Variación interanual del presupuesto nacional

Source: Actaea racemosa L. (syn. Cimicifuga racemosa (L.) Nutt.) (Family Ranunculaceae).

Common/vernacular names: Black cohosh, black snakeroot, cimicifuga, cohosh bugbane, rattleroot, rattleweed, rattle top, squaw root.

GENERAL DESCRIPTION

Perennial herb, up to 3 m high, with knotted rhizome; leaves are three divided; terminal leaflet three lobed; middle lobe is largest; flowers, white, in tall raceme; native to rich woods of eastern North America, from Maine

west to Ontario and Wisconsin, and south to Georgia. Parts used are the dried rhizome and roots.

CHEMICAL COMPOSITION

Roots contain triterpene glycosides: 26-deoxyactein, 23-epi-26-deoxyactein (27- deoxyactein or actein),1 cimicifugoside (cimigoside), cimifugoside M,2cimiracemo- sides,3 and others;4 organic acids and esters (2-hexylcyclopropaneoctanoic acid,5 caffeic, fukinolic acid cimicifugic acids, ferulic acid, isoferulic acid, and others).6 Other constitu- ents reported to be present include salicylic acid,7 cimigonite, tannin, and volatile oils (DUKE 2; WREN).

PHARMACOLOGY AND BIOLOGICAL ACTIVITIES

Extracts of the rhizome have failed to show either estrogenic or antiestrogenic activity in either animal or in vitro studies.8–10How- ever, selective estrogen receptor modulating (SERM) activity has been demonstrated fol- lowing oral administration of black cohosh extracts (e.g., inhibition of pituitary luteinizing hormone secretion11 and estrogenic-like ef- fects in fat tissue and osteoblasts in the bone of rats).10In vitro studies have shown that the triterpene glycoside fraction inhibits the growth of human breast cancer cells,12 that extracts of the rhizome show serotonin recep- tor-binding8and dopaminergic activity,9and that cimicifugoside exhibits nicotinic acetyl- choline receptor (nAChR) agonist activity.13In a rat model of hot flashes, a standardized ethanolic-aqueous extract of the rhizome ad- ministered orally reduced the symptoms and in a behavioral test in rats, showed antidepressant activity.14 The extract also reduced the loss of bone mineral density in ovariectomized rats.10

Clinical trials of standardized isopropano- lic extracts of the rhizome (randomized, dou- ble-blind, placebo-controlled) have found sig- nificant benefits in the treatment of menopause symptoms (MCKENNA), including an improve-

ment in bone metabolism.15

TOXICOLOGY

A critical review on clinical studies of black cohosh in the treatment of menopausal symp- toms concluded that specific extracts of the rhizome are safe alternatives to estrogen ther- apy. In trials of black cohosh preparations involving over 2800 patients, the incidence of adverse effects was 5.4%; the majority (97%) were minor and none attributed to black cohosh were serious.16An isopropanolic ex- tract failed to increase estrogen-dependent mammary tumors in rats17and in a rat model of endometrial cancer, failed to increase growth or metastasis of the primary tumor.18 No toxic effects were found in humans admin-

istered a fluid extract of the rhizome at doses of up to 890 mg/day. Rats administered an iso- propanolic extract (up to 5 g/kg) for 26 weeks showed no organ toxicity. The minimum acute lethal oral dose of a tincture of black cohosh in rats was reported to be>1 g/kg. No mutage- nicity was found from an isopropanolic extract in the Ames test (MCKENNA).

USES

Medicinal, Pharmaceutical, and Cosmetic.

Used in certain analgesic and tonic prepara- tions, among others. In European phytomedi- cine, isopropanol or ethanol extracts of the dried rhizome standardized to triterpene gly- coside contents are used in treating menopaus- al symptoms, menstrual disorders, including premenstrual discomfort, dysmenorrhea, and postoperatively in patients after hysterectomy or ovariectomy in the treatment of functional deficits (BLUMENTHAL1;MCKENNA).

Dietary Supplements/Health Foods. Used alone and in herbal formulas to relieve pro- blems related to menopause; capsules, tablets, tinctures, fluid extract, crude root in infusion or decoction (BRADLY;MCKENNA;WREN).

Traditional Medicine. Used in treating amenorrhea, postpartum and labor pains, uter- ine disorders, support for natural uterine con- tractions during labor, cough, dropsy, fever, nervous disorders, smallpox, yellow fever, lumbago, pain of acute rheumatism, head- ache, hysteria, nervous system disorders, in- fluenza, and itch.16Used by American Indian tribes as a galactogogue, diuretic, to stimulate menstruation, and in the treatment of colds, rheumatic pains, constipation, coughs, and kidney problems (MOERMAN).

COMMERCIAL PREPARATIONS

Available as crude and extracts (fluid, solid, and powdered). Formerly official in N.F. and U.S.P. Potencies of extracts are expressed only in strength (see glossary) based on weight- to-weight ratio of crude and extracts.

Regulatory Status. Regulated in the U.S. as a dietary supplement. The root is the subject of a German therapeutic monograph, indicated for

premenstrual discomfort and dysmenorrhea (BLUMENTHAL1).

REFERENCES

See the General References forBAILEY1;BARNES ET AL.;BLUMENTHAL1 & 2;BRADLY;DER MARDEROSIAN AND BEUTLER;FOGARTY;FOSTER;FOSTER AND DUKE;JIANGSU;KROCHMAL AND KROCHMAL;GRIEVE;MCKENNA; MERCK;UPHOF;WREN;YOUNGKEN.

1. S. Chen et al., J. Nat. Prod., 65, 601 (2002).

2. K. He et al., Planta Med., 66, 635 (2000). 3. E. Bedir and L. A. Khan, Chem. Pharm.

Bull., 48, 425 (2000).

4. K. Wende et al., J. Nat. Prod., 64, 986 (2001).

5. A. Panossian et al., Phytochem. Anal., 15, 100 (2004).

6. S. O. Kruse, Planta Med., 65, 763 (1999). 7. H. Jarry et al., Planta Med., 51, 316

(1985).

8. J. E. Burdette et al., J. Agric. Food Chem., 51, 5661 (2003).

9. H. Jarry et al., Maturitas, 44(Suppl. 1), S31 (2003).

10. D. Seidlova-Wuttke et al., Maturitas, 44(Suppl. 1), S39 (2003).

11. E. M. D€uker et al., Planta Med., 57, 420 (1991).

12. L. S. Einbond et al., Breast Cancer Res. Treat., 83, 221 (2004).

13. K. Woo et al., J. Pharmacol. Exp. Ther., 309, 641 (2004).

14. H. Winterhoff et al., Maturitas, 44(Suppl. 1), S51 (2003).

15. W. Wuttke et al., Maturitas, 44(Suppl. 1), S67 (2003).

16. T. Low Dog et al., Menopause, 10, 299 (2003).

17. J. Freudenstein et al., Cancer Res., 62, 3448 (2002).

18. T. Nilein and J. Freudenstein, Toxicol. Lett., 150, 271 (2004).