Sambucus nigra

Gewone of Zwarte vlier

Algemene en Botanische Informatie

Materia Medica, gebruikte delen

Sambuci flos, De bloemen (schermen) van Sambucus nigra L. geplukt tijdens het begin van de bloeitijd, zonder de stengels.

De beste handelswaar bevat vooral bloemkronen en meeldra­den, weinig of geen stengeldelen.

Sambuci fructus recens , De verse, goed rijpe bessen verwerkt tot sap of siroop (Sambuci siru­pus).

Sambuci cortex recens, verse schors minder gebruikt, verliest gedroogd veel van zijn werking.

Kwaliteitsnormen vlgs farmacopee

Pharmacopeial grade dried elder flower must contain not less than 0.8% total flavonoids, calculated as isoquercitrin (DAB 1997; Ph.Eur.3, 1998). The Pharmacopoeia of Switzerland requires not less than 0.7% flavonoids (Ph.Helv.VII, 1987). The dried flower should also contain not less than 25% water-soluble extract (Bradley, 1992).

Vervalsingen, vergissingen:

Samenstelling, inhoudsstoffen

Flos (2)

Fructus (vrucht)

Cortex (vooral vers)

Samenstelling vlgs Emea

Farmacologie, fysiologische werking van Sambucus

Flos (bloesem)

Fructus - succus (sap)

Cortex

Toxiciteit: Geen bij normale dosis.

Indicatie / Gebruik

Luchtwegen - Immuunmodulerend 

** Beginnende verkoudheid en griep Ook e.o. Ravensara e.a 

** Infectieziekten met koorts, vooral kinderziekten 

* Bronchiale aandoeningen (slijmvliezen) 

Ogen en Huid 

* Acuut eczeem (irritatie, roodheid) R./ Sambuci fl. 20 Althaeae fl. 20 Verbasci fl. 20 Ber.: dec. 10'/500 ml water Gebr.: als kompres 

* Comedones (meeëters) 

* Brandwonden 

** Conjunctivitis, vermoeide ogen. R./

    Centaureae fl. 30 + Plantaginis fol. 30 . Sambuci fl. 80. inf. 15'/50 g/ 1 l. als oogbad

Nieren / reuma (cortex)

Andere mogelijke toepassingen

Receptuur en Bereidingswijzen van Sambucus

Infuus: Flores 10 tot 50 g/1 l/10'.

Sirupus: Fructus (Sambuci fructus recens) als siroop. Indicaties: griep, licht laxans, bloedzuive­rend.

Decoct: Cortex (Sambuci cortex) 3'/60 g/1 l. Indicaties: jichtcrisis (urinezuren) 2 kopjes per dag

Vinum: Vlierschorswijn (Moatti)

Species: Species pectorales R./ 

Species diaphoreticae R./ 

Species laxantes / Species St. Germain (P. Helv. V)

R./ 

Bloesemsiroop of sap

Vlierbloesemazijn (Dr. Belaiche)

R./ Sambuci flos 50 g                                                                         Ber.: mac. 4 d., zeven, 2 x hoeveelheid

Wijnazijn 1 l honing toevoegen, dec. tot siroop.                Dos.: 2 eetlepels daags

                                                                                                           Ind.: reuma- en jichtcrisis

Geschiedenis en Wetenschappelijk Onderzoek

vroeger veelonderzoek in Frankrijk naar de diuretische werking van de schors

Commission E

approved the internal use of elder flower for colds. The British Herbal Compendium lists its uses for common cold, feverish conditions, and as a diuretic (Bradley, 1992). The German Standard License for elder flower tea calls it a diaphoretic medicine for the treatment of feverish common colds or catarrhal complaints (Braun et al., 1997).

Referenties

Onderzoek naar immunmodulerende werking van Sambucus

Links naar Sambucus artikels

Nog meer referenties

Scopel M, Mentz LA, Henriques AT. Comparative analysis of Sambucus nigra and Sambucus australis flowers: development and validation of an HPLC method for raw material quantification and preliminary stability study. Planta Med. Jul 2010;76(10):1026-1031.

