NAC for Systemic Lupus Erythematosus

The National Center for Complementary and Alternative Medicine at the NIH is funding a study at Upstate Medical University (Syracuse, NY) on the use of N-acetylcysteine (NAC) for Systemic lupus erythematosus (SLE). This study was motivated by some promising related research in Europe, where NAC is much more widely used and investigated than in the US. Here’s an excerpt from the study description:

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease which often has debilitating and potentially life-threatening consequences. The cause of SLE is unknown and current therapies lack specificity and carry significant side effects. Existing data in the literature provide evidence that a natural antioxidant, glutathione, is depleted in T cells of patients with SLE which may be a key factor underlying abnormal activation and predisposition of T lymphocytes to pro-inflammatory cell death via necrosis. Administration of N-acetylcysteine (NAC), that serves as a precursor of GSH, improves the clinical outcome of murine lupus, and limits the toxicity of pro-oxidant/immunosuppressant medications commonly used in patients with SLE. NAC is widely available in health food stores and large doses (up to 8 g/day) can be safely administered to humans. In a one-year study of patients with inflammatory lung disease treated with prednisone and azathioprine, addition of NAC (1.8g/day) diminished disease severity and reduced drug toxicity in comparison to placebo. Moreover, oral NAC has been found to improve muscle fatigue which is reported to be the most disabling symptom in 53% of patients with SLE. Thus, establishing a dose ranging between 1.8-7.2 g/day that is well-tolerated and capable of raising intracellular GSH in lupus patients and determining its immunological and therapeutic impact in SLE appear to be well justified.

The project is reported on the NCCAM website: Abstracts of 2008 Funded Projects.

For more on NAC, see the NYBC entry for PharmaNAC. This form of NAC is manufactured to the quality standards of the European Pharmacopoeia, and provides a good way to get the dosages under study in this research on SLE.

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Horse Chestnut for chronic venous insufficiency: Fact sheet from NCCAM

The National Center for Complementary and Alternative Medicine, one of the research centers of the federal government’s National Institutes of Health, provides an online fact sheet about the medicinal botanical Horse Chestnut.

Here’s an excerpt:

What It Is Used For

For centuries, horse chestnut seeds, leaves, bark, and flowers have been used for a variety of conditions and diseases.
Horse chestnut seed extract has been used to treat chronic venous insufficiency (a condition in which the veins do not efficiently return blood from the legs to the heart). This condition is associated with varicose veins, pain, ankle swelling, feelings of heaviness, itching, and nighttime leg cramping.
The seed extract has also been used for hemorrhoids.

How It Is Used

Horse chestnut seed extract standardized to contain 16 to 20 percent aescin (escin), the active ingredient, is the most commonly used form. Topical preparations have also been used.

What the Science Says

Small studies have found that horse chestnut seed extract is beneficial in treating chronic venous insufficiency and is as effective as wearing compression stockings.
There is not enough scientific evidence to support the use of horse chestnut seed, leaf, or bark for any other conditions.

Read the entire fact sheet at

http://nccam.nih.gov/health/horsechestnut/#

See also the NYBC entry Horse Chestnut Pro (MMS) for further information and recommendations for use.

International Team Studies South African Plant for HIV/AIDS

Here’s an excerpt from an article in the newsletter of the National Center for Complementary and Alternative Medicine (a division of the National Institutes of Health). NYBC’s own newsletter, THE SUPPLEMENT, drew attention to this international consortium studying the South African botanical Sutherlandia in its Spring, 2006 issue.

Could a Plant Be Helpful?

Lessertia frutescens. William Curtis (1792), courtesy of the Missouri Botanical Garden

Lessertia frutescens (Sutherlandia)
William Curtis (1792), courtesy of the Missouri Botanical Garden



International Team Studies South African Plant for HIV/AIDS


“It’s just overwhelming. It feels like anything you do is a drop in a huge, huge bucket. But, you drop a drop, and it causes a ripple, and that causes a lot of change. Sometimes you have to be a drop, because that’s all you’ve got.”

So Kathleen Goggin, Ph.D., describes part of what draws her to co-lead a groundbreaking study of an African traditional medicine. A plant called Sutherlandia is being examined for its potential to help patients with HIV infection. The study is being cosponsored by NCCAM and NIH’s Office of AIDS Research, Office of Dietary Supplements, and Fogarty International Center.

According to the joint United Nations program on HIV/AIDS, or UNAIDS, about 33.2 million people worldwide have HIV infection. AIDS is among the leading causes of death worldwide.

South Africa is one of the countries that have been hardest hit by HIV/AIDS. While changes in South Africa have been taking place (including a new national strategic plan for AIDS) to help prevent transmission of the virus and to treat those who are infected, the challenges are large in scale. UNAIDS states that in South Africa by the end of 2006:

  • About 5½ million people (or one in nine) were living with HIV infection. Almost one-quarter million of them were children under 15 years old.
  • More than 360,000 people were taking antiretroviral therapy (ART).
  • For every person in South Africa who begins taking ART, three more become infected with HIV.  

Working to create a ripple in the pandemic’s bucket are an international team of Western-trained clinicians and researchers from both the United States and South Africa as well as South African traditional healers. The plant they are studying, Sutherlandia, is a member of the pea family, uniquely native to South Africa, and wild-growing in places there. Its scientific name is Lessertia frutescens; some of its popular names are Insisa, Unwele, Phetola, and cancer bush.

Walk into any South African traditional medicine market, and there it is—alongside the other herbs, barks, pieces of wood, animal bones and teeth, and other products sold and traded for medicinal purposes. Sutherlandia is used to make traditional medicine believed to be helpful for many health problems—such as infections (including HIV), inflammation, depression, cancer, and stress effects—and as a wellness tonic. It is also available in South African drugstores and in some other countries such as the United States, where it is sold as a dietary supplement.

This randomized, placebo-controlled study is looking at Sutherlandia’s safety in a group of 124 volunteers who are at an early stage of HIV infection and do not qualify for government-sponsored ART. The researchers will also collect data that could shed light on the plant’s usefulness in treating some of the symptoms of HIV infection. The participants who receive Sutherlandia will take by mouth a preparation made from ground leaves and specially formulated for the study. The study will be conducted at Edendale Hospital, a large county hospital located in Pietermaritzburg, KwaZulu-Natal, South Africa, and affiliated with the Nelson R. Mandela School of Medicine.

Jack Killen, M.D., Acting Deputy Director of NCCAM and Director of NCCAM’s Office of International Health Research, said, “Many people are using this plant in South Africa, where it originated, and where traditional healers are commonly the first and/or the only medical care option.” He added, “Not much is known yet about Sutherlandia scientifically, including whether and how it works.We hope to learn a good deal from this study about Sutherlandia specifically and about the best practices for rigorous research on traditional medicines more generally.”

….
Read the rest of the article at:
http://nccam.nih.gov/news/newsletter/2007_fall/savisit.htm