Medication Guide App

Baical Skullcap

Scientific Name(s): Scutellaria baicalensis Georgi. Family: Lamiaceae (mints)

Common Name(s): Baical skullcap , huang-qin , golden root

Uses

Baical skullcap has been used for anti-inflammatory, antioxidant, immunoprotective, anticancer, antimicrobial, antiviral, and circulatory conditions.

Dosing

There is no recent clinical evidence to guide dosage of Baical skullcap.

Contraindications

Contraindications have not yet been identified.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking. Avoid use.

Interactions

None well documented.

Adverse Reactions

Few side effects have been reported. A combination product including S. baicalensis may have the potential to cause cardiovascular and other negative estrogen-like effects.

Toxicology

No data.

Botany

Baical skullcap is a herbaceous perennial, growing to 0.3 to 1.2 m in height. It has lancet-shaped leaves and purplish-blue flowers. The plant can be found in Japan, Korea, Mongolia, and Russia. It thrives on sunny, grassy slopes and grows well in dry, sandy soils. The dried root is the part of the plant used in traditional Chinese medicine. Baical skullcap is related to skullcap ( S. laterifolia ), a North American species (see Skullcap monograph). 1

History

Baical skullcap is a Chinese medicinal herb used for over 2000 years to treat fevers, hypertension, coughing, and other ailments. It still is used today as a traditional remedy for “hot and damp” conditions such as dysentery and diarrhea. Among other items, Baical skullcap was listed as an ingredient in several pharmaceutical preparations in a second century AD tomb in northwestern China. 1

Baical skullcap is prescribed in China for “hot and thirsty” conditions such as fever, cough, GI, and urinary problems. Clinical trials suggest that these traditional uses are justified. Chinese herbal medicine also uses Baical skullcap for inflammation, allergies, dermatitis, hyperlipidemias, and atherosclerosis. 1 , 2

Chemistry

Flavonoids present in S. baicalensis include baicalin, baicalein, wogonin, and wogonoside. 1 , 3 RP-HPLC determination of flavonoids from S. baicalensis root has been reported. 4 Flavones Ι and ΙΙ, chrysin, wogonin, apigenin, salvigenin, scutellarein, isoscutellarein, and others were flavonoid constituents also found in S. baicalensis leaf parts. 5 Flavones baicalein, oroxylin, and skullcapflavone ΙΙ also were identified. 6 Other reports confirm similar flavonoid content. 7 , 8 One report describes melatonin in certain plant samples. 9 Other compounds include sterols and benzoic acid. 1 The western species, S. laterifolia differs in its chemical constituents.

Uses and Pharmacology

Anti-inflammatory

The anti-inflammatory effects of bacial skullcap have been well documented. One study reports the methanolic extract of 3 flavonoids, wogonin, baicalein, and baicalin, to have an effect similar to prednisolone. 10

Animal data

Another study reported the chloroform extract of S. rivularis to exhibit greatest inhibitory actions against carrageenan-induced rat paw edema vs indomethacin. Baicalin demonstrated the greatest inhibition activity when compared with baicalein and wogonin. 11 Wogonin, baicalein, and baicalin all have been found to influence some anti-inflammatory pathways via certain proteins, antigens, and enzymes. 12 , 13 , 14

Clinical data

Research reveals no clinical data regarding the use of Baical skullcap as an anti-inflammatory agent.

Antioxidant

Flavonoids from S. baicalensis have been studied for antioxidant effects. Four major flavonoids (baicalein, baicalin, wogonin, and wogonoside) have been studied in various systems, confirming several antioxidant activities. 15

Animal data

An extract of the plant demonstrated protective actions against oxidation induced by UV light, suggesting potential use against certain skin diseases. 16 Flavonoid baicalein inhibited lipid peroxidation in rat liver microsomes. 17 Baicalein and baicalin scavenged hydroxyl radical, superoxide anion, and others in a dose-dependent manner. 3 Similarly, baicalein directly scavenged superoxide, hydrogen peroxide, and hydroxyl radicals in cardiomyocytes in another report. 18 Flavonoids wogonin and wogonoside had subtle effects on these radicals but did inhibit nitric oxide production, as did the water extract of the plant in other reports. 3 , 19 , 20 Ganhuangenin isolated from S. baicalensis had greater antioxidant potency than alpha-tocopherol. 21

Clinical data

Research reveals no clinical data regarding the use of Baical skullcap as an antioxidant.

