Plants in the therapy of inflammatory bowel disease

Czech version

Authors: Z. Vochyánová; K. Sikorová; K. Šmejkal; J. Hošek
Authors‘ workplace: Ústav přírodních léčiv, Farmaceutická fakulta, Veterinární a farmaceutická univerzita Brno
Published in: Gastroent Hepatol 2014; 68(3): 248-254
Category: IBD: Review Article

Overview

Medicinal plants have been used to treat various diseases for thousands of years. Although their popularity has changed in the course of history, the interest in plants and in their active compounds is currently increasing. Today’s research focuses on determining the active substances responsible for the effect and their mechanism of action. Plants have also their place in complementary therapy of chronic inflammatory diseases. Inflammatory bowel disease (IBD), such as Crohn’s disease and ulcerative colitis, are chronic diseases of the gastrointestinal tract. Their incidence has been increasing in recent years and it is difficult to predict the progression of the disease. Due to the unclear aetiology of inflammatory bowel disease, current therapy is not completely successful. Complementary and alternative medicine is widely used by patients because of frequent side effects and lack of effectiveness of the standard therapy. Plant products may provide an alternative or supplementary treatment option to patients. This review brings a survey of plants and their content compounds used in complementary therapy of inflammatory bowel disease with special relevance to clinical studies.

Key words:
experimental animal models – phytotherapy – inflammatory bowel disease – clinical trials

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
5. 2. 2014

Accepted:
31. 3. 2014

Sources

1. Sartor RB. Mechanisms of disease: pathogenesis of Crohn’s disease and ulcerative colitis. Nat Clin Pract Gastroenterol Hepatol 2006; 3(7): 390–407.

2. Bensoussan M, Jovenin N, Garcia B et al. Complementary and alternative medicine use by patients with inflammatory bowel disease: results from a postal survey. Gastroenterol Clin Biol 2006; 30(1): 14–23.

3. Langmead L, Rampton DS. Review article: complementary and alternative therapies for inflammatory bowel disease. Aliment Pharmacol Ther 2006; 23(3): 341–349. doi: 10.1111/j.1365-2036.2006.02761.x.

4. Life and IBD. Complementary and Alternative medicines (CAMs). [online]. Available from: http://www.lifeandibd.org/ulcerative-colitis-teenager/taking-control-of-your-ibd/complementary-and-alternative-medicines.html.

5. Mayo Clinic. Ulcerative Colitis – Alternative medicine. [online]. Available from: http://www.mayoclinic.com/health/ulcerative-colitis/DS00598/DSECTION=alternative--medicine.

6. Rahimi R, Shams-Ardekani MR, Abdollahi M. A review of the efficacy of traditional Iranian medicine for inflammatory bowel disease. World J Gastroenterol 2010; 16(36): 4504–4514.

7. Jurjus AR, Khoury NN, Reimund JM. Animal models of inflammatory bowel disease. J Pharmacol Toxicol Methods 2004; 50(2): 81–92.

8. Rahimi R, Mozaffari S, Abdollahi M. On the use of herbal medicines in management of inflammatory bowel diseases: a systematic review of animal and human studies. Dig Dis Sci 2009; 54(3): 471–480. doi: 10.1007/s10620-008-0368-x.

9. Ukil A, Maity S, Karmakar S et al. Curcumin, the major component of food flavour turmeric, reduces mucosal injury in trinitrobenzene sulphonic acid-induced colitis. Br J Pharmacol 2003; 139(2): 209–218.

10. Jian YT, Wang JD, Mai GF et al. Modulation of intestinal mucosal inflammatory factors by curcumin in rats wih colitis. Di Yi Jun Yi Da Xue Xue Bao 2004; 24(12): 1353–1358.

11. Zhang M, Deng CS, Zheng JJ et al. Curcumin regulated shift from Th1 to Th2 in trinitrobenzene sulphonic acid-induced chronic colitis. Acta Pharmacol Sin 2006; 27(8): 1071–1077.

