ANTE EL ACOSO SEXUAL, ELLAS DEBEN PONER EL LÍMITE

C

A

o

P

None known.

d

s

i

Theoretically, astragalus could be incompatible with immune suppressant drugs such as cyclosporine and corti- costeroids (Upton 1999). A limited number of human stud- ies have indicated that astragalus increases the therapeutic effects of corticosteroids and cyclophosphamide in patients with autoimmune disease (Cai et al. 2006; Pan et al. 2008; Su et al. 2007), while animal studies have indicated a reversal of cyclophosphamide-induced immune suppression (Chu et al. 1988b, 1988c).

Astragalus has been shown to potentiate the therapeu- tic effects of alpha recombinant interferon 1 ( rIFN-α-1) in humans (Qian et al. 1990), acyclovir in mice (Zuo et al. 1995), and interleukin 2 (rIL-2) and interferon in vitro (Chu et al. 1988a; Hou et al. 1981).

e

’ n

The above-ground parts of certain chemically distinct spe- cies of astragalus are known to cause a disease called loco- ism which can cause reproductive abnormalities in livestock. The compound swainsonine, which causes locoism, is not present in Astragalus mongholicus (Rios and Waterman 1997).

a

e

s

e

None known.

P

C

None known.

P

l

No information on the safety of this herb in pregnancy or lactation was identified in the scientific or traditional litera- ture. Although this review did not identify any concerns for use while pregnant or nursing, safety has not been conclu- sively established.

R

D

i. d

s

i

Clinical trials of drug or supplement interactions

Astragalus has been shown to potentiate the therapeu- tic effects of alpha recombinant interferon 1 ( rIFN-α-1) in patients with human papillomavirus type 16 or herpes sim- plex virus type 2 (Qian et al. 1990).

A purified fraction of astragalus was shown to reverse cyclophosphamide-induced immune suppression in rats, enhancing the ability of the rats to reject xenogeneic grafts (Chu et al. 1988b).

In patients with systemic lupus erythematosus, concom- itant administration (intraperitoneally) of astragalus and standard corticosteroid/immunosuppressant drug therapy (drug not specified in English language abstract) was shown to enhance the inhibitory function of the corticosteroid on apoptosis and regulate the ratio and function of T lympho- cyte subsets as compared to standard corticosteroid treat- ment alone (Cai et al. 2006). In patients with systemic lupus erythematosus complicated by kidney damage, intravenous administration of 20 ml of astragalus 12 days per month for 3 months with cyclophosphamide administered once a month, a 4.3% infection rate was observed in the astragalus group, while the rate was 25% in the control group, indicat- ing that astragalus used together with cyclophosphamide is more effective than cyclophosphamide alone in decreas- ing infection rate and urine protein and improving immune function for patients with lupus nephritis (Su et al. 2007).

Case reports of suspected drug or supplement interactions

The T-cell-stimulating activity of astragalus could, theoreti- cally, contradict the effects of immune suppressant drugs such as cyclosporine and corticosteroids.

animal trials of drug or supplement interactions

A partially purified fraction of astragalus coadministered to mice with the immune suppressant cyclophosphamide after transplantation of mononuclear cells resulted in transplant rejection, indicating a reversal of cyclophosphamide action (Chu et al. 1988b).

Astragalus has been shown to potentiate the therapeu- tic effects of alpha recombinant interferon 1 ( rIFN-α-1) in humans (Qian et al. 1990), acyclovir in mice (Zuo et al. 1995), and interleukin 2 (rIL-2) and interferon in vitro (Chu et al. 1988a; Hou et al. 1981).

ii. a

e

Case reports of adverse events

Allergic reactions including skin eruptions and pruritus have been reported in persons taking astragalus (Bensky et al. 2004). Overdoses may cause headache, tightness in the chest, insomnia, dizziness, and hypertension. Anaphylactic reactions have been reported in patients intravenously administered extracts of astragalus (Bensky et al. 2004).

iii. P

P

CD25 expression on T cells was increased in healthy volun- teers administered extracts equivalent to 1.23 g of astragalus daily for 7 days (Zwickey et al. 2007).

animal pharmacological studies

No relevant animal pharmacological studies were identified.

in Vitro pharmacological studies

An aqueous extract of astragalus was shown to enhance immune function by increasing proliferation of spleen cells,

Astragalus mongholicus

A

B cell IgG production, macrophage cytokine production of IL-6 and TNF, and enhancing induction of cytotoxic T cells (Yoshida et al. 1997).

iv. P

l

No information on the safety of astragalus during preg- nancy or lactation was identified.

v. t

s

acute toxicity

The LD50 of astragalus extract in mice has been reported

as 40 g/kg (Chang and But 1987), although no toxicity was observed after administration of a c oncentrated aqueous extract to rats at doses equivalent to 100 g/kg (routes of administration unspecified in English translations of studies)

(Chang and But 1987; Wagner et al. 1997). Intraperitoneal administration of 50 g/kg astragalus extract in mice led to prostration, paralysis, dyspnea, and cyanosis; in some ani- mals, contracture of the extremities was observed before the death of the animals (Chang and But 1987).

subchronic toxicity

No signs of clinical toxicity were observed in rats intraperi- toneally administered up to 39.9 g/kg astragalus extract for 12 weeks or in dogs intraperitoneally administered astraga- lus extract up to 19.5 g/kg for 17 weeks (Yu et al. 2007).

mutagenicity

Astragalus has been reported to have no mutagenic effects (Wagner et al. 1997).

l

c

Bensky, D., S. Clavey, and E. Stöger. 2004. Chinese herbal medicine:

Materia medica. 3rd ed. Seattle: Eastland Press.

