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Common Upper Respiratory Disorders And Alternative Treatment (part 5)

Linden, Tiliaceae
Tilia is considered as a part of the traditional folk medicine. Its extract contains mucilage, flavonoids, phenolic carbon acids and essential oils. Linden extract is used nowadays as a remedy for common cold and associated cough (114) due to its sedatives and tranquilizer effect. Studies showed that it has clear anxiolytic effect (115). 
Components prepared from Tiliaceae were also found to inhibit the histamine release induced by antigen-antibody reaction, which explains its antiallergic effect (116). 

Lavandula Vera
Many studies have been done on essential oils of Lavandula Vera and it has been concluded that when inhaled they have sedative property through their significant effect on brainwaves. The effect of oils is probably transmitted through the brain via the olfactory system (the olfactory nerve and its endings which supplies the nose). Used professionally and safely, essential oils can be of great benefit (117). 

Lavender oil is a source of vegetable aromatic substances (VAS), which has significant effect upon the oxidative-restoration enzymes activity of the body. The lack of these substances causes changes in the most important enzymes of glycolysis and pentosophosphatic cycle (118). 

Samples of essential oil Lavandula Vera has been found to contain 49 components. The major components of the oil are linalool (47-22%, linalylacetate (15-22%) and terpinen--4-ol (7-21%) (119).

Sensory evaluation and physiological measurements of the sedative properties of linalool, isolated from lavender oil was studied on humans after its inhalation. The study confirmed its efficacy in sedation (120). The sedative nature of linalool, one of the lavender's major components, on inhalation, has been shown both in animals and man. Animal experimental studies also showed that it decreases the tone in the skeletal muscle preparation of the phrenic nerve-diaphragm of rats, a result that could explain its useful effect in reducing the chest symptoms that accompany upper respiratory tract infection and allergy (121). 

The sedative effect was found to be closely dependent on the exposure time to the oil (122). 
Lavender oil, used in topical formulations, helps the relief of the musculo-skeletal pain due to its hydroxyl radical scavenging properties (123). 

Animal experimental studies showed that lavender oil inhibits immediate type allergic reactions by inhibition of mast cell degranulation in-vivo and in-vitro through both topical and intradermal applications. The inhibition was concentration dependent (124). 

In addition to the sedative, analgesic and antiallergic effect of lavender oils, it has been found to be lipophilic skin penetration enhancer (125). It thus helps the skin permeation of the other active ingredients in the same formulation on topical application.

Maritime Pine
There is growing interest in the biologic activities of plant extracts such as that obtained from the bark of the French maritime pine, Pinus maritime. Pycnogenol (PYC) is a standardized extract composed of a mixture of flavonoids, mainly procyanidins and phenolic acids. Studies indicate that PYC components are highly bioavailable. Uniquely PYC displays greater biologic effects as a mixture than its purified components do individually indicating that the components interact synergistically. Investigations of the cellular mechanisms of these therapeutic effects have demonstrated that PYC has strong free radical-scavenging activity against reactive oxygen and nitrogen species. PYC also participates in the cellular antioxidant network as indicated by its ability to regenerate the ascorbyl radical and to protect endogenous vitamin E and glutathione from oxidative stress. PYC modulates NO metabolism in activated macrophages by quenching the NO radical. Various studies showed that the active nitrous oxide radical generated by activated macrophages causes a significant loss of alpha-tocopherol and glutathione level in endothelial cells. Pycnogenol fraction of Pine Park protects alpha-tocopherol and the glutathione of endothelial cells and enhances by about 15% basal endogenous level of alpha tocopherol. This affirms that flavonoids participate in the cellular antioxidant network and that Pycnogenol may play an important role in the protection of endothelium form oxidative stress induced by reactive nitrogen species. PYC can also bind to proteins, altering their structure and thereby modulating the activity of key enzymes and proteins involved in metabolic pathways (126,127,128). 

The polysaccharide (PSE) extracted from pine seed shells as an immunopotentiator was investigated. Macrophage phagocytosis has been found to be augmented by oral administration of PSE. The activated macrophages secrete cytokines into the circulation that lead to activation of the T cells (interaction of the specific and non specific immune system) (129). The pattern of activated T cells is CD4+ T helper cells (130). The antigenic response after initial supplying of pine seed oil (PSO) showed a significant increase in the splenic production of antibodies of the IgG type (131). It has been postulated that the application of PYC in immune diseases could be of good help. 

