HARPAGOPHYTUM PROCUMBENS VE FİTOTERAPİDE KULLANIMI

Yıl 2020, Cilt: 44 Sayı: 3, 540 - 556, 30.09.2020

Zeynep Açıkgöz Semih Bulut Didem Deliorman Orhan

https://doi.org/10.33483/jfpau.680316

Öz

Amaç: Bu derlemede, Harpagophytum procumbens ile ilgili genel bilgi verilip analjezik ve antienflamatuvar aktiviteleri üzerinde yapılmış in vitro, in vivo ve klinik çalışma bulguları sunulacaktır.

Sonuç ve Tartışma: H. procumbens kökleri Güney Afrika’da geleneksel halk tıbbında, romatizma ve ağrı tedavisinde uzun yıllardan beridir kullanılmaktadır. Günümüzde, standardize edilmiş kök ekstrelerinin (%1 harpagozit içerir) antienflamatuvar etkilere sahip olmasından dolayı osteoartrit hastalarında akılcı fitoterapi uygulamaları kapsamında kullanılmaktadır. Harpagozitin, nükleer faktör-kappa B’yi inhibe ederek lipopolisakkarit kaynaklı indüklenebilir nitrik oksit sentaz ve siklooksijenaz-2 ekspresyonu üzerinde inhibisyon sağlayarak antienflamatuvar etki gösterdiği tespit edilmiştir. Ayrıca standardize ekstreler, kıkırdak degredasyonunda anahtar rol oynayan matriks metalloproteinaz ve elastaz enzimlerini inhibe ederek kondroprotektif etkiler göstermektedir. Osteoartrit hastalarında minimum 2-3 ay kullanılması gerektiği önerilen ekstrenin, herhangi bir ciddi ilaç etkileşmesi oluşturmadığı da belirtilmektedir. Kanıta dayalı fitoterapi uygulamaları açısından; standardize H. procumbens kök ekstrelerinin osteoartritli hastalarda kullanımı ile ilgili yapılmış klinik çalışmalar mevcuttur ve çalışmalar devam etmektedir.

Anahtar Kelimeler

Fitoterapi, Harpagophytum procumbens, osteoartrit, şeytan pençesi

HARPAGOPHYTUM PROCUMBENS AND USE IN PHYTOTHERAPY

Öz

Objective: In this review, general information about Harpagophytum procumbens will be given and findings of in vitro, in vivo and clinical studies on analgesic and anti-inflammatory activities will be presented.

Result and Discussion: For many years, H. procumbens roots have been used to treat rheumatism and pain in traditional folk medicine in South Africa. Today, it is used within the scope of rational phytotherapy applications in osteoarthritis patients, since its standardized root extracts (containing 1% harpagozite) have anti-inflammatory effects. It has been found that harpagozite has an anti-inflammatory effect by inhibiting nuclear factor-kappa B, providing inhibition on the expression of lipopolysaccharide-inducible nitric oxide synthase and cyclooxygenase-2. In addition, standardized extracts show chondroprotective effects by inhibiting matrix metalloproteinase and elastase enzymes, which play a key role in cartilage degredation. It is also stated that the extract, which should be used for a minimum of 2-3 months in patients with osteoarthritis, does not cause any serious drug interaction. In terms of evidence-based phytotherapy applications; there are clinical studies on the use of standardized H. procumbens root extracts in patients with osteoarthritis, and studies are ongoing.