Immunoprotective/Anticancer agent

Because of its beneficial effects as an antioxidant, Baical skullcap also has been studied in immunology and cancer research.

Animal data

In rats with Pliss lymphosarcoma, a disease associated with disorders in platelet-mediated hemostasis, S. baicalensis administration produced a normalizing effect. This activity may be responsible for its antitumor and metastasis-preventing effects. 22 A 14-flavone combination from S. baicalensis had marked inhibitory effects on mouse skin tumor promotion in another report. 23 S. baicalensis also was found to demonstrate anticancer activity in laboratory mice with head and neck squamous cell carcinoma. 24 S. baicalensis , in an herbal preparation with 7 other herbs, has been evaluated for treating prostate cancer. This combination, PC-SPES, stimulates the immune system and possesses antitumor activity. PC-SPES therapy reduced prostate-specific antigen 50% in patients with hormone-resistant prostate cancer. Enzyme prostate acid phosphatase, commonly elevated in prostate cancer, also was decreased by the preparation. 25 , 26 PC-SPES was recalled in February 2002 because it contained the undeclared prescription drug warfarin.

Clinical data

S. baicalensis administered to lung cancer patients improved certain immunoglobulins. 27 Another report attributes Scutellaria root from a combination Japanese herbal medicine sho-saiko-to as being responsible for improvement in interleukin-12 production in liver cancer patients. IL-12 is an important cytokine that maintains systemic defense and bioregulation. 28 Dry extract of Baical skullcap given to 88 lung cancer patients increased hematopoiesis stimulation and improved other anticancer parameters. 29 Flavonoid wogonin also exhibited immunostimulation by activating heat shock or stress proteins in another report. 30 Baicalin and baicalein inhibit cell proliferation in certain cell lines, 31 induce quinone reductase, 32 and induce apoptosis in prostate cancer cells. 33 In vitro effects also include antigenotoxic actions of baicalein. 34

Antimicrobial

Several studies evaluating the antimicrobial effects of Baical skullcap have been performed. In vitro testing of S. baicalensis preparation on selected oral bacteria demonstrated bacteriostatic and bactericidal effects at certain concentrations. 35 Flavone isolate, baicalin, was found to be synergistic with beta-lactam antibiotics against certain resistant strains including beta-lactam and methicilin-resistant S. aureus . 36

Animal data

Research reveals no animal data regarding the use of Baical skullcap as an antimicrobial.

Clinical data

A Scutelleria compound injection vs IV piperacillin was studied in 60 patients with pulmonary infection. Results were comparable in certain parameters, such as effective rates, leucocyte count, and low side effect incidence. However, in the piperacillin group, 4 of the 30 patients had subsequent fungal infection, whereas in the Scutelleria group, no fungal infection was found after treatment. 37 High antifungal activity was found against Candida albicans caused by S. baicalensis in an herbal screening study. 38 Antifungal effect was caused by baicalein in another report in which S. baicalensis was found to be active against Cryptococcus neoformans and Pityrosporum . 39

Antiviral

Antiviral effects of the plant also have been reported. A flavonoid compound from S. baicalensis inhibited T-cell leukemia virus type Ι (HTLV-Ι). Constituent baicalin inhibited reverse transcriptase activity in HTLV-Ι-infected cells, as well as the activity of purified reverse transcriptase from Moloney murine leukemia virus and Rous-associated virus type 2. 40 Other flavones, such as isoscutellarein from S. baicalensis leaves, also show anti-influenza virus activity in vitro. 41 Isoscutellarein-8-methylether from S. baicalensis roots had effects against influenza A and B viruses. Inhibition of replication occurs by inhibiting the fusion of viral envelopes with the endosome/lysosome membrane in the early stage of the virus infection cycle. 42

Research reveals no animal or clinical data regarding the use of Baical skullcap as an antiviral.

Circulation

Baical skullcap is used to help treat circulatory problems such as high blood pressure, arteriosclerosis, varicose veins, and bruising. 1 Flavone baicalein has inhibited thrombin and thrombin-induced calcium and plasminogen activator, suggesting potential benefits in arteriosclerosis and thrombosis. 43 Another report discusses S. baicalensis in combination (sanhuang mixture) to inhibit platelet aggregation compared with 50 mg/day aspirin. 44

Research reveals no animal or clinical data regarding the use of Baical skullcap to treat circulatory problems.

