Dong Quai
Scientific Name(s): Angelica sinensis (Oliv.) Diels. Family: Apiaceae (carrot family)
Common Name(s): Dong quai , danggui , tang-kuei , Chinese angelica
Clinical Overview
Uses of Dong Quai
Traditionally used as an analgesic for rheumatism, an allergy suppressant, and in the treatment of menstrual disorders, dong quai has been shown to possess antiasthmatic, antispasmodic, anti-inflammatory, and anticoagulant properties. It has also been used to flavor liqueurs and confections.
Dong Quai Dosing
Crude dong quai root has been given in doses ranging from 0.75 g/day to as much as 30 g/day. Typical doses are around 4.5 g/day. 1 , 2
Contraindications
Contraindications have not yet been identified.
Pregnancy/Lactation
Documented adverse effects include uterine contractions. Avoid use. 3
Dong Quai Interactions
Because warfarin has a narrow therapeutic index, patients should avoid concurrent use of dong quai and should consult their health care provider before using herbal products
Dong Quai Adverse Reactions
No reported side effects have occurred with authentic dong quai, but with A. gigas , A. dahurica , and A. pubescens , there is a very reasonable risk of phototoxicity.
Toxicology
Angelica archangelica L. is reported to be an abortifacient and to affect the menstrual cycle. A. sinensis has uterine stimulant activity.
Botany
A. sinensis (Oliv.) Diels is synonymous with A. polymorpha var. sinensis Oliv. Three species of Angelica are monographed separately in the Chinese pharmacopeia: Dong quai, the root of Angelica sinensis ; Bai zi, the root of Angelica dahurica (Fisch.) Benth. et. Hook. f. or A. dahurica var. formosana (Boiss.) Shan et Yuan; and Du huo, the root of A. pubescens Maxim. f. biserrata Shan et Yuan. 4 In Korea, A. gigas Nakai is used medicinally, while in Japan, A. acutiloba Kitagawa is used. The European A. archangelic L. is used to flavor liqueurs and confections. While botanically related, do not confuse the various species of Angelica , which differ in chemistry, pharmacology, and toxicology. A molecular biology study of A. acutiloba may lead to efficient methods for distinguishing raw materials. 5
History
Dong quai is widely used in traditional Chinese medicine and continues to be popular in China and elsewhere. It is used to treat menstrual disorders, as an analgesic in rheumatism, and in suppressing allergy symptoms. It is promoted for similar uses in the American herb market.
Chemistry
The chemistry of A. sinensis is distinct from the other species. While coumarins have been reported from this species, 6 a recent comparative study of commercial dong quai products and related species 7 found coumarins to be lacking, while the lactone Z-ligustilide was a major constituent. In fact, in this study, A. sinensis more closely resembled Levisticum officinale in chemical composition than it did the other species of Angelica . Thus, there is good justification for terming the latter plant “European dong quai.” Several other lactones related to ligustilide have been found in A. sinensis . 8 , 9 , 10 Ferulic acid and its esters were also found in A. sinensis . A capillary electrophoresis method for measuring ferulic acid in A. sinensis has been published. 11
In contrast, the roots of A. dahurica have been found to contain an abundance of coumarins. Imperatorin and isoimperatorin are the major constituents, with many other related compounds (eg, bergapten, phellopterin, scopoletin) reported. 12 Ferulic acid was also detected in this species. 13
The root of A. pubescens contains coumarins, but with some differences from A. dahurica . The simple prenylcoumarin, osthole, and the linear furocoumarins, columbianadin and columbianetin acetate, are the major constituents while the coumarins, angelols A-H, are characteristic of the species. 14 , 15
The common polyacetylene falcarindiol has been isolated from various species of Angelica . 7 Polysaccharides have been isolated from different species of Angelica ; however, they have not been characterized sufficiently to permit comparison. 16 Simple plant sterols and lipids have also been found. 17
Dong Quai Uses and Pharmacology
Antiallergy effectsAnimal data
A water extract of A. sinensis inhibited IgE-antibody production in a mouse model of atopic allergy. The extract was active orally and the activity was retained on dialysis, indicating that it was caused by high molecular weight components of the extract. 18
Clinical dataResearch reveals no clinical data regarding the use of dong quai for allergy.