Cai, X.Y., Y.L. Xu, and X.J. Lin. 2006. Effects of radix Astragali injection on apoptosis of lymphocytes and immune function in patients with systemic lupus erythematosus. Zhongguo Zhong

Xi Yi Jie He Za Zhi 26(5):443-445.

Chang, H., and P. But. 1987. Pharmacology and applications of Chinese

materia medica, volume 2. Singapore: World Scientific.

Chu, D.T., J. Lepe-Zuniga, W .L. Wong, R. LaPushin, and G.M. Mavligit. 1988a. Fractionated extract of Astragalus membrana-

ceus, a Chinese medicinal herb, potentiates LAK cell cytotoxic - ity generated by low dose of recombinant interleukin-2. J. Clin.

Lab. Immunol. 26(4):183-187.

Chu, D.T., W.L. Wong, and G.M. Mavligit. 1988b. Immunotherapy with Chinese medicinal herbs. II. Reversal of cyclophospha - mide-induced immune suppression by administration of frac - tionated Astragalus membranaceus in vivo. J. Clin. Lab. Immunol. 25(3):125-129.

Chu, D.T., W.L. Wong, and G.M. Mavligit. 1988c. Immunotherapy with Chinese medicinal herbs. I: Reversal of cyclophospha - mide-induced immune suppression by administration of frac - tionated Astragalus membranaceus in vivo. J. Clin. Lab. Immunol. 25(3):119-123.

Hou, Y., Z. Zhang, S. Su, and S. Duan. 1981. Interfer on induc- tion and lymphocyte transformation stimulated by Astragalus

membranaceus in mouse spleen cell cultures. Zhonghua Weisheng

Wuxue Hemian Yixue Zazhi 1(2):137-139.

Pan, H.F., X.H. Fang, W.X. Li, D.Q. Ye, G.C. Wu, and X.P. Li. 2008. Radix Astragali: A promising new tr eatment option for sys - temic lupus erythematosus. Med. Hypotheses 71(2):311-312. Qian, Z., S. Mao, X. Cai, X. Zhang, F . Gao, M. Lu, X. Shao, Y. Li,

X. Yang, and Y. Zhuo. 1990. Viral etiology of chronic cervicitis and its therapeutic response to α-recombinant interferon. Chin.

Med. J. (Engl.) 103(8):647-651.

Rios, J., and P. Waterman. 1997. A review of the pharmacology and toxicology of astragalus. Phytother. Res. 11:411-418.

Su, L., J.C. Mao, and J.H. Gu. 2007. Ef fect of intravenous drip infusion of cyclophosphamide with high-dose Astragalus injec- tion in tr eating lupus nephritis. Zhong Xi Y i Jie He Xue Bao 5(3):272-275.

Upton, R. 1999. Astragalus root: Astragalus membranaceus and

Astragalus membranaceus var. mongholicus: Analytical, qual- ity control, and therapeutic monograph. Santa Cr uz, CA: American Herbal Pharmacopoeia.

Wagner, H., R. Bauer , X. Peigen, C. Jianming, and H. Michler . 1997. Radix Astragali [huang qi]: Chinese dr ug monographs and analysis. Bayer, Wald: Verlag für Ganzheitliche Medizin Dr Erich Wühr GmbH. Volume 1(8). Available from American Botanical Council, Austin, TX.

Yoshida, Y., M.Q. Wang, J.N. Liu, B.E. Shan, and U. Yamashita. 1997. Immunomodulating activity of Chinese medicinal herbs and Oldenlandia diffusa in particular. Int. J. Immunopharmacol. 19(7):359-370.

Yu, S.Y., H.T. Ouyang, J.Y. Yang, X.L. Huang, T. Yang, J.P. Duan, J.P. Cheng, Y.X. Chen, Y.J. Yang, and P. Qiong. 2007. Subchronic toxicity studies of Radix Astragali extract in rats and dogs. J.

Ethnopharmacol. 110(2):352-355.

Zuo, L., X. Dong, and X. Sun. 1995. The curative effects of

Astragalus membranaceus Bunge (A-6) in combination with acy- clovir on mice infected with HSV-1. Virol. Sin. 110(2).

Zwickey, H., J. Br ush, C.M. Iacullo, E. Connelly, W.L. Gregory, A. Soumyanath, and R. Bur esh. 2007. The ef fect of Echinacea

purpurea, Astragalus membranaceus and Glycyrrhiza glabra on CD25 expression in humans: A pilot study . Phytother. Res. 21(11):1109-1112.