Other uses

Baicalin exhibited hepatoprotective actions in rats as well. 45

Baical skullcap may have CNS actions, specifically sedative effects. 1 Flavonoids baicalin and baicalein affect glial cells, which play a role in maintaining neural cell function. 45 Flavones baicalein, oroxylin, and skullcapflavone II were found to bind with the benzodiazepine site of GABA-A receptors.

Other uses of Baical skullcap preparations include treatment of neonatal jaundice, 46 marked antiulcerogenic actions, 47 sores, swelling, boils, and diabetic problems. 1

Dosage

There is no recent clinical evidence to guide dosage of baical skullcap.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking. Avoid use.

Interactions

None well documented.

Adverse Reactions

Few side effects of Baical skullcap have been reported. No side effects were reported in liver, kidney, or medulla regions in a 60-patient study of IV Scutellaria compound. 37 Isolate isoscutellarein from S. baicalensis leaves produced negligible toxic effects in mice. 36 A combination product including S. baicalensis may have potential to cause cardiovascular and other negative estrogen-like effects. 26

Toxicology

Research reveals little or no information regarding toxicology with the use of this product.

Bibliography

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3. Gao Z, Yang X, Huang K, Xu H. Free-radical scavenging and mechanism study of flavonoids extracted from the radix of Scutellaria baicalensis Georgi. Appl Magn Reson . 2000;19:35-44.
4. Stojakowska A, Malarz J. A quantitative RP-HPLC determination of flavonoids in the roots of Scutellaria baicalensis Georgi. Herba Pol . 1998;44:300-306.
5. Miyaichi Y, Imoto Y, Saida H, Tomimori T. Studies on the constituents of Scutellaria species. (X). On the flavonoid constituents of the leaves of Scutellaria baicalensis Georgi. Shoyakugaku Zasshi . 1988;42:216-219.
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9. Murch S, Simmons C, Saxena P. Melatonin in feverfew and other medicinal plants. Lancet . 1997;350:1598-1599.
10. Chung C, Park J, Bae K. Pharmacological effects of methanolic extract from the root of Scutellaria baicalensis and its flavonoids on human gingival fibroblast. Planta Med . 1995;61:150-153.
11. Lin CC, Shieh DE. The anti-inflammatory activity of Scutellaria rivularis extracts and its active components, baicalin, baicalein and wogonin. Am J Chin Med . 1996;24:31-36.
12. Chang Y, Shen J, Wung B, Cheng J, Wang D. Chinese herbal remedy wogonin inhibits monocyte chemotactic protein-1 gene expression in human endothelial cells. Mol Pharmacol . 2001;60:507-513.
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15. Gao Z, Huang K, Yang X, Xu H. Free radical scavenging and antioxidant activities of flavonoids extracted from the radix of Scutellaria baicalensis Georgi. Biochim Biophys Acta . 1999;1472:643-650.
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17. Gao D, Sakurai K, Chen J, Ogiso T. Protection by baicalein against ascorbic acid-induced lipid peroxidation of rat liver microsomes. Res Commun Mol Pathol Pharmacol . 1995;90:103-114.
18. Shao Z, Li C, Vandon Hoek T, et al. Extract from Scutellaria baicalensis Georgi attenuates oxidant stress in cardiomyocytes. J Mol Cell Cardiol . 1999;31:1885-1889.
19. Kim H, Kim Y, Kim S, Suk K. The plant flavonoid wogonin suppresses death of activated C6 rat glial cells by inhibiting nitric oxide production. Neurosci Lett . 2001;309:67-71.
20. Tezuka Y, Irikawa S, Kaneko T, et al. Screening of Chinese herbal drug extracts for inhibitory activity on nitric oxide production and identification of an active compound of Zanthoxylum bungeanum . J Ethnopharmacol . 2001;77:209-217.
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22. Razina T, Udintsev S, Tiutrin I, Borovskaia T, Iaremenko K. The role of thrombocyte aggregation function in the mechanism of the antimetastic action of an extract of Baikal skullcap [Russian]. Vopr Onkol . 1989;35:331-335.