Experimental studies showed that the pinecone extract (PCE) suppress the growth of influenza virus due to interaction between virus proteins and pine cone antitumor substance of the extract, thus inhibiting the viral RNA synthesis and suppress virus multiplication (132). 

Experimental studies in mice have shown that pine seed shell extract has anti-bacterial effect against common bacterial infection of the respiratory tract. Experimental work showed that it has protective effect against lethal doses of Klebsiella pneumonia, Pseudomonas aeruginosa and staphylococcus aureus and also moderately inhibited the cytopathogenic effect induced by human immunodeficiency virus (HIV). These data suggest a medicinal potential of pine seed shell extract against opportunistic infection of HIV patients. It has also antifungal activity against Candida Albicans (133,134,135). The potent antiviral, antibacterial and antifungal effects of the antitumor substances isolated from pinecone extract by ethanol-precipitation have been explained by the presence of lignin-related structures complexed with the polysaccharides. This natural lignified substance is capable of stimulating the endogenous production of cytotoxic factor (possibly tumor necrosis factor). These data suggested the importance of conjugating lignins with polysaccharides for in vivo expression of various kinds of immunopotentiating activity (136). 

Rosemary (Rosmarinus Officinalis Linn.)
Rosemary (Rosmarinus Officinalis Linn.) is a common household plant grown in many parts of the world. It is used for flavouring food, a beverage drink, as well as in cosmetics. In folk medicine it is used in relieving respiratory disorders. Extract of rosemary relaxes smooth muscles of trachea. The most important constituents of rosemary are caffeic acid and its derivatives such as rosmarinic acid. These compounds have antioxidant effect. Rosmarinic acid is well absorbed from gastrointestinal tract and from the skin. It has anti-inflammatory effect due to the increased production of prostaglandin E2, and the inhibition of the complement system. It is concluded that rosemary and its constituents especially caffeic acid derivatives such as rosmarinic acid have a therapeutic potential in treatment or prevention of bronchial asthma, inflammatory diseases (137). 

Rosemary extract was found to scavenge O-2 in a concentration-dependent manner. The antioxidative effect observed is believed to be partly due to this radical scavenger activity (138), which is similar to Superoxide Dismutase enzyme (139). The presence of rosemary mixture in the different creams lead to significantly lower rate of decomposition of highly unsaturated fatty acids and so the mixture works as preservative in addition to its biological activity (140). 

Clinical trial, using natural concentrations of rosemary, basil, eucalyptus and Lavandula essential oils to study their effect on the system lipid peroxidation-antioxidant defence in 150 patients with chronic bronchitis demonstrated their beneficial effect for the treatment of chronic bronchitis (141). There is an increasing interest in the antiviral activity of plant products. A liquid, deodorized rosemary extract was tested for antioxidant and antiviral action in vitro. The main active components in the herbal preparations, carnosol and carnosic acid were found capable of inhibiting human immunodeficiency virus (HIV) infection (142). Carnosol and carnosic acid have been also suggested to account for over 90% of the antioxidant properties of rosemary extract (143). 

Immunological experiment to illustrate the impact of rosemary extract on splenic mononuclear cell proliferation was determined. The results suggest that although the use of rosemary might not have a generalized immuno-enhancing effect, it will probably be effective in some stressed conditions, such as protein or antioxidant deficiency (144). 

Melaleuca alternifolia (tea tree) oil
Tea-tree oil (oil of Melaleuca alternifolia) has recently received much attention as a natural remedy for bacterial and fungal infections of the skin and mucosa. As with most naturally occurring agents, several published studies have recently demonstrated tea-tree oil's antibacterial activity. The in vitro results suggest also that tea-tree oil may be useful in the treatment of yeast and fungal mucosal and skin infections even in immunodeficiency diseases (145). The antimicrobial activity of eight components of tea tree oil were evaluated using disc diffusion and broth micro-dilution methods to determine the susceptibility of a range of micro-organisms to 1,8-cineole, 1-terpinene-4-ol, rho-cymene, linalool, alpha-terpinene, gamma-terpinene, alpha-terpineol and terpinolene. The results had significant implications for later development of tea tree oil as an antimicrobial agent (146,147). 

Major components of tea-tree oil, terpinen-4-ol, alpha-terpineol and alpha-pinene were found to be active against Staphylococcus aureus (148). 66 isolates of Staphylococcus aureus tested were susceptible to the essential oil of Melaleuca alternifolia (149). 

