Lady's Mantle

Scientific Name(s): Alchemilla caucasica, Alchemilla mollis, Alchemilla vulgaris, Alchemilla xanthochlora
Common Name(s): Alchemilla, Bear's foot, Common lady's mantle, Ladder brake, Lady's mantle, Lion's foot

Medically reviewed by Drugs.com. Last updated on Sep 1, 2022.

Clinical Overview

Use

Limited clinical studies have investigated effects of lady's mantle on wound healing and postintubation sore throat. Use cannot be recommended for any indication.

Dosing

Clinical studies are lacking to support specific dosing recommendations for lady's mantle.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

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

Interactions

None well documented.

Adverse Reactions

Information regarding potential adverse reactions is lacking; none were reported at low doses.

Toxicology

No data.

Scientific Family

• Rosaceae (rose)

Botany

Alchemilla, an aggregate of species collectively referred to as "lady's mantle," is native to cool, temperate regions of Europe and Asia, with some species cultivated in North America, and grows in meadows, woodland clearings, and pastures. It is a perennial herb that grows up to 40 cm in height and consists of a short rhizome carrying ascending or sprawling stems and large (up to 8 cm in width) circular or kidney-shaped grey-green leaves at the base. The main ribs of the leaf protrude to the lower face and have small teeth at their tips. The inflorescence is a compound terminal cyme of dense clusters of small, yellow-green flowers, with sepals occurring in 2 rings of 4 without petals. The fruit is of the achene type (formed from one carpel). The entire plant is covered in fine, soft, short hairs.(Bisset 1994, Ghedira 2012, USDA 2016)

History

In the Middle Ages, alchemists used rainwater or dew that collected in the lady’s mantle leaf center for its purported magical and medicinal powers, a custom derived from the plant's common name alchemilla, which is from the Arabic word alkimiya, meaning "universal cure for disease." The plant has long been associated with the Virgin Mary due to the shape of its leaf lobes, which resemble the edges of a mantle, and was one of several herbal plants used in wreaths during Corpus Christi celebrations. Traditional uses for lady's mantle include as a mild astringent, anti-inflammatory, antidiarrheal, diuretic, menstrual cycle regulator, treatment for digestive disorders, and relaxant for muscular spasms. Externally, lady's mantle has been widely used in bath preparations, wound healing, skin bruises, and as an herbal cosmetic.(Bisset 1994, Ghedira 2012, Luczaj 2012, Smolyakova 2012)

Chemistry

Lady's mantle, similar to most members of the Rosaceae family, contains flavonoids and phenolic acids, which may account for its antioxidant activity.(Condrat 2009, Condrat 2010, Denev 2014, Olafsdottir 2001) The flavonoids quercetin, rutin, and kaempferol have been identified, as well as the phenols gallic acid and caffeic acid, although concentrations among species vary.(Condrat 2010, Denev 2014, Fraisse 2000, Ghedira 2012, Smolyakova 2012, Takir 2014) The presence of tannins (ellagitannins such as pedunculagin and alchemillin) at concentrations of 6% to 8% has also been described.(Bisset 1994, Ghedira 2012) Aldehydes, alcohols, terpenes, esters, acids, and hydrocarbons have been identified in the essential oil.(Falchero 2009)

Uses and Pharmacology

Anti-inflammatory effects

In vitro data

Various extract preparations have demonstrated significant anti-inflammatory effects in vitro.(Küpeli Akkol 2015, Oz 2016, Seker Karatoprak 2017) A 70% methanol and water extract was particularly effective in reducing nitric oxide against lipopolysaccharide-stimulated cells, while all extract preparations significantly inhibited tumor necrosis factor-alpha secretion with maximum suppression observed with the 70% methanol extract.(Seker Karatoprak 2017)

Antimicrobial and antiviral effects

In vitro data

In vitro, lady's mantle leaf extract demonstrated some activity against human bacterial and fungal pathogens, including Helicobacter pylori.(Denev 2014, Krivokuća 2015) Various extract preparations from aerial parts of A. mollis showed moderate to high activity against Staphylococcus aureus, Salmonella enteritidis, S. typhimurium, Escherichia coli, and Candida albicans.(Seker Karatoprak 2017)

An inhibitory effect against influenza viruses was also observed in vitro.(Makau 2013) Extracts from the root and aerial parts of lady's mantle demonstrated activity against orthopoxviruses in an in vitro study.(Filippova 2017)

Antioxidant effects

In vitro and animal data

A. mollis conferred protection and exhibited antioxidant effects and radical scavenging activity in vitro and in a murine model.(Hwang 2018, Oz 2016, Seker Karatoprak 2017, Trendafilova 2011)