Thole JM, Kraft TF, Sueiro LA, et al. A comparative evaluation of the anticancer properties of European and American elderberry fruits. J Med Food. Winter 2006;9(4):498-504.

Krawitz C, Mraheil MA, Stein M, et al. Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses.BMC Complement Altern Med. 2011;11:16.

Picon PD, Picon RV, Costa AF, et al. Randomized clinical trial of a phytotherapic compound containing Pimpinella anisum, Foeniculum vulgare, Sambucus nigra, and Cassia augustifolia for chronic constipation. BMC Complement Altern Med. 2010;10:17.

Roschek B, Jr., Fink RC, McMichael MD, et al. Elderberry flavonoids bind to and prevent H1N1 infection in vitro. Phytochemistry. Jul 2009;70(10):1255-1261.

Christensen KB, Petersen RK, Kristiansen K, et al. Identification of bioactive compounds from flowers of black elder (Sambucus nigra L.) that activate the human peroxisome proliferator-activated receptor (PPAR) gamma. Phytother Res. Jun 2010;24 Suppl 2:S129-132.

Waknine-Grinberg JH, El-On J, Barak V, et al. The immunomodulatory effect of Sambucol on leishmanial and malarial infections. Planta Med. May 2009;75(6):581-586.

Youdim KA, Martin A, Joseph JA. Incorporation of the elderberry anthocyanins by endothelial cells increases protection against oxidative stress. Free Radic Biol Med. Jul 1 2000;29(1):51-60.

Jing P, Bomser JA, Schwartz SJ, et al. Structure-function relationships of anthocyanins from various anthocyanin-rich extracts on the inhibition of colon cancer cell growth. J Agric Food Chem. Oct 22 2008;56(20):9391-9398.

Fink RC, Roschek B, Jr., Alberte RS. HIV type-1 entry inhibitors with a new mode of action. Antivir Chem Chemother. 2009;19(6):243-255.

Bell DR, Gochenaur K. Direct vasoactive and vasoprotective properties of anthocyanin-rich extracts. J Appl Physiol. Apr 2006;100(4):1164-1170.

Curtis PJ, Kroon PA, Hollands WJ, et al. Cardiovascular disease risk biomarkers and liver and kidney function are not altered in postmenopausal women after ingesting an elderberry extract rich in anthocyanins for 12 weeks. J Nutr. Dec 2009;139(12):2266-2271.

Murkovic M, Abuja PM, Bergmann AR, et al. Effects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study. Eur J Clin Nutr. Feb 2004;58(2):244-249.

Zakay-Rones Z, Thom E, Wollan T, et al. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res. Mar-Apr 2004;32(2):132-140.

U.S. Food and Drug Administration. Available at:http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm257781.htm…Google257782&utm_source=fdaSearch&utm_medium=website&utm_term=elderberry&utm_content=257781.

Dellagreca M, Fiorentino A, Monaco P, et al. Synthesis of degraded cyanogenic glycosides from Sambucus nigra. Nat Prod Res. Jun 2003;17(3):177-181.

Barros L, Duenas M, Carvalho AM, et al. Characterization of phenolic compounds in flowers of wild medicinal plants from Northeastern Portugal. Food Chem Toxicol. May 2012;50(5):1576-1582.

Schmitzer V, Veberic R, Slatnar A, et al. Elderberry (Sambucus nigra L.) wine: a product rich in health promoting compounds. J Agric Food Chem. Sep 22 2010;58(18):10143-10146.

Barak V, Birkenfeld S, Halperin T, et al. The effect of herbal remedies on the production of human inflammatory and anti-inflammatory cytokines. Isr Med Assoc J. Nov 2002;4(11 Suppl):919-922.

Harokopakis E, Albzreh MH, Haase EM, et al. Inhibition of proinflammatory activities of major periodontal pathogens by aqueous extracts from elder flower (Sambucus nigra). J Periodontol.Feb 2006;77(2):271-279.

Frank T, Janssen M, Netzet G, et al. Absorption and excretion of elderberry (Sambucus nigra L.) anthocyanins in healthy humans. Methods Find Exp Clin Pharmacol. Oct 2007;29(8):525-533.

