Elderberry
Scientific Name(s): Sambucus canadensis L. (American elder) and Sambucus nigra L. (European elder). Family: Caprifoliaceae.
Common Name(s): Sweet elder , common elder , elderberry , sambucus 1
Clinical Overview
 |
Uses of Elderberry
Elder flowers and berries have been used in flavorings and in traditional medicines. Interest in its role in viral infections is increasing.
Elderberry Dosing
There is no clinical evidence to support dosage of elderberry.
Contraindications
Contraindications have not yet been identified.
Pregnancy/Lactation
Information regarding safety and efficacy in pregnancy and lactation is lacking.
Elderberry Interactions
None well documented.
Elderberry Adverse Reactions
Nausea, vomiting, weakness, dizziness, numbness, and stupor have been reported.
Toxicology
No data.
Botany
The American elder is a tall shrub that grows to 4 m. It is native to North America. The European elder grows to about 10 m. Although it is native to Europe, the European elder has been naturalized to the United States.
History
Elder flowers and berries have been used in traditional medicine and as flavorings for centuries. In folk medicine, the flowers have been used for their diuretic and laxative properties and as an astringent. Various parts of the elder have been used to treat cancer and a host of other unrelated disorders. 2 Distilled elder flower water has been used as a scented vehicle for topical preparations and extracts are used to flavor foods, including alcoholic beverages. The fruits have been used to prepare elderberry wine.
Chemistry
European elder flowers contain about 0.3% of an essential oil composed of free fatty acids and alkanes. The triterpenes α- and β-amyrin, ursolic acid, oleanic acid, betulin, betulic acid, and a variety of other minor components have been identified. 3 , 4 The elder leaf contains sambunigrin, a cyanogenic glucoside (0.042% by weight). 1 Leaves of S. nigra express 2 classes of thaumatin-like proteins (TLP). The fruit-specific TLP accumulates only during the final stages of fruit ripening. 5
The following 4 anthocyanins have been isolated from elderberry extract: Cyanidin 3-sambubioside-5-diglucoside, cyanidin-3,5-diglucoside, cyanidin 3-sambubioside, and cyanidin 3-glucoside. 6 Another study has demonstrated that anthocyanins contained in an elderberry extract can be absorbed by humans in their glycosidic forms. 7
The Sambucus species are now undergoing significant scrutiny because they contain a number of plant lectins that have hemagglutinin characteristics. These compounds are useful in blood typing and defining other hematologic characteristics. 6 , 8
Elderberry Uses and Pharmacology
Stimulation of immune systemAnimal data
Sambucus may strongly stimulate the immune system through inducing cytokine production in healthy individuals as well as in patients with influenza, or in other immunocompromised patients such as those with cancer or HIV. Sambucus formulations have been shown to have a strong stimulatory effect on the production of inflammatory and anti-inflammatory cytokines (IL-1β, TNFα, IL-6, IL-8, IL-10). The production of all 5 cytokines was increased by sambucol 1.3- to 1.6-fold as compared with placebo. 9
Clinical dataResearch reveals no clinical data regarding the use of elderberry for the stimulation of the immune system.
Antiviral effectsAnimal data
A standardized elderberry extract, Sambucol , (SAM) was tested against herpes simplex virus-1 (HSV-1) in MS 9 (human diploid fibroblasts) and buffalo green monkey cells. The replication of HSV-1 strains was completely inhibited: a) by preincubation with SAM before infection of the cells; b) when SAM and the virus were added simultaneously to the cells; and c) when SAM was added 30 minutes after viral adsorption on the cells. 10
A significant reduction in the infectivity of HIV strains (ELI, LAI, HIV IIIb) was seen in the presence of Sambucol , measured by the level of HIV core antigen p24. HIV antigen was not detected 5 and 9 days postinfection in cultures infected with patient isolates which were previously treated with Sambucol . 11
Clinical dataSambucol was shown to inhibit the hemagglutination and replication of 10 different human influenza virus strains (both A and B).
In a double-blind, placebo-controlled, randomized study of patients with influenza, patients recovered in 2 to 3 days in nearly 90% of the SAM-treated group. Convalescent phase serologies showed higher mean and mean geometric hemagglutination inhibition titers to influenza B in the group treated with SAM than in the control group. 12
Antioxidant effectsDietary consumption of anthocyanin has been shown to improve overall antioxidant status of human plasma.