Antispasmodic effectsAnimal data
The simple lactone ligustilide is thought to be a major bioactive principle of dong quai. Its antiasthmatic action was studied in guinea pigs. 19 Ligustilide and the related butylidenephthalide and butylphthalide were found to have antispasmodic activity against rat uterine contractions and in other smooth muscle systems. The compounds were characterized as nonspecific antispasmodics with a mechanism different from papaverine. 20 The ligustilide and butylidenephthalide constituents of Japanese angelica root were found to reverse the decrease in pentobarbital sleep induced by either isolation stress or yohimbine, implicating central noradrenergic or GABA systems in their actions. 21
Clinical dataResearch reveals no clinical data regarding the use of dong quai for antispasmodic effects.
Anticoagulant effectsThe coumarins of Angelica species have been associated with both bioactivity and toxicity of the plants; however, the low coumarin content of A. sinensis minimizes its importance in dong quai pharmacology. In other species of Angelica , coumarins clearly play an important role. Simple coumarins often have anticoagulant effects, while the linear furocoumarins are well known as photosensitizing agents. 22
Animal/Clinical dataResearch reveals no animal or clinical data regarding the use of dong quai for anticoagulant effects.
Antiinflammatory effectsAnimal data
The simple prenylcoumarin, osthole, is a major constituent of A. pubescens (Du huo). 23 Osthole showed anti-inflammatory activity in carageenan-induced rat paw edema and acetic acid-induced writhing in mice. 23 Osthole also caused relaxation of rat thoracic aorta preparations 24 and inhibited proliferation of rat vascular smooth muscle cells. 25 Another study found that osthole inhibited the second phase of edema caused by formalin in the rat. 26 An inhibitory effect was also seen for osthole on 5-lipoxygenase and cyclooxygenase. 27 The related prenylcoumarin angelols were shown to inhibit platelet aggregation. 28
The linear furocoumarin phellopterin was found to bind with high affinity to benzodiazepine receptors in vitro; however, other closely related furocoumarins were weaker or inactive. 29 Phellopterin was characterized as a competitive partial agonist of central benzodiazepine receptors by GABA and TBPS shift assays. 30 No in vivo experiments were reported. Other furocoumarins from A. dahurica inhibited histamine release in a mouse peritoneal cavity assay, 31 while isoimperatorin was analgesic; columbianadin, columbianetin acetate, and bergapten were anti-inflammatory and analgesic. 26 Finally, the action of various coumarins from A. dahurica on lipolysis in fat cells of rats were examined, with some coumarins activating lipolysis and other coumarins inhibiting lipolysis. 32
Clinical dataResearch reveals no clinical data regarding the use of dong quai as an antiinflammatory.
MenopauseAnimal data
Research reveals no animal data regarding the use of dong quai in menopause.
Clinical dataDong quai is widely used in the US to treat hot flashes and other symptoms of menopause. A randomized, double-blind, placebo-controlled trial of A. sinensis as a single agent found no effect on vasomotor flushes, endometrial thickness, or on the level of estradiol or estrone. The study material was standardized for ferulic acid content. 1 A polyherbal preparation including dong quai was shown to reduce menopausal symptoms in a much smaller clinical trial. 2
Dosage
Crude dong quai root has been given in doses ranging from 0.75 g/day to as much as 30 g/day. Typical doses are around 4.5 g/day. 1 2
Pregnancy/Lactation
Documented adverse effects include uterine contractions. Avoid use. 3
Interactions
The anticoagulant effect of warfarin was increased in a patient stabilized on 5 mg/day of warfarin while she was taking 565 mg of dong quai daily for a 1 month. 33 When she stopped taking dong quai, her international normalized ratio and prothrombin time returned to the therapeutic range over a 4 week period. The mechanism for this interaction is unknown
Adverse Reactions
Coumarins are the focus of toxicology in Angelica . Furanocoumarins such as bergapten and psoralen have been widely studied for their photoactivated toxicity; however, only A. gigas (Korean angelica) has been demonstrated to cause photodermatitis. 34 Clearly the risk of phototoxicity should be correlated with the content of specific toxic furocoumarins. In the case of A. sinensis , there appears to be little risk, but with A. gigas , A. dahurica , and A. pubescens , there is a very reasonable cause for caution. Possible synergism with calcium channel blockers may occur.
Toxicology
Angelica archangelica L. is reported to be an abortifacient and to affect the menstrual cycle. A. sinensis has uterine stimulant activity.
Bibliography
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