Frank T, Sonntag S, Strass G, et al. Urinary pharmacokinetics of cyanidin glycosides in healthy young men following consumption of elderberry juice. Int J Clin Pharmacol Res. 2005;25(2):47-56.

Centers for Disease Control and Prevention. Poisoning from elderberry juice—California. MMWR Morb Mortal Wkly Rep. Apr 6 1984;33(13):173-174.

Tsui B, Dennehy CE, Tsourounis C. A survey of dietary supplement use during pregnancy at an academic medical center. Am J Obstet Gynecol. Aug 2001;185(2):433-437.

Forster-Waldl E, Marchetti M, Scholl I, et al. Type I allergy to elderberry (Sambucus nigra) is elicited by a 33.2 kDa allergen with significant homology to ribosomal inactivating proteins. Clin Exp Allergy. Dec 2003;33(12):1703-1710.

Beaux D, Fleurentin J, Mortier F. Effect of extracts of Orthosiphon stamineus Benth, Hieracium pilosella L., Sambucus nigra L. and Arctostaphylos uva-ursi (L.) Spreng. in rats. Phytother Res.May 1999;13(3):222-225.

Schroder-Aasen T, Molden G, Nilsen OG. In vitro Inhibition of CYP3A4 by the Multiherbal Commercial Product Sambucus Force and its Main Constituents Echinacea purpurea and Sambucus nigra. Phytother Res. Feb 8 2012.

Zakay-Rones Z, Varsano N, Zlotnik M, et al. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med. Winter 1995;1(4):361-369.

                                                                                                                                            

The Traditional Plant Treatment, Sambucus nigra (elder), Exhibits Insulin-Like and Insulin-Releasing Actions In Vitro1

Alison M. Gray2, Yasser H. A. Abdel-Wahab, and Peter R. Flatt

Although elder has been long advocated as an effective traditional plant treatment to counter the symptoms of diabetes (Atkinson 1979, Palaiseul 1983), scientific studies to evaluate its efficacy and possible mode of action are lacking. The present study reports for the first time that elder flowers contain water-soluble natural products which directly stimulate glucose metabolism by muscle and promote insulin secretion from clonal pancreatic β-cells.

The effect of elder extract on glucose transport and metabolism was evaluated in vitro using an insulin-sensitive muscle preparation (Gray and Flatt 1997b). AEE (1 g/L) significantly enhanced glucose uptake, glucose oxidation and glycogen synthesis in a magnitude similar to 10-8 mol/L of insulin. Although this effect was observed in the absence of added insulin, it does not preclude involvement of residual insulin receptor binding within the muscle preparation. However, the lack of significant potentiation by AEE and insulin in combination implies that the extract is likely to act via pathways (at least terminally) that are utilized by insulin rather than entirely separate pathways. Notably, the effect of AEE on glucose uptake is different from that of the established antihyperglycemic drug, metformin, which enhances glucose uptake via insulin-mediated enhanced peripheral glucose uptake (Bailey and Puah 1986, Prager et al. 1986). The ability of AEE to enhance glucose uptake and oxidation in vitro is paralleled by findings for other aqueous plant extracts, including agrimony, lucerne, coriander, mushroom, mistletoe and eucalyptus (Gray and Flatt 1997b, Gray and Flatt 1998a,b,c, Gray and Flatt 1999a,b).

Incubations were performed with glucose-responsive BRIN-BD11 cells (McClenaghan et al. 1996) to investigate the possible effects of AEE on insulin secretion in vitro. This revealed a stepwise dose-dependent stimulation of insulin secretion by AEE at low (non-stimulatory) glucose concentration. Evaluation of cell viability using modified neutral red assay and the insulin-releasing action of L-alanine following exposure of clonal β-cells to extract argues against a simple cytotoxic action at or below 1 g/L of extract.

