Transcript April 17 - St. John`s Wort

St. John’s Wort
Rachael Krob, Melissa Morrison &
Katie Wooten
St. John’s Wort
• Hypericum perforatum from the family Hypericaceae
– genus Hypericum
– 400 species worldwide
• Common Name: Goatweed
Klamath Weed
Amber Touch-and-Heal
Blood of Christ
Hardhay
Guttiferae
Tipton weed
Botanical Description
• SJW is an aromatic perennial herb, usually growing between 1-3
feet
-small oblong leaves dotted with glandular trichomes
containing essential oils
-flowers are yellow with an abundance of bushy stamens
- 5 petals with black dots on the periphery
• Native to Europe, Asia and parts of Africa
• Widespread in the U.S. and can be found in sunny places such as
fields, meadows, and roadsides
Ethnobotany -What’s in a name?
• “wort”- English word for plant
• “perforatum”- Latin word for hole
• Legend of SJW
• Origin of name dates back to the Middle Ages
-believed the red resin was blood from the beheaded St.
John the Baptist
-flowers have brightest appearance on June 24th, John
the Baptist’s birthday
Ethnobotany
• Gaelic tradition
• Food flavoring
• Crop blessings
– Soaked plant in olive oil until “blood” was released
– Red oil used to bless crops
• Pre-Christian Religious practices
– Protect from evil spirits and banish witches
– Sleeping with plant provided blessings
– “herba demonis fuga”: herb that chases away the devil
Historical Usage
• Used by various countries to treat:
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Depression
Kidney disorders
Wound treatment
Antibacterial
Anti-viral (AIDS)
GI disorders
Diuretic
Night terrors
Cancer
Historical Uses
• Many early herbalist/physicians recommended SJW
– Hippocrates, Gerard, Pliny the Elder, Dioscorides
• Medicinal usage well document with 1st written record dating back to
1st century A.D.
– Pliny the Elder
• Dioscorides recommended SJW in his medical text for the treatment
of sciatica and burns
• First suggested by Paracelsus to treat mental illnesses
– Work led to centuries of research in this area
– 1630: Agelo Sala mentioned SJW’s excellent reputation for
treating “illnesses of the imagination, melancholia, and anxiety”
Historical Usage
• SJW continued to spread and was eventually introduced
to the American Indians
– Used to treat tuberculosis and other breathing
conditions
• Today, SJW is best known for anti-depressive activities,
but research continues in many areas, especially cancer
and AIDS
• Currently, SJW is listed in national pharmacopoeias of
France, Poland, Czechoslovakia, Russia, Germany and
Romania
Current Medical Uses
• Depression
• Cancer
• HIV/AIDS
***(Further research and trials is needed to confirm effectiveness)
• Burns, cuts, and herpes (painful
blisters of genital herpes).
Methods of Use
•Capsules
•Tinctures
•Teas (powder)
•Depremin and Depesin : contains 0.5 mg Hypericin
•Natrol
•Kira or Jarsin 300
Depression
• In any given 1-year period, 9.5 percent of the population,
or about 18.8 million American adults, suffer from a
depressive illness (Robins)
• “In Germany, it is prescribed twenty times more often
than popular pharmaceutical drugs Zoloft and Prozac”
• Effectiveness of St John's Wort. in Major Depression
(Shelton et al. 1978-1986)
• St.John’s wort for depression-an overview and metaanalysis of randomised clinical trials (Linde et al. 253-258)
Cancer
• Compounds from St.John’s Wort have
anticancer properties
• St.John’s Wort More Implications for Cancer
Patients (Mansky et al. 1187-1188)
• Anti-cancer Activities of Hypericin in the Dark
(Blank et al. 120-125)
• Antivascular Tumor Eradication by Hypericinmediated Photodynamic Therapy (Chen et al. 509-513)
HIV/AIDS
• Hypericin seems to interfere with the
reproduction of retroviruses
• Further research is needed
• P27SJ, a novel protein in St John's Wort,
that suppresses expression of HIV-1 genome
(Sarkissian et al. 288-295)
Side Effects
• Anxiety, dry mouth dizziness,
gastrointestinal symptoms, fatigue,
headache, or sexual dysfunction.
• Research shows that St. John’s Wort
interacts with some drugs.
• Indinavir, Irinotecan, Cyclosporine,
Digoxin, Warfarin, Birth control pills, and
Antidepressants.
Compounds
• SJW contains naphtodiantrons, flavonoids,
phloroglucinols, phenolic acids, and
essential oils
• The active compounds are:
– Hypericin, pseudohypericin (naphtodiantrons)
• Cancer
– Hyperforin (phloroglucinol)
• Used for depression
Compound Structures
Mode of Action - Depression
• Hyperforin – major component
• Inhibits the 3H-GABA transporter GAT1 and the
3H-L-glutamate transporter EAAC1
• Monensin, a Na+ ionophore, inhibits reuptake of
these, serotonin, and dopamine
• Hyperforin does not act on this channel, but it
appears to act on a sodium conductive pathway
(Wonnemann, 2000)
• 2003 study – upregulates serotonin 5-HT(2)
receptors in mice
(Butterweck, 2003)
Mode of Action - Cancer
• Study by F. Pajonk, 2005
– Hypericin inhibits NF-κB, a major transcription
factor influencing apoptosis
– Leads to premature apoptosis
• Study by B. Chen, 2002
– Photodynamic therapy and hypericin
– Destroys vascular cells in tumors
– Has potential for use in solid tumors
Mode of Action – HIV/AIDS
• Protein from SJW - p27SJ
• Binds to C/EBPβ – inhibits its interaction
with DNA
• p27SJ decreases level of viral replication in
HIV infected cells
(Darbinian-Sarkissian , 2006)
Contraindications
• Hyperforin
– May activate pregnane X receptor
– PXR induces CYP3A4 transcription
– Results in quicker metabolism of certain
xenobiotics
(Moore, 2000)
Work Cited
Blank, Michael, Mathilda Mandel, Sadick Hazan, and Yona Keisari. "ANTI-cancer
Activities of Hypercin in the Dark." Photochemistry and Photobiology May 2001:
120-125.
Chen, Bin, Tania Roskams, and Peter A.M. de Witte. "Antivascular Tumor eradication by
Hypericin-mediated Photodynamic Therapy." Photochemistry and Photobiology
76.5 (2002): 509-513.
Linde, Klaus, Gilbert Ramirez, Cynthia Mulrow, and Dieter Melchart. "St. John's wort
for depression- an overview and meta-analysis of randomised clinical trials." BMJ
313 (1996): 253-258.
Mansky, Patrick, and Stephen Straus. "St.John's Wort: More Implications for Cancer
Patients." Journal of the National Cancer Institute Aug 2002: 1187-1188.
Shelton, Richard, Martin Keller, Alan Gelenberg, and David Dunner. "Effectiveness of St
John's Wort in Major Depression." JAMA 285.15 (2001): 1978-1986.
"St. John's Wort." July 2005. National Center for Complementary and Alternative
Medicine. 10 Apr. 2006
Robins LN, Regier DA (Eds). Psychiatric Disorders in America, The Epidemiologic
Catchment Area Study, 1990; New York: The Free Press.
Rosenthal, Norman. St.John's Wort: the herbal way to feeling good. New York:
HarperCollins, 1998.
Sarkissian, N Darbinian, A Darbinyan, J Otte, and S Radhakrishnan. "P27SJ, a novel
protein in St John's Wort, that suppresses expression of HIV-1 genome." Gene
Therapy 13 (2005): 288-295.