WHO: Recommendation of increased use of traditional natural products in the fight against influenza

Hong Kong/​China – As from now on the WHO public health rese­arch agen­da for influ­en­za also includes the explo­ra­ti­on of natu­ral pro­ducts, both in terms of pro­phy­la­xis and the­ra­py [1], repor­ted Prof. Dr. Ste­phan Lud­wig, Flu­Re­se­arch­Net, Uni­ver­si­ty of Muenster/​Germany, at an inter­na­tio­nal sci­en­ti­fic con­gress in Hong Kong [2]. His key­note address drew atten­ti­on to the ongo­ing and ground­brea­king rese­arch approa­ches into anti­vi­ral drugs also based on natu­ral pro­ducts that are stu­di­ed at his aca­de­mic insti­tu­te – which includes the pre­ven­ti­on of influ­en­za infec­tions by non­spe­ci­fi­cal­ly blo­cking viral adhe­si­on through her­bal extracts.

Cis­tus inca­nus spp. Pandalis

The well-known poten­ti­al of seve­ral plant extra­cts for anti­mi­cro­bi­al acti­vi­ty is found in many of the tra­di­tio­nal indi­ca­ti­ons descri­bed in detail by the cur­rent WHO mono­graphs on 118 sel­ec­ted medi­cinal plants [3]. The virus inhi­bi­ting acti­vi­ty of seve­ral her­bal extra­cts tes­ted so far is main­ly cau­sed by the high con­cen­tra­ti­on of poly­phe­nols, e.g. in the spe­cial rock­ro­se extra­ct Cystus052 [3]. The pos­tu­la­ted effect is main­ly a non-spe­ci­fic blo­cka­de of viral sur­face pro­te­ins by the extra­ct, accor­ding to Lud­wig. In the case of influ­en­za A viru­s­es, the poly­phe­nols inhi­bit the viral hem­ag­glu­ti­nin. Exact­ly that miss­ing spe­ci­fi­ci­ty deter­mi­nes both the broad anti­vi­ral spec­trum and – in con­trast to neu­r­a­mi­ni­da­se inhi­bi­tors – the miss­ing deve­lo­p­ment of resis­tance during tre­at­ment with the afo­re­men­tio­ned spe­cial extra­cts of Cis­tus inca­nus [5]. This her­bal extra­ct, accor­ding to the stu­dies at the Uni­ver­si­ty of Muens­ter, has an extre­me­ly high con­tent of poly­me­ric poly­phe­nols. In addi­ti­on, the tre­at­ment with Cystus052 had no effects on cel­lu­lar via­bi­li­ty and meta­bo­lism, intracel­lu­lar signal­ing or cyto­ki­ne respon­ses. Thus, Lud­wig equal­ly assu­mes a non-spe­ci­fic bin­ding of viru­s­es by the extra­ct ingre­di­ents and an absence of phar­ma­co­lo­gi­cal effect on cells. The unspe­ci­fic action of the Cis­tus extra­ct tes­ted in Muens­ter also accounts for the near­ly com­ple­te lack of the emer­gence of resistant viral strains, unli­ke neu­r­a­mi­ni­da­se inhi­bi­tors. Mean­while other groups of sci­en­tists could also demons­tra­te anti­vi­ral as well as the­ra­peu­tic effects by the same spe­cial Cis­tus-extra­ct in ani­mal models and cli­ni­cal stu­dies. Eit­her with distinct infec­tion-blo­cking effects (ani­mal model [6]) or by shor­tening the dura­ti­on of sym­ptoms and acce­le­ra­ted ame­lio­ra­ti­on of sym­ptoms (RCT [7]).

In Ludwig’s opi­ni­on the­re are seve­ral sub­s­tances pro­mi­sing to be effi­ci­ent tools in the war on influ­en­za while tur­ning prac­ti­cal medi­ci­ne away from clas­si­cal immu­no­lo­gi­cal con­cepts for pre­ven­ti­on or estab­lished post-infec­tious the­ra­peu­tic approa­ches. Doing this, Lud­wig empha­si­zed, will be a true para­digm chan­ge at least in anti­vi­ral rese­arch. Alt­hough a few phy­to­the­ra­peu­tic approa­ches are alre­a­dy pre­sent, medi­cal pro­ducts from tra­di­tio­nal medi­ci­ne should be given more atten­ti­on. Not only to com­ply with WHO recom­men­da­ti­ons with regard to low resour­ce are­as in the world, but also to pro­vi­de more secu­re opti­ons for influ­en­za pro­phy­la­xis and the­ra­py than befo­re. Of cour­se, to fol­low the WHO recom­men­da­ti­ons, also more con­trol­led cli­ni­cal tri­als with natu­ral pro­ducts are nee­ded in future.