Anahtar Kelimeler

Phytotherapy, Harpagophytum procumbens, osteoarthritis, devil’s claw

Kaynakça

• 1. Lim, D.W., Kim, J.G., Han, D., Kim Y.T. (2014). Analgesic effect of Harpagophytum procumbens on postoperative and neuropathic pain in rats. Molecules, 19(1), 1060-1068.
• 2. Serrano, A., Ros, G., Nieto, G. (2018). Bioactive compounds and extracts from traditional herbs and their potential anti-inflammatory health effects. Medicines, 5(3), 76.
• 3. Sanders, M., Grundmann, O. (2011). The use of glucosamine, devil's claw (Harpagophytum procumbens), and acupuncture as complementary and alternative treatments for osteoarthritis. Alternative Medicine Review, 16(3), 228.
• 4. Gümüş, K., Ünsal, A. (2014). Osteoartritli bireylerin günlük yaşam aktivitelerinin değerlendirilmesi. Türk Osteoporoz Dergisi, 20(3), 117-124.
• 5. Altindağ, Ö., Sırmatel, Ö., Tabur, H. (2006). Diz osteoartriti olan hastalarda Demografik özellikler ve klinik parametrelerle ilişkisi. Harran Üniversitesi Tıp Fakültesi Dergisi, 3(2), 62-66.
• 6. Moura, M.D.G., Lopes, L.C., Biavatti, M.W., Busse, J.W., Wang, L., Kennedy, S.A., Bhatnaga, N., Bergamaschi, C. (2016). Brazilian oral herbal medication for osteoarthritis: A systematic review protocol. Systematic Reviews, 5(1), 86.
• 7. Mncwangi, N., Chen, W., Vermaak, I., Viljoen, A.M., Gericke, N. (2012). Devil's Claw- A review of the ethnobotany, phytochemistry and biological activity of Harpagophytum procumbens. Journal of Ethnopharmacology, 143(3), 755-771.
• 8. Stewart, K.M., Cole, D. (2005). The commercial harvest of devil's claw (Harpagophytum spp.) in southern Africa: The devil's in the details. Journal of Ethnopharmacology, 100(3), 225-236.
• 9. Street, R.A., Prinsloo, G. (2012). Commercially important medicinal plants of South Africa: A review. Plant Production. Medicinal plants of South Africa. Journal of Chemistry, 2013, Article ID 205048, 16 pages.
• 10. Foundational Medicine Review site. Retrieved March 26, 2019, from https://www.foundationalmedicinereview.com/blog/resource/harpagophytum-procumbens-devils-claw/
• 11. Kriukova, A.I., Vladymyrova, I.M., Gubar, S.M., Kotov, A.G., Kotova, E.E. (2018). Question introduction to the State Pharmacopoeia of Ukraine monograph «Devil’s claw root». Upravlìnnâ, Ekonomìka ta Zabezpečennâ Akostì v Farmacìï, 1(53), 6-12.
• 12. Williamson, E., Driver, S., Baxter, K. (2009). Stockley's herbal medicines interactions, Pharmaceutical Press, London, p. 165.
• 13. Raimondo, D., Newton, D., Fell, C., Donaldson, J.S., Dickson, B. (2005). Devil’s claw, Harpagophytum spp. in South Africa: Conservation and livelihoods issues. Traffic Bulletin, 20(3), 98-112.
• 14. Anauate, M.C., Torres, L.M., de Mello, S.B.V. (2010). Effect of isolated fractions of Harpagophytum procumbens DC (Devil's claw) on COX‐1, COX‐2 activity and nitric oxide production on whole-blood assay. Phytotherapy Research, 24(9), 1365-1369.
• 15. Chrubasik, S. (2004). Addendum to the ESCOP monograph on Harpagophytum procumbens. Phytomedicine, 11(7-8),691-695.
• 16. European Medicines Agency site. (1995). Retrieved March 26, 2019, from https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-harpagophytum-procumbens-dc/harpagophytum-zeyheri-decne-radix_en.pdf
• 17. Mahomed, I.M., Ojewole, J.A. (2004). Analgesic, antiinflammatory and antidiabetic properties of Harpagophytum procumbens DC (Pedaliaceae) secondary root aqueous extract. Phytotherapy Research, 18(12), 982-989.