The in-vitro activity of tea tree oil, against the yeast candida was examined. Fifty-seven Candida isolates were tested for sensitivity to tea tree oil by the agar dilution method; the minimum concentration of oil inhibiting 90% of isolates was 0.5% (150). Clinical study has been done to evaluate the efficacy of melaleuca oral solution in AIDS patients with fluconazole-resistant oropharyngeal candida infections and it has been concluded that Melaleuca oral solution appears to be effective as an alternative regimen for AIDS patients with oropharyngeal candidiasis refractory to fluconazole (151). 

The antifungal activity of tea tree oil, in vitro was compared to miconazole, an established topical antifungal. The studies suggested that the in vivo effect of tea tree oil ointment in the therapy of fungal infections of the skin and mucous membranes is due to an antifungal activity of tea tree oil (152). 

Other active compounds were isolated from the methanol extract of Melaleuca, Stilbenes, piceatannol and oxyresveratrol, were isolated as active compounds from the methanol extract of Melaleuca and it has been found that they strongly inhibited histamine release from activated mast cells, a property that might help controlling the allergic reactions (153).

Ocimum basilicum (Labiatae)
Ocimum basilicum fixed oil may be considered to be a medication of natural origin, which possesses antioxidant, antimicrobial, anti-inflammatory and anti-ulcer activity (154). 

The essential oil composition of Ocimum basilicum, and their antimicrobial and antioxidant activity were tested. The volatile oils exhibited considerable inhibitory effect against twenty-five different genera of bacteria. The oils also demonstrated antioxidant capacities, comparable with alpha-tocopherol (155). Studies showed that the highest concentration of total anthocyanins occurred just prior to flowering, although by day 8 seedlings already had accumulated all 14 anthocyanins. Comparisons were made to other anthocyanin sources; with results showing that purple basils Ocimum basilicum L is an abundant source of acylated and glycosylated anthocyanins (156). 
Eight known terpenoids were isolated from the roots and stems of Ocimum basilicum (Labiatae). These compounds included a sesquiterpene, T-cadinol (1), a monoterpene, linalool (2), and six triterpenoids, betulinic acid (3), betulin (4), pomolic acid (5), alphitolic acid (6), ursolic acid (7) and tormentic acid (8). Their structures were determined on the basis of spectral and physical data. The anti-inflammatory activities of the triterpenoids were investigated (157). It has been found that Fixed oil of O. basilicum possesses significant anti-inflammatory activity. The results of anti-inflammatory activity of O. basilicum support the dual inhibition of arachidonate metabolism, as it blocks both cyclooxygenase and lipooxygenase pathways of arachidonic acid metabolism (158). 

Ocimum basilicum extract has also showed potent anti-HIV-1 activity. The active components in the extract samples were found to be water-soluble polar substances, not non-polar compounds such as essential oils (159). 

Many investigators have studied the antifungal activity of the essential oils of Ocimum basilicum. The most abundant compounds in the oils of O. basilicum, alcohols and oxides (>40%), possess potent antifungal activity against wide range of fungi that include: Candida albicans, Cryptococcus neoformans, Aspergillus flavus, Aureobasidium pullulans, Microsporum gypseum, Trichophyton rubrum, and Trichoderma viride (160). 

Atropa Belladonna
Eight steroidal glycosides of the spirostane type have been isolated from the methanolic extract of Atropa belladonna L. seeds. They are tentatively named atroposides A, B, C, D, E, F, G, and H (according to their increase in polarity) (161). The efficacy of belladonna has been studied in a prospective observational study carried out by 1 homoeopathic and 4 conventional ENT practitioners, the 2 methods of treating acute pediatric otitis media were compared. Group A received treatment with homoeopathic single remedies Belladonna, Chamomile, whereas group B received nasal drops, antibiotics, secretolytics and/or antipyretics. The study involved 103 children in group A and 28 children in group B, aged between 6 months and 11 years in both groups. For duration of pain, the median was 2 days in group A and 3 days in group B. For duration of therapy, the median was 4 days in group A and 10 days in group B: this is due to the fact that antibiotics are usually administered over a period of 8-10 days, whereas homoeopathic treatment can be discontinued at an earlier stage once healing has started. Of the children treated, 70.7% were free of recurrence within a year in group A and 29.3% were found to have a maximum of 3 recurrences. In group B, 56.5% were free of recurrence, and 43.5% had a maximum of 6 recurrences. Out of the 103 children in group A, 5 subsequently received antibiotics, though homoeopathic treatment was carried to the healing stage in the remaining 98. No permanent sequels were observed in either group (162,163).