Studies to evaluate the possible mechanisms underlying the insulin-releasing action of elder indicated a similarity to the sulfonylurea class of drugs currently used for diabetes therapy (Bailey and Flatt 1995). These agents enhance insulin secretion by binding to sulfonylureas receptors on the β-cell, with subsequent closure of K+-ATP channels, membrane depolarization and Ca2+ influx (Rorsman 1997). Diazoxide inhibits the stimulatory action of sulfonylureas by preventing closure of the K+-ATP channels (Dunne et al. 1994). In the present study the insulin-releasing action of elder extract was inhibited by diazoxide. Importantly, the action of AEE was potentiated by 16.7 mmol/L of glucose, suggesting that β-cell glucose metabolism is able to augment the insulinotropic effect. Consistent with this view, L-alanine, which promotes insulin secretion through changes in Na+ transport (Yada 1994), failed to augment the insulin-releasing effect of AEE. In contrast to sulfonylureas (Eliasson et al. 1996, Flatt et al. 1994), AEE failed to stimulate insulin secretion from beta-cells depolarized by 25 mmol/L of KCl, indicating absence of similar K+-ATP channel-independent effects. Interestingly, the phosphodiesterase inhibitor IBMX which increases cyclic AMP and promotes insulin release (Sharp 1979) did not potentiate the insulin-releasing effect of AEE, raising the possibility that AEE itself may inhibit islet phosphodiesterase (Leibowitz et al. 1995).

Elder flowers contain a number of established natural products including lectin, the flavenoid rutin, choline tannin and lipophilic triterpenoid and sterol compounds such as lupeol and β-sitosterol (Shoaib et al. 1972, Willuhn and Richter 1997). It was therefore of interest to evaluate if any of these available compounds could account for the insulin-releasing action. Since Agaricus bisporus (mushroom) lectin documented insulinotropic activity (Ahmad et al. 1984a and 1984b; Ewart et al. 1975), it was particularly interesting to evaluate whether the lectin component of elder might be important. However, neither S. nigra lectin, rutin, lupeol, β-sitosterol, tannic acid or choline affected insulin release over a wide range of concentrations approximating to 1% of active plant extract. Thus, the chemical nature of potential antihyperglycemic components(s) of elder remains to be established. In terms of insulin-releasing activity, the present study indicates that the active principle(s) is heat-stable, acetone-insoluble and unaffected by altered pH environment. The approximate 40% decrease in the insulin-releasing activity of AEE following overnight dialysis (to remove components with a molecular mass < 2000 Da) suggests some involvement of smaller molecules or ions in the insulin releasing effect. Sequential solvent extractions point toward a cumulative effect of more than one active constituent, likely to be more polar in nature. Other aqueous plant extracts have also been shown to enhance insulin secretion using this model (Gray and Flatt 1997b, Gray and Flatt 1998a,b,c, Gray and Flatt 1999a and 1999b). However, the precise mechanisms by which these extracts enhance insulin secretion and the chemical identity of biologically active component(s) remain to be elucidated.

In conclusion, the traditional antidiabetic plant elder contains water-soluble components capable of stimulating insulin secretion and enhancing muscle glucose uptake and metabolism. Sambucus nigra therefore represents a possible dietary adjunct for the treatment of diabetes and a potential source for the discovery of new orally active agent(s) for future diabetes therapy.


BMC Vet Res. 2014 Jan 16;10:24. doi: 10.1186/1746-6148-10-24. Sambucus nigra extracts inhibit infectious bronchitis virus at an early point during replication. Chen C, Zuckerman DM, Brantley S, Sharpe M, Childress K, Hoiczyk E, Pendleton AR1.

Infectious bronchitis virus (IBV) is a pathogenic chicken coronavirus. Currently, vaccination against IBV is only partially protective; therefore, better preventions and treatments are needed. Plants produce antimicrobial secondary compounds, which may be a source for novel anti-viral drugs. Non-cytotoxic, crude ethanol extracts of Rhodiola rosea roots, Nigella sativa seeds, and Sambucus nigra fruit were tested for anti-IBV activity, since these safe, widely used plant tissues contain polyphenol derivatives that inhibit other viruses.

