Web Pages about Echinacea Found via Major Search Engines, August 2001 and 2002
Search Engine 08/30/2001 08/30/2002 Annual Increase (%) Pages/Year
Google: www.google.com 167,000 269,000 61.1 102,000
Alta Vista: www.altavista.com 57,346 126,954 121.4 69,608
Lycos: www.lycos.com 90,805 540,421 495 449,616
related to Echinacea found when using some search engines has reached 100,000 to 450,000 per year (Table 9.3). It can be seen that the popularity of Echinacea is dramatically increasing along with the rising popularity of CAM worldwide.
The current areas of cultivation of Echinacea now extend beyond North America and Europe, into South America (Berti et al., 2002), Australia (Walker, 2000), and other areas of the world. Even in North Africa, Echinacea purpurea has been cultivated successfully in Egypt (Shalaby et al., 1997a, 1997b). In China, E. purpurea has been introduced in the areas of Beijing, Nangjing, and Shanghai (Xiao, 1996), and high-quality plants have been harvested in the Beijing area (Dou et al., 2001). In 2001, the global cultivation area of Echinacea was roughly estimated at several thousand hectares (Commonwealth Secretariat, 2001).
In Canada, an investigation into the use of herbal products showed that the most popular herbal product recommended by both medical doctors and naturopaths was Echinacea (Einarson et al., 2000). According to a national consumer survey conducted in 1999 by Gallup Canada, 33% of the persons surveyed believed that Echinacea was a good way to treat the common cold. The Nonpre-
scription Drug Manufacturers Association of Canada published a survey in 1999 to evaluate the consumption patterns and healthcare behavior of 8,000 consumers. Survey results indicated that consumption of herbal products rose from 15% to 35% (from 1996 through 1998). Garlic and Echinacea were the most popular self-care herbs (Saskatchewan Nutraceutical Network, 2001).
An estimated 83 million U.S. consumers use CAM (Gertz and Bauer, 2001). Of all CAM treatments, herbal medicine has grown the fastest and Echinacea is one of the six top-selling herbal medicinal products (Ernst, 2002). Surveys in the U.S. have shown that more than 7.3 million Americans are using Echinacea, and that herbal medicine usage increased from nearly 3% of the population in 1991 to over 37% in 1998 (Briskin, 2000). A dietary supplement survey of 70 pharmacists in the U.S. showed that a majority (53%) of pharmacists reported taking dietary supplements in which Echinacea is the top item for colds and influenza (Howard et al., 2001). In another survey determining the frequency of CAM use in surgical patients, results showed that 1,003 of 2,560 patients used CAM, of which herbal medicine (Echinacea among the most frequently used) was the most common, primarily for general health maintenance (Leung et al., 2001).
In Germany, physicians prescribed Echinacea over 2.5 million times in 1994 (Foster, 2000) and more than 2 million prescriptions for Echinacea were filled each year (Kemp and Franco, 2002). In Australia, it is reported that 50% of the population use CAM, of which Echinacea-containing products are increasingly popular (Mullins and Heddle, 2002). Annual Australian consumption of E. purpurea is approximately 80 MT; dried E. angustifolia root, 15 to 20 MT; and E. pallida, 1 MT (Walker, 2000).
In 1998, Echinacea was the tenth most important medicinal plant sold in Europe with annual sales of about $120 million (Commonwealth Secretariat, 2001). The largest Echinacea market in Europe is in Germany where scientists led research on Echinacea research throughout the 20th century (Barrett, 2003).
In North America, Echinacea is listed as the first among 11 top-selling herbal extracts and among the 12 top-selling bulk herbs (Manitoba Agriculture and Food, 2001). Echinacea ranked as one of the best-selling herbal remedies sold in the United States, accounting for 12% of all herbal sales in 1997 (Bent and Avins, 1999). The annual sales of Echinacea in the U.S. are estimated to range from more than $200 million (Blendon et al., 2001) to more than $300 million (American Herbal Products Association, 1999; O'Hara et al., 1998; Weil, 1999).
However, the sales of Echinacea in 2000 and 2001 declined about 20% in the U.S. (Blumenthal, 2001, 2002). The recent "Product Profile: Medicinal Plants" (International Trade Centre, 2001) indicated that the current trend is oversupply. International markets are overstocked with raw materials, leading to consistently falling prices over the past 2 years. This is particularly true of the main medicinal herbs such as Echinacea, which have been greatly overproduced mainly in the developed countries (International Trade Centre, 2001).
diversity of ECHINACEA
Echinacea diversity will be discussed in terms of its species, varieties, cultivating stage and regions, plant parts, processing of plant and products, methodology, quality, clinical trials, and legislation. The diversity is shown at the level of the following constituents that are thought to show individual or combined biological and pharmacological activity:
Lipophilic alkamides (dodecatetraenoic acid isobutylamides and related compounds, also called alkylamides)
Moderately hydrophilic phenolic caffeoyl derivatives (cichoric acid, cynarin, echinacoside, caftaric acid, chlorogenic acid, etc.)
Lipophilic polyalkynes and polyalkenes
High-molecular weight hydrophilic glycoproteins and polysaccharides including heteroxy-lans, fructofuranoside, and arabinogalactans.
The lipophilic alkamides and polar phenolic caffeoyl derivatives are considered to be the main pharmacologically active components in Echinacea alcohol extracts in which the polar polysaccharides are at very low level. The polysaccharides exist in expressed Echinacea juice, aqueous extract, and powdered whole herb. However, their levels in most Echinacea preparations and effects on the immune system after oral intake have been disputed (Awang, 1999; Bone, 1997a; Borchers et al., 2000).
Table 9.4 lists the species and varieties of Echinacea Moench (Heliantheae: Asteraceae). In the most recent publication, genus Echinacea has been reclassified as four species and eight varieties, together with a group of introgressant hybrids. E. purpurea, E. angustifolia, and E. pallida are revised as E. purpurea (L.) Moench; E. pallida var angustifolia (DC.) Cronq.; and E. pallida var. pallida (Nutt.) Cronq. (Binns et al., 2002).
In this chapter, we still use the former general names and discuss E. purpurea, E. angustifolia, and E. pallida, although certain species or varieties show the highest contents of specific phy-tochemicals. For example, wild E. pallida var sanguinea roots contain the highest level (1.9% dwt) of dodeca-2E,4E,8Z,10E/Z-tetraenoic acid isobutylamides; E. pallida var tennesseensis flowers contain the highest level (1.04% dwt) of dodeca-2E,4E,8Z,10E/Z-tetraenoic acid isobutylamides; wild E. atrorubens var paradoxa roots contain the highest level (3.3% dwt) of echinacoside; and E. pallida var sanguinea flowers contain the highest level (3% dwt) of cichoric acid (Binns et al., 2002).
The phytochemical components of various species have been analyzed and compared in a number of studies (Bauer et al., 1988; Bauer and Wagner, 1991; Baugh and Ignelzi, 2000; Hu and Kitts, 2000; Perry et al., 1997; Pomponio et al., 2002; Sloley et al., 2001). Binns et al. (2002) published the most detailed comparison, and by using reverse-phase high-performance liquid chromatography (HPLC) have shown quantitatively the phytochemical variation in the roots and flower heads of native plant populations in genus Echinacea.
The diversity of chemical components and antioxidant capacity in the extracts of Canadian-grown E. purpurea, E. pallida, and E. angustifolia have been reported (Binns et al., 2002; Hu and Kitts, 2000; Sloley et al., 2001). Table 9.5 collectively lists some characteristic chemicals (only
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