Studies also reached the conclusion that the airway smooth muscle contraction is a possible cause of airflow obstruction and this contraction is almost totally abolished by belladonna (anticholinergics) (164). 

Phytolacca Americana (pokeweed plant)
Pokeweed antiviral protein (PAP) of the pokeweed plant, Phytolacca Americana, is a naturally occurring single-chain ribosome-inactivating protein that inhibits viral RNA synthesis. The therapeutic antiviral potential of PAP has gained considerable interest in recent years (165). Pokeweed antiviral protein from seeds (PAP-S) has the lowest toxicity and highest inhibition activity as opposed to other pokeweed antiviral proteins (166). An antimicrobial peptide against both gram positive and gram-negative bacteria has been also isolated from the seeds of pokeweed (Phytolacca americana) (167). 

It has the capacity to modulate the antibody response as it has been proved by studies that the antibody response to type III pneumococcal polysaccharide (SSS-III) is enhanced by lectins from Phytolacca Americana (168). Recently, many investigators were able to isolate an antifungal peptide from seeds of Phytolacca Americana, designated PAFP-s. Its amino acid sequence corresponded to the amino acid sequence from chemical sequencing that exhibited a broad spectrum of antifungal activity (169). 

Experimental studies showed that it exhibited strong antifungal activity against Candida albicans and its activity was retained even after boiling for 30 minutes and treating with proteinase K (1.0mug/mug protein) (170). 
The efficacy of Phytolacca Americana used in homeopathy to treat acute tonsillitis was evaluated by clinical observation. The objective and subjective symptoms of acute tonsillitis were noted. A significant decrease in symptoms was observed as early as 2.5 days after treatment startup; no serious adverse effects were reported. It was concluded that acute tonsillitis could be treated with such a homeopathic remedy, which is characterized, by its immunomodulatory, analgesic, and anti-inflammatory properties (171). 

Populus Tremula
The efficacy of Populus Tremula extract as anti-inflammatory, analgesic and antipyretic natural remedy has been investigated both individually and in combination with other extracts by many Russian and German investigators.

Marked anti-inflammatory and anti-ulcerative properties of a Populus tremula bark extract were demonstrated in animal experiments (172). 

The phytotherapeutic preparation, containing Populus tremula, Solidago virgaurea produced dose-dependent anti-inflammatory, analgesic and antipyretic effects which were similar to those of the reference substances salicylic alcohol and indomethacin (173,174). 

Aqueous/alcoholic extracts of Populus tremula, Solidago virgaurea were tested individually and in combinations for anti-inflammatory activity (175). and it has been found that they inhibit biochemical model reactions representing inflammatory situations to various extents. It has been concluded that the extract possesses antipyretic, analgesic, anti-inflammatory and anti-rheumatic activity. The beneficial activities may at least in part be due to the reported antioxidative functions of the individual components. The anti-inflammatory and analgesic properties were shown clearly in pharmacological tests (176).

Balm, Melissa Officinalis, Labiatae
Rosmarinic acid (RA), a naturally occurring extract from Melissa Officinalis, inhibits several complement-dependent inflammatory processes (177). 

The sedative effect of Melissa Officinalis extracts was proved by quantitative EEG analysis and by self-assessment (178). 

Analytical studies showed that Melissa Officinalis contains high concentrations of total ascorbic acid (approximately equal to 300 mg/100 g FW) and relatively high ascorbate oxidase activity (10.1-21.1 micro mol min-1 g FW-1) (179). Besides acting as an important cofactor in the modulation of the biosynthesis of catecholamine, ascorbic acid modulates the secretion of immunoreactive beta-endorphin, which stimulates the brain opiate system responsible for pain control (180). 

Experimental studies showed that supplementation with ascorbic acid in humans enhances a number of aspects of lymphocyte function (blood cells responsible for the immune response) (181). 
In Europe, M. Officinalis is used to treat nervous disorders. Experimental studies showed that it exhibited significant analgesic activity (182).

Camomille, Matricaria recutita, Compositae.
It has been found that en-yne dicycloether one of the constituents of the essential oil of C. recutita) could partly inhibit protamine sulfate-induced degranulation (histamine release) of mast cells and thus inhibits allergic reactions (183). Chamomil extract also exerts anti-inflammatory activity (184). 


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