RESULTS:

Dose-response cytotoxicity curves on Vero cells using trypan blue staining determined the highest non-cytotoxic concentrations of each plant extract. To screen for IBV inhibition, cells and virus were pretreated with extracts, followed by infection in the presence of extract. Viral cytopathic effect was assessed visually following an additional 24 h incubation with extract. Cells and supernatants were harvested separately and virus titers were quantified by plaque assay. Variations of this screening protocol determined the effects of a number of shortened S. nigra extract treatments. Finally, S. nigra extract-treated virions were visualized by transmission electron microscopy with negative staining.Virus titers from infected cells treated with R. rosea and N. sativa extracts were not substantially different from infected cells treated with solvent alone. However, treatment with S. nigra extracts reduced virus titers by four orders of magnitude at a multiplicity of infection (MOI) of 1 in a dose-responsive manner. Infection at a low MOI reduced viral titers by six orders of magnitude and pretreatment of virus was necessary, but not sufficient, for full virus inhibition. Electron microscopy of virions treated with S. nigra extract showed compromised envelopes and the presence of membrane vesicles, which suggested a mechanism of action.

CONCLUSIONS: These results demonstrate that S. nigra extract can inhibit IBV at an early point in infection, probably by rendering the virus non-infectious. They also suggest that future studies using S. nigra extract to treat or prevent IBV or other coronaviruses are warranted.


Pharm Biol. 2015 Apr;53(4):533-9. doi: 10.3109/13880209.2014.931441. Epub 2014 Oct 20. Effects of Sambucus nigra and Aronia melanocarpa extracts on immune system disorders within diabetes mellitus.

Badescu M1, Badulescu O, Badescu L, Ciocoiu M.

The fruits of Aronia melanocarpa Elliot (Rosaceae), (black chokeberry), and Sambucus nigra L. (Caprifoliaceae), elderberries are rich in anthocyanins. Many studies have reported that anthocyanins are beneficial in diabetes due to their capacity to stimulate insulin secretion and reduce oxidative stress.

OBJECTIVE:

The purpose of this study is to prove the biologically active properties of polyphenols extracted from S. nigra and A. melanocarpa fruit. The study also details the influence of plant polyphenols on immune system imbalances within diabetes mellitus.

MATERIALS AND METHODS:

Polyphenolic extract was administered to Wistar rats 0.040 g/kg body every 2 d for 16 weeks. The absorbencies of all the solutions were determined using a V-550 Able Jasco UV-VIS spectrophotometer. The immunomodulatory capacity of vegetal extracts was assessed by studying cytokines TNF-α and IFN-γ through the ELISA method and fibrinogen values.

RESULTS AND DISCUSSION:

At 48 h, the anti-inflammatory effects of S. nigra and A. melanocarpa substances have been revealed by an increase of the TNF-α and IFN-γ levels in the diabetic group protected by these extracts. Seventy-two hours post-administration of both substances in the diabetic groups, the TNF-α level returns to the values read 24 h after substance administration. The vegetal extracts limit the production of fibrinogen in the diabetic rats under polyphenolic protection, the values being highly significant compared with the diabetic group.

CONCLUSIONS: Natural polyphenols extracted from S. nigra and A. melanocarpa modulate specific and non-specific immune defenses in insulin-deficiency diabetes and reduce the inflammatory status and self-sustained pancreatic insulitis.


J Nutr. 2000 Jan;130(1):15-20. The traditional plant treatment, Sambucus nigra (elder), exhibits insulin-like and insulin-releasing actions in vitro. Gray AM1, Abdel-Wahab YH, Flatt PR.

