Herbal Medicine: Expanded Commission E
Artichoke leaf
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Latin Name: Cynara scolymus
Pharmacopeial Name: Cynarae folium
Other Names: globe artichoke
Overview
Globe artichoke is a perennial herb native to Mediterranean southern Europe and northern Africa and the Canary Islands (Leung and Foster, 1996). Its cultivation in Europe dates back to ancient Greece and Rome (Grieve, 1971). It is cultivated in North Africa as well as in other subtropical regions (Iwu, 1993). The material of commerce comes as whole or cut dried leaves obtained mainly from southern Europe and northern Africa (BHP, 1996). Artichoke leaf has been used as a choleretic and diuretic in traditional European medicine since Roman times (Bianchini and Corbetta, 1977). Traditional medicinal uses of artichoke pertain to liver function. Artichoke leaf is considered choleretic (bile increasing), hepatoprotective, cholesterol-reducing, and diuretic (Kirchhoff et al., 1994). In Germany, it is used today as a choleretic (BAnz, 1998; Meyer-Buchtela, 1999) for its lipid-lowering, hepato-stimulating, and appetite-stimulating actions (Hnsel et al., 19921994; Meyer-Buchtela, 1999). In German pediatric medicine, herbs with a relatively low bitter value (8002000), such as artichoke leaf, are considered suitable for the treatment of appetite disorders (Schilcher, 1997). Modern human studies have investigated its choleretic activity for treatment of digestive disorders (Kirchhoff et al., 1994). An article by Kraft summarized various post-marketing surveillance studies conducted on patients with dyspepsia and/or diseases of the liver or bile duct. The studies included anywhere from 417 to 557 patients and treatment duration ranged from 4 to 6 weeks. Statistically significant reduction of symptoms (e.g., abdominal pain, bloating, flatulence, and nausea) were reported for the surveillance studies referred to in this paper. Artichoke preparations were well tolerated (up to 95% of cases) with a low rate of side-effects (Kraft, 1997). In one clinical trial, 20 men with acute or chronic metabolic disorders were separated at random into two groups. The test group was given a standardized artichoke extract (Hepar SL forte, Seturner, Germany) of 320 mg in a capsule dissolved in 50 ml water, taken intraduodenally. Results were assessed by measuring intraduodenal bile secretions, which increased 127.3% after 30 minutes, 151.5% after 60 minutes, and 94.3% after 90 minutes. The relative differences for the placebo were significant. The researchers concluded that artichoke extract can be used for the treatment of digestive disorders characterized by poor assimilation of fat due to insufficient bile secretion. No adverse side effects were observed (Kirchhoff et al., 1994). Pharmacopeial grade artichoke leaf consists of the dried radical leaves of Cynara scolymus L. Botanical identification is carried out by thin-layer chromatography (TLC), macroscopic and microscopic evaluations, and organoleptic tests. The dried leaf must contain not less than 25% water-soluble extractive (BHP, 1996).
Description
Artichoke leaf consists of the fresh or dried leaf of C. scolymus L. [Fam. Asteraceae] and its preparations in effective dosage. The preparation contains caffeoylquinic acid derivatives such as cynarin and bitter principles.
Chemistry and Pharmacology
Artichoke leaf contains up to 2% phenolic acids, mainly 3-caffeoylquinic acid (chlorogenic acid), plus 1,5-di-O-caffeoylquinic acid (cynarin), and caffeic acid; 04% bitter sesquiterpene lactones of which 4783% is cynaropicrin; 0.11.0% flavonoids including the glycosides luteolin-7-b-rutinoside (scolymoside), luteolin-7-b-D-glucoside and luteolin-4-b-D-glucoside; phytosterols (taraxasterol); sugars; inulin; enzymes; and a volatile oil consisting mainly of the sesquiterpenes b-selinene and caryophyllene (Hnsel et al., 19921994; Leung and Foster, 1996; Meyer-Buchtela, 1999; Newall et al., 1996). The Commission E reported choleretic activity. The British Herbal Pharmacopoeia reported hepatic action (BHP, 1996). In vivo, artichoke leaf has demonstrated hepatoprotective and hepatostimulating properties (Adzet et al., 1987; Maros et al., 1966). The Merck Index reported the therapeutic category of cynarin, an active principle of artichoke, as choleretic (Budavari, 1996). The African Pharmacopoeia reported diuretic and anti-atherosclerotic actions (Iwu, 1993). Artichoke leaf has shown cholesterol-lowering and lipid-lowering activity in rats and humans (Lietti, 1977). Human studies have validated carminative, spasmolytic, antiemetic, and choleretic actions (Kraft, 1997).
Uses
The Commission E approved artichoke leaf for dyspeptic problems. The African Pharmacopoeia indicates its use for the treatment of liver dysfunction (Iwu, 1993). Preparations of artichoke have been used for bloating, nausea, and impairment of digestion (Bruneton, 1995). It is specifically indicated for 'dyspeptic syndrome' though its proven lipid-lowering actions suggest that it may also be useful as a prophylactic against atherosclerosis (Kraft, 1997).