• 18. Grant, L., McBean, D.E., Fyfe, L., Warnock, A.M. (2007). A review of the biological and potential therapeutic actions of Harpagophytum procumbens. Phytotherapy Research, 21(3), 199-209.
• 19. Menghini, L., Recinella, L., Leone, S., Chiavaroli, A., Cicala, C., Brunetti, L., Viladimir, S., Orlando, G., Ferrante, C. (2019). Devil's claw (Harpagophytum procumbens) and chronic inflammatory diseases: A concise overview on preclinical and clinical data. Phytotherapy Research, 33(9), 2152-2162.
• 20. McGregor, G., Fiebich, B., Wartenberg, A., Brien, S., Lewith, G., Wegener, T. (2005). Devil’s claw (Harpagophytum procumbens): An anti-inflammatory herb with therapeutic potential. Phytochemistry Reviews, 4(1), 47-53.
• 21. Ahmed, M.I., Afifi, M.I., Younos, I.H. (2005). Harpagophytum procumbens (Devil's Claw): A possible natural anti-inflammatory agent (An experimental study). Iranian Journal of Pharmacology and Therapeutics, 4(1), 54-63.
• 22. Parenti, C., Aricò, G., Chiechio, S., Di Benedetto, G., Parenti, R., Scoto, G. (2015). Involvement of the heme-oxygenase pathway in the antiallodynic and antihyperalgesic activity of Harpagophytum procumbens in rats. Molecules, 20(9), 16758-16769.
• 23. Parenti, C., Aricò, G., Pennisi, M., Venditti, A., Scoto, G.M. (2016). Harpagophytum procumbens extract potentiates morphine antinociception in neuropathic rats. Natural Product Research, 30(11), 1248-1255.
• 24. Huang, T.H.W., Tran, V.H., Duke, R.K., Tan, S., Chrubasik, S., Roufogalis, B.D., Duke, C.C. (2006). Harpagoside suppresses lipopolysaccharide-induced iNOS and COX-2 expression through inhibition of NF-kappa B activation. Journal of Ethnopharmacology, 104(1-2), 149-155.
• 25. Kaszkin, M., Beck, K.F., Koch, E., Erdelmeier, C., Kusch, S., Pfeilschifter, J., Loew, D. (2004). Downregulation of iNOS expression in rat mesangial cells by special extracts of Harpagophytum procumbens derives from harpagoside-dependent and independent effects. Phytomedicine, 11(7-8), 585-595.
• 26. Chrubasik, J.E., Lindhorst, E., Neumann, E., Gerlach, U., Faller-Marquardt, M., Torda, T., Müller-Ladner, U., Chrubasik, S. (2006). Potential molecular basis of the chondroprotective effect of Harpagophytum procumbens. Phytomedicine, 13(8), 598-600.
• 27. Chantre, P., Cappelaere, A., Leblan, D., Guedon, D., Vandermander, J., Fournie, B. (2000). Efficacy and tolerance of Harpagophytum procumbens versus diacerein in treatment of osteoarthritis. Phytomedicine, 7(3), 177-183.
• 28. Chrubasik, S., Thanner, J., Künzel, O., Conradt, C., Black, A., Pollak, S. (2002). Comparison of outcome measures during treatment with the proprietary Harpagophytum extract Doloteffin® in patients with pain in the lower back, knee or hip. Phytomedicine, 9(3), 181-194.
• 29. Haseeb, A., Ansari, M.Y., Haqqi, T.M. (2017). Harpagoside suppresses IL‐6 expression in primary human osteoarthritis chondrocytes. Journal of Orthopaedic Research, 35(2), 311-320.
• 30. Brien, S., Lewith, G.T., McGregor, G. (2006). Devil's Claw (Harpagophytum procumbens) as a treatment for osteoarthritis: a review of efficacy and safety. Journal of Alternative and Complementary Medicine, 12(10), 981-993.
• 31. Brendler, T., Gruenwald, J., Ulbricht, C., Basch, E. (2006). Devil’s Claw (Harpagophytum procumbens DC) an evidence-based systematic review by the natural standard research collaboration. Journal of Herbal Pharmacotherapy, 6(1), 89-126.