23. Konoshima T, Kokumai M, Kozuka M, et al. Studies on inhibitors of skin tumor promotion. XI. Inhibitory effects of flavonoids from Scutellaria baicalensis on Epstein-Barr virus activation and their antitumor-promoting activities. Chem Pharm Bull . 1992;40:531-533.
24. Zhang D. HerbalGram . 2001;53:66-67.
25. Small E, Frohlich M, Bok R, et al. Prospective trial of the herbal supplement PC-SPES in patients with progressive prostate cancer. J Clin Oncol . 2000;18:3595-3603.
26. Oh W, George D, Hackmann K, Manola J, Kantoff P. Activity of the herbal combination, PC-SPES, in the treatment of patients with androgen-independent prostate cancer. Urology . 2001;57:122-126.
27. Smol'ianinov, E, Gol'dberg V, Matiash M, et al. Effect of Scutellaria baicalensis extract on the imunologic status of patients with lung cancer receiving antineoplastic chemotherapy. Eskp Klin Farmakol . 1997;60:49-51.
28. Yamashiki M, Nishimura A, Huang X, Nobori T, Sakaguchi S, Suzuki H. Effects of the Japanese herbal medicine “Sho-saiko-to” (TJ-9) on interleukin-12 production in patients with HCV-positive liver cirrhosis. Dev Immunol . 1999;7:17-22.
29. Gol'dberg V, Ryzhakov V, Matiash M, et al. Dry extract of Scutellaria baicalensis as a hemostimulant in antineoplastic chemotherapy in patients with lung cancer. Eksp Klin Farmakol . 1997;60:28-30.
30. Cho S. Scutellaria baicalensis and Rauwolfia serpentina extracts as immunostimulants. Patent application: JP 99-217734 19990730.
31. Hsu S, Hsieh Y, Hsieh W, Chou C. Baicalein induces a dual growth arrest by modulating multiple cell cycle regulatory molecules. Eur J Pharmacol . 2001;425:165-171.
32. Park H, Lee Y, Park H, Lee Y, Kwon I, Yu J. Induction of quinone reductase by a methanol extract of Scutellaria baicalensis and its flavonoids in murine Hepa 1c1c7 cells. Eur J Cancer Prev . 1998;7:465-471.
33. Chan FL, Choi HL, Chen ZY, et al. Induction of apoptosis in prostate cancer cell lines by a flavonoid baicalin. Cancer Lett . 2000;160:219-228.
34. Lee, B, Lee S, Kang T, et al. Baicalein. An in vitro antigenotoxic compound from Scutellaria baicalensis . Planta Med . 2000;66:70-71.
35. Tsao T, Newman M, Kwok Y, Horikoshi A. Effect of Chinese and western antimicrobial agents on selected oral bacteria. J Dent Res . 1982;61:1103-1106.
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39. Yang D, Michel D, Bevalot F, Chaumont J, Millet-Clerc J. Antifungal activity in vitro of Scutellaria baicalensis Georgi upon cutaneous and ungual pathogenic fungi. Ann Pharm Fr . 1995;53:138-141.
40. Baylor NW, Fu T, Yan YD, Ruscetti FW. Inhibition of human T cell leukemia virus by the plant flavonoid baicalin (7-glucuronic acid, 5,6-dihydroxyflavone). J Infect Dis . 1992;165:433-437.
41. Nagai T, Miyaichi Y, Tomimori T, Suzuki Y, Yamada H. In vivo anti-influenza virus activity of plant flavonoids possessing inhibitory activity for influenza virus sialidase. Antiviral Res . 1992;19:207-217.
42. Nagai T, Suzuki Y, Tomimori T, Yamada H. Antiviral activity of plant flavonoid, 5,7,4′-trihydroxy-8-methoxyflavone, from the roots of Scutellaria baicalensis against influenza A (H3N2) and B viruses. Biol Pharm Bull . 1995;18:295-299.
43. Kimura Y, Yokoi K, Matsushita N, Okuda H. Effects of flavonoids isolated from Scutellariae radix on the production of tissue-type plasminogen activator and plasminogen activator inhibitor-1 induced by thrombin and thrombin receptor agonist peptide in cultured human umbilical vein endothelial cells. J Pharm Pharmacol . 1997;49:816-822.
44. Huang WM, Yan J, Xu J. Clinical and experimental study on inhibitory effect of sanhuang mixture on platelet aggregation [Chinese]. Zhongguo Zhong Xi Yi Jie He Za Zhi . 1995;15:465-467.
45. Kyo R, Nakahata N, Sakakibara I, Kubo M, Ohizumi Y. Baicalin and baicalein constituents of an important medicinal plant, inhibit intracellular Ca2+ elevation by reducing phospholipase C activity in C6 rat glioma cells. J Pharm Pharmacol . 1998;50:1179-1182.
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