12. Borrelli F, Aviello G, Romano B et al. Cannabidiol, a safe and non-psychotropic ingredient of the marijuana plant Cannabis sativa, is protective in a murine model of colitis. J Mol Med 2009; 87(11): 1111–1121. doi: 10.1007/s00109-009-0512-x.

13. Borrelli F, Fasolino I, Romano B et al. Beneficial effect of the non-psychotropic plant cannabinoid cannabigerol on experimental inflammatory bowel disease. Biochem Pharmacol 2013; 85(9): 1306–1316. doi: 10.1016/j.bcp.2013.01.017.

14. Wei X, Gong J, Zhu J et al. Therapeutic effects of triptolide on interleukin-10 gene-deficient mice with colitis. Int Immunopharmacol 2008; 8(13–14): 1808–1812. doi: 10.1016/j.intimp.2008.08.019.

15. Wei X, Gong J, Zhu J et al. The suppressive effect of triptolide on chronic colitis and TNF-alpha/TNFR2 signal pathway in interleukin-10 deficient mice. Clin Immunol 2008; 129(2): 211–218. doi: 10.1016/j.clim.2008.07.018.

16. Wang X, Zhao L, Han T et al. Protective effects of 2,3,5,4'-tetrahydroxystilbene-2-O-beta-d-glucoside, an active component of Polygonum multiflorum Thunb, on experimental colitis in mice. Eur J Pharmacol 2008; 578(2–3): 339–348.

17. Wang YH, Yang XL, Wang L et al. Effects of proanthocyanidins from grape seed on treatment of recurrent ulcerative colitis in rats. Can J Physiol Pharmacol 2010; 88(9): 888–898. doi: 10.1139/y10-071.

18. Maity S, Ukil A, Karmakar S et al. Thearubigin, the major polyphenol of black tea, ameliorates mucosal injury in trinitrobenzene sulfonic acid-induced colitis. Eur J Pharmacol 2003; 470(1–2): 103–112.

19. Brückner M, Westphal S, Domschke W et al. Green tea polyphenol epigallocatechin-3-gallate shows therapeutic antioxidative effects in a murine model of colitis. J Crohns Colitis 2012; 6(2): 226–235. doi: 10.1016/j.crohns.2011.08.012.

20. El-Abhar HS, Hammad LN, Gawad HS et al. Modulating effect of ginger extract on rats with ulcerative colitis. J Ethnopharmacol 2008; 118(3): 367–372. doi: 10.1016/j.jep.2008.04.026.

21. Martín AR, Villegas I, La Casa C et al. Resveratrol, a polyphenol found in grapes, suppresses oxidative damage and stimulates apoptosis during early colonic inflammation in rats. Biochem Pharmacol 2004; 67(7): 1399–1410.

22. Sánchez-Fidalgo S, Cárdeno A, Villegas I et al. Dietary supplementation of resveratrol attenuates chronic colonic inflammation in mice. Eur J Pharmacol 2010; 633(1–3): 78–84. doi: 10.1016/j.ejphar.2010.01.025.

23. Jiang H, Deng CS, Zhang M et al. Curcumin-attenuated trinitrobenzene sulphonic acid induces chronic colitis by inhibiting expression of cyclooxygenase-2. World J Gastroenterol 2006; 12(24): 3848–3853.

24. Zhang M, Deng C, Zheng J et al. Curcumin inhibits trinitrobenzene sulphonic acid-induced colitis in rats by activation of peroxisome proliferator-activated receptor gamma. Int Immunopharmacol 2006; 6(8): 1233–1242.

25. Camacho-Barquero L, Villegas I, Sánchez-Calvo JM et al. Curcumin, a Curcuma longa constituent, acts on MAPK p38 pathway modulating COX-2 and iNOS expression in chronic experimental colitis. Int Immunopharmacol 2007; 7(3): 333–342.

