Integrative Medicine Insights
Synopsis: An open access, peer reviewed electronic journal that covers integration of complementary medicine into the over-all pursuit of patient health.
Indexing: 5 major databases. Pubmed indexing for NIH-funded research.
Processing time: Decision in 2 weeks for 90% of papers.
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Black Cohosh: Insights into its Mechanism(s) of Action
Rachel L. Ruhlen1, Grace Y. Sun2 and Edward R. Sauter1
From the Departments of Surgery1 and Biochemistry2, University of Missouri-Columbia, Columbia, Missouri, U.S.A.
Abstract
The Women’s Health Initiative found that combination estrogen and progesterone hormone replacement therapy increases breast cancer and cardiovascular disease risk, which compelled many women to seek herbal alternatives such as black cohosh extract (BCE) to relieve their menopausal symptoms. While several clinical trials document the efficacy of BCE in alleviating menopausal symptoms, preclinical studies to determine how BCE works have yielded conflicting results. Part of this is because there is not a universally accepted method to standardize the dose of black cohosh triterpenes, the presumed active ingredients in the extract. Although the mechanism by which BCE relieves symptoms is unknown, several hypotheses have been proposed: it acts 1) as a selective estrogen receptor modulator, 2) through serotonergic pathways, 3) as an antioxidant, or 4) on inflammatory pathways. We found that while the most prominent triterpene in BCE, 23-epi- 26-deoxyactein, suppresses cytokine-induced nitric oxide production in brain microglial cells, the whole BCE extract actually enhanced this pathway. A variety of activities have been reported for black cohosh and its compounds, but the absorption and tissue distribution of these compounds is unknown.
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