Echinacea

 

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Zusammenfassung

Trotz zahlreicher neuer Untersuchungen kann die therapeutische Wirkung von Echinacea nicht eindeutig einer bestimmten Komponente zugeschrieben werden. Allerdings deuten die jüngsten Daten darauf hin, dass die Alkamide eine sehr wichtige Rolle spielen. Sie besitzen zahlreiche immunmodulatorische und entzündungshemmende Eigenschaften und binden an CB2-Rezeptoren. Dies könnte ein Wirkungsmechanismus im Sinne eines Infektions-Mimiking bedeuten. Die Tatsache, dass für Echinacea-Alkamide auch die Bioverfügbarkeit nachgewiesen wurde und pharmakologisch relevante Blutspiegel erreicht werden, macht sie noch mehr zu klinisch hoch relevanten Inhaltsstoffen und eine entsprechende Standardisierung von Präparaten ist gerechtfertigt.

Die klinische Studienlage ist bei Echinacea-Präparaten immer noch nicht zufriedenstellend. Es deuten zwar viele Studien auf eine Wirksamkeit hin, insbesondere bei Zubereitungen aus den oberirdischen Teilen von E. purpurea, aber wegen der unterschiedlichen Zusammensetzung der verwendeten Zubereitungen sind die Ergebnisse der Studien widersprüchlich. In Zukunft sollten klinische Studien mit klar definierten Produkten gemacht werden.

Das Nebenwirkungs- und Interaktionspotenzial von Echinacea-Präparaten ist nicht besorgniserregend. Kontraindikationen bei Autoimmunerkrankungen sind substanziell nicht gerechtfertigt. Die Vorsichtsmaßnahme, „Echinacea“ nicht bei atopischen Patienten zu verwenden, ergibt sich aus der allgemein bekannten Allergenität gegen Pollen-Proteine von Korbblütlern. Ein besonderes Risiko für Kinder über einem Jahr ist nicht dokumentiert.

Summary

Echinacea – a survey of current literature
In spite of numerous new studies, the therapeutic effect of echinacea cannot be clearly attributed to one specific component. Nonetheless, recent data suggest that the alkamides play a very important role due to their numerous immunomodulatory and anti-inflammatory properties and the ability to bind to CB2 receptors. This could be related to a mechanism of action referred to as infection mimicking. Echinacea alkamides are clinically relevant ingredients warranting an appropriate standardization as a result of their established bio-availability and the pharmacologically relevant blood levels.

Clinical studies on echinacea preparations are still not satisfactory. Although many studies suggest their efficacy, especially those of preparations from the aerial parts of E. purpurea, the results of the studies are contradictory due to the different composition of the applied preparations. It is recommended that future clinical trials be carried out with well defined products.

The side-effects and interaction potential of echinacea preparations are not a serious cause for concern. Moreover, contraindications in autoimmune diseases are not substantially justified. The precaution, not to use "echinacea", in atopic patients arises from the widely known allergenicity against pollen proteins from composite flowers. A particular risk for children over one year has not been documented.

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