26. Lee IA, Hyun YJ, Kim DH. Berberine ameliorates TNBS-induced colitis by inhibiting lipid peroxidation, enterobacterial growth and NF-κB activation. Eur J Pharmacol 2010; 648(1–3): 162–170. doi: 10.1016/j.ejphar.2010.08.046.

27. Oh PS, Lim KT. Plant originated glycoprotein has anti-oxidative and anti-inflammatory effects on dextran sulfate sodium-induced colitis in mouse. J Biomed Sci 2006; 13(4): 549–560.

28. Park MY, Kwon HJ, Sung MK. Dietary aloin, aloesin, or aloe-gel exerts anti-inflammatory activity in a rat colitis model. Life Sci 2011; 88(11–12): 486–492. doi: 10.1016/j.lfs.2011.01.010.

29. Rodríquez-Cabezas ME, Gálvez J, Camuesco D et al. Intestinal anti-inflammatory activity of dietary fiber (Plantago ovata seeds) in HLA-B27 transgenic rats. Clin Nutr 2003; 22(5): 463–471.

30. Jian YT, Mai GF, Wang JD et al. Preventive and therapeutic effects of NF-kappaB inhibitor curcumin in rats colitis induced by trinitrobenzene sulfonic acid. World J Gastroenterol 2005; 11(12): 1747–1752.

31. Ran ZH, Chen C, Xiao SD. Epigallocatechin-3-gallate ameliorates rats colitis induced by acetic acid. Biomed Pharmacother 2008; 62(3): 189–196. doi: 10.1016//j.biopha.2008.02.002.

32. Abboud PA, Hake PW, Burroughs TJ et al. Therapeutic effect of epigallocatechin-3-gallate in a mouse model of colitis. Eur J Pharmacol 2008; 579(1–3): 411–417.

33. Ukil A, Maity S, Das PK. Protection from experimental colitis by theaflavin-3,3´-digallate correlates with inhibition of IKK and NF-kappaB activation. Br J Pharmacol 2009; 149(1): 121–131.

34. Zhou YH, Yu JP, Liu YF et al. Effects of Ginkgo biloba extract on inflammatory mediators (SOD, MDA, TNF-alpha, NF-kappaBp65, IL-6) in TNBS-induced colitis in rats. Mediators Inflamm 2006; 2006(5): 92642.

35. Holt PR, Katz S, Kirshoff R. Curcumin therapy in inflammatory bowel disease: a pilot study. Dig Dis Sci 2005; 50(11): 2191–2193.

36. Hanai H, Iida T, Takeuchi K et al. Curcumin maintenance therapy for ulcerative colitis: randomized, multicenter, double-blind, placebo-controlled trial. Clin Gastroenterol Hepatol 2006; 4(12): 1502–1506.

37. Tang T, Targan SR, Li ZS et al. Randomised clinical trial: herbal extract HMPL--004 in active ulcerative colitis – a double-blind comparison with sustained release mesalazine. Aliment Pharmacol Ther 2011; 33(2): 194–202. doi: 10.1111//j.1365-2036.2010.04515.x.

38. Sandborn WJ, Targan SR, Byers VS et al. Andrographis paniculata extract (HMPL--004) for active ulcerative colitis. Am J Gastroenterol 2013; 108(1): 90–98. doi: 10.1038//ajg.2012.340.

39. Gerhardt H, Seifert F, Buvari P et al. Therapy of active Crohn disease with Boswellia serrata extract H 15. J Gastroenterol 2001; 39(1): 11–17.

40. Gupta I, Parihar A, Malhotra P et al. Effects of Boswellia serrata gum resin in patients with ulcerative colitis. Eur J Med Res 1997; 2(1): 37–43.

41. Gupta I, Parihar A, Malhotra P et al. Effects of gum resin of Boswellia serarata in patients with chronic colitis. Planta Med 2001; 67(5): 391–395.

42. Anthoni C, Laukoetter MG, Rijcken E et al. Mechanisms underlying the anti-inflammatory action of boswellic acid derivatives in experimental colitis. Am J Physiol Gastrointest Liver Physiol 2006; 290(6): G1131–G1137.

