it was refreshing for an event to offer new information. The Phytomedicines of Europe Symposium, co-chaired by Dr. Larry Lawson of Murdock, Madaus, Schwabe and Dr. Rudolf Bauer of Heinrich-Heine Universität, Düsseldorf, brought together leading researchers from Europe and elsewhere to present on perspectives, effects, and specific plants related to European phytomedicinals, which now dominate the American market. The resulting volume, Phytomedicines of Europe: Chemistry and Biological Activity, edited by L. D. Lawson and R. Bauer, is an excellent reference, adding new and important information to the literature on phytomedicines.
The book is divided into three main sections. The first, "Perspectives," includes presentations by Dr. Varro Tyler on the importance of European phytomedicinals in the American market. R. Anton and B. Kuballa on the status of phytopharmaceuticals in the European market, Mark Blumenthal on the German Commission E monographs as a regulatory model for the United States, and Loren Israelsen presenting a review on the American regulatory situation with a focus on the Dietary Supplement Health and Education Act of 1994 (DSHEA).
The second section deals with "Specific Effects" including H. Wagner on plant constituents with antiasthmatic and antihypertonic activity, H. Schilcher on drugs for the treatment of benign prostatic hyperplasia, G. Franz on plant polysaccharides and cancer E. Eich on promising compounds with anti-HIV activity, and H. W. Rauwald with a perspective on mechanism of actions of anthraquinone herbal laxatives.
The third and largest section of the book includes detailed presentations on specific plants. Twelve plant groups treated in detail include arnica, Curcuma (turmeric), echinacea, feverfew, garlic, Ginkgo biloba, ginseng, hawthorn, milk thistle, mistletoe, St. John's wort, and Vitex agnus-castus (chaste tree).
In the book's first section, readers will particularly find Chapter 2, "Status of Phytopharmaceuticals within the European Market," by R. Anton and B. Kuballa, to add a valuable perspective on the significance of phytomedicinals in medical practice in various European countries. Details on the scope of the European market in EC countries (some 1,400 herb drugs), are broken down by category in order of importance in the market. An excellent overview of the legal status in Germany and France is given along with shorter discussions of the regulatory status in 12 other western European countries. The authors also discuss registration procedures within the European Union. Problems related to introducing new species from relatively little known families are detailed along with cases of toxic events that have resulted in the removal of a number of products from the market. Information on five leading extracts is provided along with facts on new manufacturing procedures. A discussion o f the role of the World Health Organization, European Scientific Cooperative on Phytotherapy, and the European Pharmacopoeia round out a clear picture of the role of phytomedicines in European health care. Coupled with the papers of Blumenthal, Israelsen, and Tyler, the reader is given all of the tools necessary for understanding the inner workings of the European market, the dramatic impact it has had on the American market (especially from a scientific perspective), and what the Europeans have learned that is useful to the American industry as our regulatory situation, despite the freedoms of DSHEA, grows more tenuous and ill-conceived on a weekly basis.
The five chapters on specific effects stand alone in presenting comprehensive reviews of the above subjects. A more comprehensive treatment of saw palmetto as a "specific plant" review, rather than its short treatment in Dr. H. Schilcher's chapter on "herbal drugs in the treatment of benign prostatic hyperplasia" would have added value in light of the current marketplace. However, the broader treatment of natural products used in BPH is a valuable contribution to the subject.
For this reader, the book's greatest value and benefit resides in the chapters on specific plants. The chapters on echinacea, feverfew, garlic, and St. John's wort, in particular, add detailed new research findings to the English-language literature. Despite the fact that the discussions are dated by more than two years, these chapters provide information on the current state of scientific understanding on the chemical, pharmacological and clinical bases of use not found in any other work in English.
Dr. Bauer's chapter, "Echinacea: Biological Effects and Active Principles," provides the best current review of the principles of Echinacea and their significance toward immunostimulatory activity. According to the review it appears cichoric acid, alkamides, and glycoproteins/polysaccharides are more relevant for immuno-modulatory activity. This begs the question why, in the American market, are so many products standardized to the immuno-modulatory irrelevant compound, echinacoside? Clinical studies are briefly reviewed on products made from the expressed juice of fresh flowering Echinacea purpurea, along with alcoholic tinctures of E. pallida and E. purpurea roots in the treatment of colds and flu.
The feverfew chapter by S. Heptinstall and D. V. C. Awang provides some of the most detailed speculation on possible or probable mechanisms of action related to prophylaxis of migraine. In vitro studies, we learn, have shown inhibition of platelet aggregation and granule secretion (serotonin release), and inhibition functions of white blood cells and vascular smooth muscle cells. A discussion of the now controversial clinical relevance of parthenolide as an active constituent is also presented. This chapter is required reading for anyone who wishes to understand the medicinal value of fevefew.
Lawson's analysis of the medicinal effects and indicated active compounds of garlic is an excellent brief review of the major pharmacological, clinical, and, particularly, chemical studies on this important herb. The chemical discussion covers the enzymatic processes involved in development or transformation of sulfur compounds, their natural variation, stability, aging, changes upon commercial processing, absorption and metabolic fate, plus the composition of garlic's odor. Major biological activity such as lipid-lowering effects, antithrombotic effects, blood pressure lowering and anticancer activity, among others, are reviewed. This is one of the best short comprehensive reviews on garlic.
The ginseng chapter disappoints only in that it does not focus on clinical studies, but contains excellent sections on qualitative and quantitative analysis of ginsenosides and quality control of ginseng products. The hawthorn chapter is rich in comprehensive detail, adding a major contribution to the English-language literature on the topic. The milk thistle chapter narrowly focuses on mechanism of action of silibinin on hepatocyte and kidney cells. The mistletoe discussion, one of the briefest chapters, provides a good overview of the use of preparations of the herb in oncology, but fails to capture the polemics of what became the most controversial paper presented, evolving into the most contentious debate at the Symposium itself.
The St. John's wort paper is of particular relevance to the American market, since a wide range of mechanisms of action, as well as biologically active chemical components besides the hypericins, was presented for the first time to an American scientific audience. The American market has yet to catchup to the scientific data presented by Dr. Hans Reuter at this Symposium.
Most Symposium proceedings in the medicinal plant field tend to tell us what we've heard in one form or another before. Phytomedicines of Europe is different. It provides a timely, comprehensive overview of the state of the art of scientific information on European phytomedicines. Much of the review is fresh, the primary research original, presented by the leading experts in their areas of focus. Although the presentations were initially delivered over two years ago, new data was added or updated up to the time this volume went to press. Phytomedicines of Europe is a key reference tool for anyone engaged in selling herb products, and certainly an important collection of perspectives for moving phytomedicines forward toward their rightful place in making a substantial contribution to health care options in the United States.
Article copyright American Botanical Council.
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By Steven Foster