Sambucus nigra (elder) has been documented as a traditional treatment of diabetes. In the present study, an aqueous extract of elder (AEE, 1 g/L) significantly increased 2-deoxy-glucose transport, glucose oxidation and glycogenesis of mouse abdominal muscle in the absence of added insulin (2 x 2 factorial design). in acute 20-min tests, 0.25-1 g/L AEE evoked a stepwise stimulation of insulin secretion from clonal pancreatic beta-cells. The insulin releasing effect of AEE (0.5 g/L) was significantly potentiated by 16.7 mmol/L of glucose and significantly reduced by 0.5 mmol/L of diazoxide. AEE did not further enhance insulin secretion in cells stimulated by 10 mmol/L of L-alanine, 1 mmol/L of 3-isobutyl-1-methylxanthine or a depolarizing concentration of KCl (25 mmol/L). Prior exposure of clonal pancreatic beta-cells to AEE did not alter subsequent stimulation of insulin secretion induced by 10 mmol/L of L-alanine, thereby precluding a detrimental effect on cell viability. The insulinotropic action of AEE was partially dependent upon use of heat during extract preparation. Activity of AEE was heat-stable, acetone-insoluble and unaltered by prolonged exposure to acid/alkali (0.1 mol/L of HCl and NaOH). However, activity was significantly decreased 41% by dialysis to remove components with molecular mass <2000 Da. Sequential extraction with solvents revealed activity in both methanol and water fractions, indicating a cumulative effect of more than one extract constituent. Known constituents of elder, including lectin, rutin and the lipophilic triterpenoid (lupeol) and sterol (beta-sitosterol), did not stimulate insulin secretion. The results demonstrate the presence of insulin-releasing and insulin-like activity in the traditional antidiabetic plant, Sambucus nigra.


Pharmacodynamics http://www.ema.europa.eu/docs/en_GB/document_library/Herbal_-_HMPC_assessment_report/2009/12/WC500018238.pdf

In vitro experiments SAMBUCI FLOS

Effect on blood glucose

Researchers in Northern Ireland conducted an in vitro study to evaluate the effect on blood sugar. In a  two-armed study, aqueous extract of elder flower significantly increased glucose uptake, glucose  oxidation, and glucogenesis in rat abdominal muscle. Elder flower extract incubated with rat pancreatic cells also had a dose-dependent stimulatory effect on insulin secretion. It was concluded  that elder flower contains water-soluble components capable of stimulating insulin secretion and  enhancing muscle glucose uptake and metabolism. However, the chemical nature of potential antihyperglycemic components of elder flower remains to be established.(Gray et al. 2000).

Anti-inflammatory activity

The ability of aqueous extracts from elder flower to inhibit the proinflammatory activity of major  virulence factors from the periodontal pathogens Porphyromonas gingivalis and Actinobacillus  actinomycetemcomitans has been investigated. The study indicated that elder flower extract inhibits macrophage release of pro-inflammatory cytokines induced by P. gingivalis, A. actinomycetemcomitans, and selected components of these pathogens. Moreover, the elder flower  extract suppressed the activation of neutrophils, which have also been implicated as effectors of  periodontal tissue destruction. These effects could be attributed to inhibition of activation of NF-κB  and phosphatidylinositol 3-kinase (PI3K).

The active ingredients responsible for the anti-inflammatory action of elder flower aqueous extract are  unknown. The ability of aqueous extract (SNAE) to inhibit P13K has been suggested to be mediated at  least partially through quercetin. The presence in S.nigra of anthocyanins with antioxidant action may  be responsible for the ability of SNAE to inhibit oxidative burst of neutrophils, and partially, the  inhibitory effect of SNAE on NF-κB activation (Harokopakis et al. 2006). A study by Yeşilada et al.  (1997) et al. showed that the methanolic extract of elder flower and its lipophilic fractions possess a

medium to low inhibitory effect on the biosynthesis of interleukin-1α, interleukin-1β and tumor  necrosis factor α.

Antibacterial activity

Izzo et al. (1995) investigated 68 plant extracts from 65 species (including elder flower ethanol  extract) for antibacterial activity against eight gram-positive and eight gram-negative bacteria. Elder  flower showed activity against Bacillus subtilis, Staphylococcus aureus, Salmonella typhi, Klebsiella pneumoniae and Pseudomonas aeruginosa. According to Izzo et al (1995), a search of the literature  showed that antibacterial properties of elder flower could be attributed to chlorogenic and caffeic  acids. 

European Elder

by Gayle Engels, Josef Brinckmann

HerbalGram. 2012; American Botanical Council

Sambucus nigra, L.

