Echinacea for the Treatment of Common Cold - Term Paper Example

Running head: Echinacea for the treatment of common cold Student’s name Institution Course Professor Date Key words: Echinacea, treatment, common cold, Randomized Trials, Efficacy, Rhinoviruses Search areas: Medicine, Pharmacology, Immunology, Microbiology Databases: Pubmed, Medscape Scopus.com, Medline Common cold is the most common infection worldwide. It is a highly infectious illness that primarily affects the nose. It is a viral infection with rhinoviruses causing majority of the common cold ,close personal contact with infected respiratory secretions ,overcrowding and poor ventilation,(Kumar,2007) facilitate the spread of infection. It presents with a tiredness, pyrexia, malaise, sneezing with a sore nose and pharynx followed by a profuse, watery nasal discharge occurring for about a week, (Kumar et al, 2007). Secondary bacterial infection may complicate some cases of common cold causing Pneumonia , otitis media and sinusitis,(Brooks, 2004, ) accounting for large proportion of pediatric admission. The highest Infection rates of common cold are among infants and children .It occurs worldwide, (Brooks,2004) causing an average individual to suffer two to three colds per year which lessens with age, due to accumulating virus specific immunity to the causative strains. High economic costs are incurred from common cold, with most of this coming from increased physician visits and loss of school and workdays. No specific method of treatment is available with management mainly comprising of symptomatic relief with analgesics, antipyretics, decongestants and herbal remedies such as Echinacea. Echinacea is one of the most commonly used medicinal plants in the western world,(Bluementhal,2001).It is a herbal plant existing as different species whose various organs and different preparations (extracts and juice) primarily used in the management of upper respiratory tract infection (URI), such as the common cold (Barret, 2002). Most studies looking into of the therapeutic benefits of Echinacea have been inconclusive and often complicated by confounding factors leaving a paradox in the issue. Echinacea preparations immunologically have been shown to activate macrophages and polymorphonuclear leukocytes via cytokine response mechanism (Rininger,2000) .Thus possibility immunomodulation, with a decrease in the susceptibility to upper respiratory tract infections exists (Rininger,2000) In a trial study, (Barret, 2010) carried out in Dane County, Wisconsin to assess the potential benefits of Echinacea as a treatment of common cold, random assignment, allocation, and blinding was done. The sample size was 719 patients between 12 and 80 years, with new-onset common cold who were assigned 4 parallel groups. These included no pills, placebo pills (blinded), Echinacea pills (blinded), or Echinacea pills (open-label). The primary was defined as the area under the curve for global severity calculated using trapezoidal approximation, with the duration and severity assessed from self-report by patients twice daily using the Wisconsin Upper Respiratory Symptom Survey. Secondary outcomes included self-report on psychosocial questionnaires and assay of biomarkers of immunity and inflammation. Though the trial showed that the regimen of the Echinacea formulation did not have a large effect on the course of the common cold, compared with both the blinded placebo and no pills. The open-label Echinacea group did not appear to progress better than the blinded Echinacea group. Benefit was noted among those who considered Echinacea highly effective, the illnesses shortened 1.21 days having 26% to 29% less severity for the pills group compared with those using no pills. These were statistically significant for duration (p =0.022), but not for the severity (P = .055). Given the CIs the different groups, reduction of in duration and reduction in overall severity attributable to Echinacea is plausible hinting some possible clinical benefits. The clinical effects noted by reduction in duration of symptoms and objectively give an idea of possible benefits that is objectively shown by increased Il 8 levels and neutrophils counts in the nasal secretions hence possible immunostimulatory effects of Echinacea. Though subjective the patient well being improvement is notable marker of the role Echinacea plays in hastening recovery. The outcome from the study cannot be ascertained whether it is due to placebo mechanisms alone or whether it is due Echinacea’s pharmacological’ action. Subjective patient self reporting about their well being, stress levels makes making a firm conclusion unlikely. Also other environmental factors such as food, social parameters that could influence humoral and immune factors and other research related biases. In another study by Goel V et al, conducted as a randomized, double blind, placebo-controlled trial during October 2001 to April 2002 at the University of Alberta, Edmonton, Canada to 282 subjects aged 18–65 years were recruited. The groups were identical in most aspects with respect to age, smoking status, and history of past colds except for a gender bias. They were instructed to start the treatments at the onset of the first symptom related to a common cold. The subjects were randomized to receive either Echinacea or placebo at the onset of the first symptom related to a cold, consuming 10 doses the first day and four doses per day on subsequent days for 7 days. The subjects’ carried out a self assessment and scoring with further validation by a nurse to improve its accuracy. Data were analysis for two populations under blind conditions that is, intention to treat (ITT,) and per protocol (PP) excluding those with gross violations. Of these, 128 contracted a common cold, of those who 59 received Echinacea and 69 placebos. In both populations the mean severity scores for all specific symptoms, apart from cough, were found to be lower in the Echinacea group. During the treatment, the self assessed Total Daily Symptom Scores (TDSS) were lower in the Echinacea group (P < 0.05). From the ITT population, a 17.6% reduction in TDSS (P Read More