43. Krieglstein CF, Anthoni C, Rijcken EJ et al. Acetyl-11-keto-beta-boswellic acid, a constituent of a herbal medicine from Boswellia serrata resin, attenuates experimental ileitis. Int J Colorectal Dis 2001; 16(2): 88–95.

44. Holtmeier W, Zeuzem S, Preiss J et al. Randomized, placebo-controlled, double-blind trial of Boswellia serrata in maintaining remission of Crohn´s disease: good safety profile but lack of efficacy. Inflamm Bowel Dis 2011; 17(2): 573–582. doi: 10.1002/ibd.21345.

45. Langmead L, Feakins RM, Goldthorpe S et al. Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis. Aliment Pharmacol Ther 2004; 19(7): 739–747.

46. Ben-Arye E, Goldin E, Wengrower D et al. Wheat grass juice in the treatment of active distal ulcerative colitis: a randomized double-blind placebo-controlled trial. Scand J Gastroenterol 2002; 37(4): 444–449.

47. Kanauchi O, Suga T, Tochihara M et al. Treatment of ulcerative colitis by feeding with germinated barley foodstuff: first report of a multicenter open control trial. J Gastroenterol 2002; 37 (Suppl 14): 67–72.

48. Hanai H, Kanauchi O, Mitsuyama K et al. Germinated barley foodstuff prolongs remission in patients with ulcerative colitis. Int J Mol Med 2004; 13(5): 643–647.

49. Faghfoori Z, Navai L, Shakerhosseini R et al. Effects of an oral supplementation of germinated barley foodstuff on serum tumour necrosis factor-alpha, interleukin-6 and -8 in patients with ulcerative colitis. Ann Clin Biochem 2011; 48(3): 233–237. doi: 10.1258//acb.2010.010093.

50. Fernández-Banares F, Hinojosa J, Sánchez-Lombrana JL et al. Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Spanish Group for the Study of Crohn’s Disease and Ulcerative Colitis (GETECCU). Am J Gastroenterol 1999; 94(2): 427–433.

51. Naftali T, Lev LB, Yablecovitch D et al. Treatment of Crohn´s disease with cannabis: an observational study. Isr Med Assoc J 2011; 13(8): 455–458.

52. Schicho R, Storr M. Topical and systemic cannabidiol improves trinitrobenzene sulfonic acid colitis in mice. Pharmacology 2012; 89(3–4): 149–155. doi: 10.1159/000336871.

53. Greenfield SM, Green AT, Teare JP et al. A randomized controlled study of evening primrose oil and fish oil in ulcerative colitis. Aliment Pharmacol Ther 1993; 7(2): 159–166.

54. Dong WG, Liu SP, Zhu HH et al. Abnormal function of platelets and role of angelica sinensis in patients with ulcerative colitis. World J Gastroenterol 2004; 10(4): 606–609.

55. Biedermann L, Mwinyi J, Scharl M et al. Bilberry ingestion improves disease activity in mild to moderate ulcerative colitis – an open pilot study. J Crohns Colitis 2013; 7(4): 271–279. doi: 10.1016/j.crohns.2012.07.010.

56. Omer B, Krebs S, Omer H et al. Steroid-sparing effect of wormwood (Artemisia absinthium) in Crohn’s disease: a double-blind placebo-controlled study. Phytomedicine 2007; 14(2–3): 87–95.

57. Kaliora AC, Stathopoulou MG, Triantafillidis JK et al. Chios mastic treatment of patients with active Crohn's disease. World J Gastroenterol 2007; 13(5): 748–753.

58. Liu J. Oleanolic acid and ursolic acid: research perspectives. J Ethnopharmacol 2005; 100(1–2): 92–94.

59. Ren J, Tao Q, Wang X et al. Efficacy of T2 in active Crohn’s disease: a prospective study report. Dig Dis Sci 2007; 52(8): 1790–1797.