Antiulcer effects

Animal data

In an indomethacin-induced gastric ulcer rat model, A. caucasica extract exerted significant antiulcer activity, with the 200 mg/kg dose demonstrating the largest effect, which was comparable to famotidine. Additionally, antioxidant effects were noted.(Karaoglan 2020)

Cardiovascular effects

Animal data

In one study examining the vascular effects of methanol and aqueous extracts of A. vulgaris in rats, the methanol extract was high in quercetin and had a relaxant effect on aortic tissue, while the aqueous extract was higher in gallic acid content and resulted in enhanced contractility.(Takir 2014, Takir 2015) Oral administration of the methanol extract had a hypotensive effect.(Takir 2015) Rheological effects of A. vulgaris extract was explored in an arterial hypertension rat model. The extract demonstrated significant improvements in RBC surface architectonic and membrane lipid composition. The increase in membrane lipid content and normalization of phospholipid composition contributed to improvement in erythrocyte deformability and membrane function.(Plotnikov 2006)

Diabetes

Animal data

Despite traditional purported use in diabetes, lady's mantle showed no effect on hyperphagia, polydipsia, body weight loss, hyperglycemia, or hyperinsulinemia in a study involving mice with streptozotocin-induced diabetes.(Swanston-Flatt 1990)

Endometriosis

Animal data

In a rat model of endometriosis, A. mollis extract significantly reduced adhesion scores and reduced mean endometrioma volume (from 101.35 to 11.87 mm³).(Küpeli Akkol 2015)

Hepatoprotective effects

Animal data

In a rat model of carbon tetrachloride-induced hepatotoxicity, serum ALT levels were significantly reduced by the aerial part and root extracts of A. mollis (P<0.05 vs control).(Ozbek 2017)

Neuroprotective effects

Animal data

Infusion of A. vulgaris aerial extract (5 and 25 mL/kg/day for 5 days) to mice exposed to hypoxic conditions protected CNS functioning in mice that survived hypoxic shock. Exploratory behavior was restored and the lower dose had a more pronounced effect on locomotor activity than controls, which was greater than that seen with the reference drug (piracetam). Both doses possessed an anti-amnestic effect that facilitated retention of previously learned behavior with the lower dose demonstrating a maximum effect.(Shilova 2020)

Postintubation sore throat

Clinical data

In a randomized, double-blind, controlled trial of 88 patients undergoing thoracic surgery using double lumen tube intubation, the effects of A. vulgaris in glycerin were compared with dexamethasone for incidence of postoperative sore throat and hoarseness. Forty-five patients received dexamethasone 0.2 mg/kg intravenously (IV) and 2 mL of normal saline sprayed into the oropharyngeal cavity before intubation, and 43 patients received 0.04 mL/kg of normal saline IV and 1 g of A. vulgaris in glycerin mixed with 1 mL of normal saline sprayed into the oropharyngeal cavity before intubation. No statistically significant differences were noted in incidence of sore throat 24 hours postoperatively (57.8% for dexamethasone vs 46.5% for A. vulgaris; P=0.29). Additionally, there were no differences in the intensity or severity of sore throat and hoarseness at 1, 6, and 24 hours postoperatively between groups.(Chung 2021)

Wound healing

Animal and in vitro data

Inhibition of the activity of the proteolytic enzymes elastase, trypsin, and alpha-chymotrypsin has been attributed to the tannin content of lady's mantle extracts.(Ghedira 2012, Jonadet 1986, Lamaison 1990) Promitotic activity in epithelial cells and myofibroblasts was demonstrated in rats administered A. vulgaris extract.(Shrivastava 2007) In a study of rats with induced endometrial adhesions, A. mollis aerial plant parts administered daily by gavage resulted in modulation of inflammatory cytokines (including tumor necrosis factor, endothelial growth factor, and interleukin 6).(Küpeli Akkol 2015) Improved tensile strength and re-modelling were observed with A. mollis root and aerial extracts that led to significant wound healing effects in mice. The extract of aerial parts, which contained high hydroxyproline content, had more effect than the root extract.(Oz 2016)

In an in vitro study, application of a 2% gel containing A. vulgaris aqueous or ethanolic extract or a 6% gel containing A. vulgaris propylene glycolic extract accelerated wound closure in L929 fibroblasts.(Tasic-Kostov 2019)

Clinical data

In an open-label study in patients with recurrent aphthous ulcers (N=48), topical applications of A. vulgaris 3% extract in glycerine (Aptharine) resulted in faster self-reported healing of ulcers.(Abascal 2010, Shrivastava 2006)

In a double-blind study, gels containing 2% or 6% A. vulgarisextracts promoted damaged skin barrier repair in healthy volunteers (N=18).(Tasic-Kostov 2019)

Dosing