St John’s Wort
St. John’s Wort- The Miracle Medicine
Main Content Highlights
1) History
a. Hypericcum perforatum
b. Light/Dark green leaves with yellow flowers
c. Leaves and flowers have glands (black spots) which are able to
produce a red oil when rubbed
d. Grows from June to August
e. Claimed by alternative medical practitioners to be able to treat burns,
wounds and inflammation
f. Used all over the world
g. An example of the ‘like treating like’ concept
h. Research work by mainstream medical practitioners only started in the
1970s
2) St. John’s Wort as a Medicine
a. Using the whole plant vs. using only its constituents
b. Quinones(most researched on): benzene-based compounds
i. Display antiviral, anti-cancer(several types) and antidepressant
properties.
ii. Highly concentrated in flowers.
iii. 2 prominent types: hypericin and pseudohypericin
c. Flavonoids: phenol compounds
i. Used as diuretics(increase urination rate), anti-spasmodics,
anti-inflammatories, anti-bacterials, anti-fungals and cures for
circulatory illnesses.
ii. Display some evidence of anti-cancer properties.
iii. Found in yellow plant parts, hence it is highly concentrated in
the flowers of H. perforatum.
iv.
5 prominent types: hypderin, biflavone, quericitin,
proanthocyanidin and amentoflavone
d. Essential oils
i. Found in high concentrations in the whole part except the stem.
ii. Monoterpenes: Display anti-fungal properties, stimulates the
circulatory system and soothes the nervous system.
iii. Sesquiterpenes: Display anti-septic, anti-inflammatory and
antispasdomic properties and soothes the nervous system.
e. Xanthones: subgroup of flavonoids called flavonoid aglycones
i. Exhibit similar properties as their parent group
ii. Display cardiotonic properties.
f. Tannins: phenol compounds
i. Astringent properties (shrink or constrict body tissues) allow
them to heal wounds, burns and reduce inflammations.
ii. Treats diarrhea and internal bleeding.
iii. Highly concentrated in leaves and flowers.
g. Coumarins
i. Dicumarol: displays anti-blood clotting properties.
ii. Umbelliferone and scopoletin: display anti-fungal, antiinflammatory and in vitro anti-tumour properties.
h. Other secondary constituents
i. Phloroglucinols (hyperforin and adhyperforin): anti-bacterial
and wound-healing.
ii. Carotenoids: burn-healing by increasing the oxygen
concentration in the body.
iii. Gamma-aminobutyric acid (GABA, a type of AA): a sedative.
iv. Beta-sitosterol: estrogenic compound which may be the
treatment for menstrual and menopausal problems.
Uses
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St. John's wort has been used in the treatment of anxiety, mild to moderate
depression, stomach upset, insomnia, fluid retention, and hemorrhoids. St.
John's wort has also been used topically in the treatment of nerve and muscle
pain, skin inflammation, skin wounds, and burns.
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There is scientific evidence that St. John's wort may be useful for short-term
treatment of mild to moderate depression. Although some studies have
reported benefits for more severe depression, others have not; for example, a
large study sponsored by NCCAM found that the herb was no more effective
than placebo in treating major depression of moderate severity.
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Hypericum extract has a potential antioxidant activity, which may be of value
in treating dementia as well as other disorders of senility in which free radical
generation is implicated. In addition, besides its antidepressant activities, H.
perforatum also possesses anxiolytic, antiviral, wound healing, antimicrobial,
analgesic, and anti-inflammatory effects (R. Mukerjee, S.L. Deshmane, N.
Darbinian, M. Czernik, K. Khalili, S. Amini & B.E. Sawaya. (2008). St john’s
wort protein, p27sj, regulates the mcp-1 promoter. Mol Immunol, 45(15), 4028
- 4035.)
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Hypericin has been extensively studied for its application in the photodynamic
therapy. Photodynamic therapy (PDT) involves the administration of a tumorlocalizing nontoxic drug known as photosensitizer, systemically, locally, or
topically. The photosensitizer should accumulate in the tumor. After an
incubation period follows illumination of the tissue or tumor with visible light
(usually long wavelength red light) in the presence of oxygen, during which
the photosensitizer (PS) is activated generating reactive oxygen species toxic
to the tumor cells and thus leads to tumor death and tissue destruction. (A.
Karioti & A.R. Bilia. (2010). Hypericins as Potential Leads for New
Therapeutics. Int. J. Mol. Sci. (2010)11, 562-594.)
Applications
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The use of PDT as a cancer therapy is particularly attractive because of its
selectivity. This is better understood once the mechanism of PDT is
considered. The photophysical processes that take place during PDT are very
well explained in the review article by Castano et al. [72]. In brief, the PS
absorbs light and is boosted from the ground state or singlet state (low energy
at which the electrons occupy opposite spins) to the first excited singlet state.
The excited singlet state PS may also undergo the process known as
intersystem crossing whereby the spin of the excited electron inverts to form
the so called excited triplet-state (electron spins parallel). The PS excited
triplet can undergo two kinds of reactions (Figure 4): Type 1 reaction, during
which it can react directly with a substrate, such as the cell membrane or a
molecule, and Type 2 reaction, where the triplet PS can transfer its energy
directly to molecular oxygen (itself a triplet in the ground state), to form
excited state singlet oxygen. Both Type 1 and Type 2 reactions generate
further reactions that have as a result the formation of ROS which are toxic to
several cell structures and macromolecules (DNA, lipids, enzymes). Only
molecules and structures that are proximal to the area of ROS production
(areas of PS localization) are directly affected by PDT. Due to the fact that the
PS localizes in the malignant tissue the light is also spatially focused on the
tumor. (A. Karioti & A.R. Bilia. (2010). Hypericins as Potential Leads for
New Therapeutics. Int. J. Mol. Sci. (2010)11, 562-594.)
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Could possibly be used to treat the HIV virus as previous clinical tests on
infected mice had halted the virus’ progress. However when tested on humans,
the results are inconclusive, though anecdotal information reports a significant
improvement in some patients. (http://www.all-natural.com/hyp-1.html)
Side Effects
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Causes gastrointestinal problems, confusion, headache, dizziness, tiredness,
nausea and sedation.
Disturbs hormonal interactions and decreases the effectiveness of hormonal
contraceptives, such as Implanon (contraceptive implant).
Induces the effect of certain enzymes, increasing the metabolism of certain
drugs, decreasing the effectiveness of these drugs.
Interacts with other drugs which increase serotonin levels in the central
nervous system, increasing the risks of serotonin syndrome.
Reacts with light to produce free radicals, increasing photosensitivity.
Reduces the absorption of iron and other minerals.
http://en.wikipedia.org/wiki/St_John's_wort#Adverse_effects_and_drug_interactions
http://www.personalhealthzone.com/stjohnswort.html