[1] Glo­bal Influ­en­za Pro­gram­me (WHO): WHO public health rese­arch agen­da for influ­en­za. WHO Press, Genf, 2010 (https://bit.ly/d2df1C).
[2] Con­gress: “Opti­ons for the Con­trol of Influ­en­za VII”. Orga­ni­zer: Inter­na­tio­nal Socie­ty for Influ­en­za and other Respi­ra­to­ry Virus Dise­a­ses (isirv.org), Hong­kong, 2010, Sep­tem­ber 3–7. (https://www.controlinfluenza.com/webcasts/optionsvii).
[3] World Health Orga­niza­ti­on: WHO mono­graphs on sel­ec­ted medi­cinal plants (Vol. 1–4). Genf, 1999–2005.
[4] Hud­son JB: The use of her­bal extra­cts in the con­trol of influ­en­za. J Med Plants Res. 2009 Dec;3(13):1189–95.
[5] Ehr­hardt C, Hrin­ci­us ER, Kor­te V, Mazur I, Droeb­ner K, Poet­ter A, Dre­schers S, Schmol­ke M, Planz O, Lud­wig S: A poly­phe­nol rich plant extra­ct, CYSTUS052, exerts anti influ­en­za virus acti­vi­ty in cell cul­tu­re wit­hout toxic side effects or the ten­den­cy to indu­ce viral resis­tance. Anti­vi­ral Res. 2007 Oct;76(1):38–47.
[6] Droeb­ner K, Ehr­hardt C, Poet­ter A, Lud­wig S, Planz O: CYSTUS052, a poly­phe­nol-rich plant extra­ct, exerts anti-influ­en­za virus acti­vi­ty in mice. Anti­vi­ral Res. 2007 Oct;76(1):1–10.
[7] Kalus U, Gri­go­rov A, Kade­cki O, Jan­sen JP, Kie­se­wet­ter H, Rad­tke H: Cis­tus inca­nus (CYSTUS052) for trea­ting pati­ents with infec­tion of the upper respi­ra­to­ry tract. A pro­s­pec­ti­ve, ran­do­mi­sed, pla­ce­bo-con­trol­led cli­ni­cal stu­dy. Anti­vi­ral Res. 2009 Dec;84(3):267–71.

Addi­tio­nal informations
WHO: “Impro­ve cli­ni­cal manage­ment of pati­ents: […] Alt­hough anti­vi­ral drugs can redu­ce the dura­ti­on and seve­ri­ty of ill­ness and help con­trol out­breaks, they are not wide­ly used for tre­at­ment or pro­phy­la­xis in both under- and well-resour­ced count­ries during annu­al epi­de­mics. They must be taken soon after the onset of ill­ness and resis­tance can deve­lop. Expan­si­on and opti­miza­ti­on of the cur­rent reper­toire of anti­vi­ral drugs and deve­lo­p­ment of cli­ni­cal rese­arch to assess effi­ca­cy of puta­ti­ve adju­vant tre­at­ment moda­li­ties such as immu­no­mo­du­la­tors, pas­si­ve immu­no­the­ra­py and tra­di­tio­nal medi­ci­ne that are sui­ta­ble for use in under-resour­ced are­as would be most bene­fi­ci­al. […] Deve­lop novel and effec­ti­ve tre­at­ment stra­te­gies inclu­ding adjunc­ti­ve tre­at­ments (e.g. immu­no­mo­du­la­tors, immu­no­glo­bu­lin, natu­ral pro­ducts) that are appli­ca­ble in low resour­ce set­tings and easy to admi­nis­ter in pedia­tric and inten­si­ve care settings. […]”
Source: Glo­bal Influ­en­za Pro­gram­me (WHO): WHO public health rese­arch agen­da for influ­en­za. WHO Press, Gen­e­va, 2010 (https://bit.ly/d2df1C).

• Rai­ner H. Buben­zer, Heil­pflan­­zen-Welt (26.10.2010).

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