Contraindications
Known allergies to artichokes and related species (Asteraceae or Compositae). Obstruction of bile ducts. In case of gallstones, use only after consulting a physician.
Side Effects
None known.
Use During Pregnancy and Lactation
No restrictions known.
Interactions with Other Drugs
None known.
Dosage and Administration
Unless otherwise prescribed: 6 g per day of dried cut leaves, pressed juice of fresh plant, and other equivalent galenical preparations for internal use. Leaf: 2 g, three times daily. Infusion: Artichoke leaf is not typically prepared as an infusion. Dry extract 12:1 (w/w): 0.5 g single daily dose. Fluidextract 1:1 (g/ml): 2 ml, three times daily. Tincture 1:5 (g/ml): 6 ml, three times daily.
References
Adzet, T. et al. 1987. Action of an artichoke extract against CC14-induced hepatotoxicity in rats. Acta Pharm Jugosl 37:183187. BAnz. See Bundesanzeiger. Bianchini, F. and F. Corbetta. 1977. Health Plants of the WorldAtlas of Medicinal Plants. New York: Newsweek Books. British Herbal Pharmacopoeia (BHP). 1996. Exeter, U.K.: British Herbal Medicine Association. Bruneton, J. 1995. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier Publishing. Budavari, S. (ed.). 1996. The Merck Index: An Encyclopedia of Chemicals, Drugs, and Biologicals, 12th ed. Whitehouse Station, N.J.: Merck & Co, Inc. 467-468. Bundesanzeiger (BAnz). 1998. Monographien der Kommission E (Zulassungs- und Aufbereitungskommission am BGA f r den humanmed. Bereich, phytotherapeutische Therapierichtung und Stoffgruppe). Kln: Bundesgesundheitsamt (BGA). Grieve, M. 1971. A Modern Herbal. New York: Dover Publications, Inc. 60. Hnsel, R., K. Keller, H. Rimpler, G. Schneider (eds.). 19921994. Hagers Handbuch der Pharmazeutischen Praxis, 5th ed. Vol. 46. Berlin-Heidelberg: Springer Verlag. Iwu, M.M. 1993. Handbook of African Medicinal Plants. Boca Raton: CRC Press. 167168. Kirchhoff, R. et al. 1994. Increase in choleresis by means of artichoke extract. Phytomedicine 1:107115. Kraft, K. 1997. Artichoke leaf extractrecent findings reflecting effects on lipid metabolism, liver, and gastrointestinal tracts. Phytomedicine 4(4):369378. Leung, A.Y. and S. Foster. 1996. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2nd ed. New York: John Wiley & Sons, Inc. 4244. Lietti, A. 1977. Choleretic and cholesterol lowering properties of two artichoke extracts. Fitoterapia (48):153-158. Maros T, G. Racz, B. Katonai, V.V. Kovacs. 1966. Wirkungen der Cynara scolymus-Extrakte auf die Regeneration der Rattenleber [Effects of Cynara scolymus extracts on the regeneration of rat liver. 1]. Arzneimforsch 16(2):127129. Meyer-Buchtela, E. 1999. Tee-RezepturenEin Handbuch f r Apotheker und rzte. Stuttgart: Deutscher Apotheker Verlag. Newall, C.A., L.A. Anderson, J.D. Phillipson. 1996. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press. 3738. Schilcher, H. 1997. Phytotherapy in Paediatrics: Handbook for Physicians and Pharmacists. Stuttgart: Medpharm Scientific Publishers. 4546.
Additional Resources
Adzet, T., J. Camarasa, J.C. Laguna. 1987. Hepatoprotective activity of polyphenolic compounds from Cynara scolymus against CCl4 toxicity in isolated rat hepatocytes. J Nat Prod 50(4):612617. Fintelmann, V. and H.G. Menssen. 1996. Artischockenbltterextrakt - Aktuelle Erkenntnis zur Wirkung als Lipidsenker und Antidyspeptium. Dtsch Apoth Ztg 136(17):14051414. Mills, S.Y. 1985. The Dictionary of Modern Herbalism. Wellingborough: Thorsons. Mitchell, J.C. 1975. Recent Advances in Phytochemistry, Vol. 9. New York: Plenum. Reynolds, J.E.F. (ed.). 1982. Martindale: The Extra Pharmacopoeia, 28th ed. London: The Pharmaceutical Press. Wren, R.C. 1988. Potter's New Cyclopaedia of Botanical Drugs and Preparations. Essex: The C.W. Daniel Company Ltd. This material was adapted from The Complete German Commission E MonographsTherapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.
1) The Overview section is new information. 2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references. 3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example: - Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]
- Infusion: 2 g in 150 ml of water
- Fluidextract 1:1 (g/ml): 2 ml
- Tincture 1:5 (g/ml): 10 ml
4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes. This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.
Excerpt from Herbal Medicine: Expanded Commission E Monographs
Copyright 2000 American Botanical Council
Published by Integrative Medicine Communications
Available from the American Botanical Council.
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