Animal dataAnthocyanins found in the S. nigra L. have been shown to significantly enhance endothethial cell resistance to the damaging effects of reactive oxygen species. Protection against H 2 O 2 -induced loss in cell viability was most striking. 13 Elderberry samples were observed to possess oxygen-radical absorbing capacity values comparable with cranberry and raspberry seed (approximately 22), but were significantly lower than blueberry and wild bilberry samples ( P < 0.05). 14
Clinical dataResearch reveals no clinical data regarding the use of elderberry for antioxidant effects.
Lipid-lowering effectsAnimal data
Research reveals no animal data regarding the use of elderberry for lipid-lowering effects.
Clinical dataIn a placebo-controlled study, there was only a small and statistically insignificant change in cholesterol in the elderberry-treated group compared with placebo. 15
Other usesElder flowers are considered to have diuretic and laxative properties; however, the specific compounds responsible for these activities have not been well established. The compound sambuculin A and a mixture of alpha- and beta-amyrin palmitate have been found to exhibit strong antihepatotoxic activity against carbon tetrachloride-induced liver damage. 16
Dosage
There is no clinical evidence to support dosage of elderberry.
Adverse Reactions
One report of severe illness following the ingestion of juice prepared from elderberries has been recorded by the Centers for Disease Control. 17 People attending a picnic who ingested several glasses of juice made from berries picked the day before reported nausea, vomiting, weakness, dizziness, numbness, and stupor. One person who consumed 5 glasses of juice was hospitalized for stupor. All recovered. Although cyanide levels were not reported, there remains the possibility of cyanide-induced toxicity in these patients. While elderberries are safe to consume, particularly when cooked, leaves and stems should not be crushed when making elderberry juice. Uncooked berries may produce nausea.
Toxicology
Because of the cyanogenic potential of the leaves, extracts of the plant may be used in foods, provided hydrogen cyanide levels do not exceed 25 ppm in the flavor. Toxicity in children who used peashooters made from elderberry stems has been reported. 2
Bibliography
1. Leung AY. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics . New York: Wiley; 1980.2. Duke JA. CRC Handbook of Medicinal Herbs . Boca Raton, FL: CRC Press; 1985.
3. Gruenwald J, ed. PDR for Herbal Medicines . 2nd ed. Montvale, NJ: Thomson Medical Economics; 2000:288-289.
4. Inoue T, Sato K. Triterpenoids of Sambucus nigra and S. canadensis . Phytochemistry . 1975;14:1871.
5. Van Damme EJ, Charels D, Menu-Bouaouiche L, et al. Biochemical, molecular and structural analysis of multiple thaumatin-like proteins from the elderberry tree ( Sambucus nigra L.). Planta . 2002;214:853-862
6. Mach L, Scherf W, Ammann M, et al. Purification and partial characterization of a novel lectin from elder ( Sambucus nigra L.) fruit. Biochem J . 1991;278(pt 3):667-671.
7. Cao G, Prior RL. Anthocyanins are detected in human plasma after oral administration of an elderberry extract. Clin Chem . 1999;45:574-576.
8. Kaku H, Peumans WJ, Goldstein IJ. Isolation and characterization of a second lectin (SNA- II ) present in elderberry ( Sambucus nigra L.) bark. Arch Biochem Biophys . 1990;277:255.
9. Barak V, Birkenfeld S, Halpern T, Kalickman I. The effect of herbal remedies on the production of human and inflammatory and anti-inflammatory cytokines. Isr Med Assoc J . 2002:4(suppl 11);919-922
10. Morag A, et al. Inhibition of sensitive and acyclovir-resistant HSV-1 strains by an elderberry extract in vitro. Xth International Congress of Virology Jerusalem, Israel 11-16 August 1996. Phytoparasitica . 1997:25:1.
11. Shapira-Nahor O, et al. The effect of Sambucol on HIV infection in vitro. Congr Microbiol . Feb 6-7, 1995.
12. Zakay-Rones Z, Varsano N, Zlotnik M, et al. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract ( Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med . 1995;1:361-369.
13. Youdim KA, Martin A, Joseph JA. Incorporation of the elderberry anthocyanins by endothelial cells increases protection against oxidative stress. Free Radic Biol Med . 2000;29:51-60.
14. Roy S, Khanna S, Alessio HM, et al. Anti-angiogenic property of edible berries. Free Radic Res . 2002;36:1023-1031.
15. Murkovic M, Abuja PM, Bergmann AR, et al. Effects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study. Eur J Clin Nutr . 2004;58:244-249.
16. Lin CN, Tome WP. Antihepatotoxic principles of Sambucus formosana . Planta Med . 1988;54:223-224.
17. Poisoning from elderberry juice-California. MMWR Morb Mortal Wkly Rep . 1984;33:173-177.
 |
Link to Page |  |
Print Page |  |
Email Page |  | Add to List |