Family: Caprifoliaceae

European elder (Sambucus nigra, Caprifoliaceae), also known as black elder1 and elderberry, is a deciduous tree that grows to 30 feet and is native to Europe, northern Africa, and western Asia.2 It has flat-topped clusters of small, creamy-white flowers in early summer, followed by large, drooping bunches of purplish-black, juicy drupes (commonly referred to as berries) in late summer or early fall.2,3

Both the elder flower and berry are used medicinally. Most of the elder flower in commerce is collected from the wild, mainly from Albania,4 Bosnia-Herzegovina, Bulgaria, Croatia, Romania,5 Hungary, Macedonia,6 Poland,7 Russia,8 Serbia, and Montenegro.9 Elderberries also are wild-collected in the aforementioned countries, but there are several distinct cultivars grown in commercial orchards, particularly in Austria (e.g., mainly the “Haschberg,” “Rubin,” and “Tattin” varieties), Denmark (e.g., “Sambu,” “Sampo,” “Samdal,” “Samyl,” “Allesoe,” and “Korsör”), and Germany (e.g., “Haschberg,” “Sambu,” “Sampo,” “Samyl,” and “Haidegg 13”). Due to successful auto-vegetative propagation, regular yields, and high coloring matter content, “Haschberg” is the chief variety cultivated in both Austria and Germany.10

For the sake of convenience, European elder will be referred to as elder in this article, and the plant part under discussion will be specified.

HISTORY AND CULTURAL SIGNIFICANCE

The genus Sambucus contains more than 20 species, many with similar chemical constituents to S. nigra. One such species, American elder (S. canadensis), is a fast-growing, deciduous North American shrub that can reach up to 12 feet with flowers and berries similar to S. nigra.1,3 While this species was used by Native American tribes and as a folk remedy in some of the same ways as S. nigra, it will not be discussed in this article for reasons set forth below in the Modern Research section.

The use of elder as a medicine dates back to antiquity, according to the writings of Hippocrates (ca. 470-410 BCE), Pliny the Elder (ca. 23-79 CE), and Dioscorides (ca. 40-90 CE).11 The word elder is derived from the Anglo-Saxon word æld, meaning “fire,” because one could start a fire by blowing through its young, hollow branches.12 Historically, medicinal uses for European elder could be found in Italian, Dutch, Portuguese, Croat-Slovak, German, Austrian, Swiss, and Hungarian pharmacopeias.13

Of interesting historical note, in Anatomi Sambuci: The Anatomy of the Elder, written in 1677, the physician Martin Blochwich described medicines made from the various parts of elder, including a berry tincture, extract (or essence), wine, spirits (fermentation), syrup, tragea (powdered elderberry kernels), and rob (a thickened juice made from the berries, either with or without sugar), as well as seed oil.14 He also noted elder flower-derived preserves, syrup or honey, water and spirits, vinegar and oxymel (vinegar and honey), wine, and oil. Additionally, Blochwich elaborated upon powder, preserves, and syrup that could be made from the buds or sprouts of the plant, and also medicines that could be made with the leaves, middle bark, roots, pith, and fungus, including those in the form of water, syrup, oils, and liniments. Lastly, he chronicled making a “salt and its spirit” by reducing the entire plant to ashes over an open fire, pouring boiling water over it, and again reducing it over a low fire. This process produced the salt from which the spirit was then made. Blochwich then addressed the many ways in which these elder preparations were used alone (some of which might seem quite strange to the modern reader) and in combination with other “medicines” that are now known to be toxic. Common ailments these elder preparations were used to treat include headache, toothache, eye conditions, facial blemishes, mouth and throat conditions, cough, asthma, hoarseness, fever, smallpox, measles, stomach and intestinal conditions, stones, arthritis, menstrual complaints, inflammation, edema, and burns. Some of the more unusual conditions treated include deliria and affections (in combination with lily water, rose water, and opium); melancholy (by provoking vomiting); epilepsy (using an elder amulet worn over the heart); apoplexy and palsy (by vigorous rubbing of the extremities with elder spirit); protection from plague (by carrying and smelling an elder vinegar-soaked sponge in a hollow juniper-wood globe); and wound healing (by drinking wine that had elder leaves pounded into it, followed by a poultice of elder kernel oil, Venice turpentine, and verdigris [a poisonous green pigment caused by the action of acetic acid on copper]).

Traditionally, numerous ailments have been treated by elderberry including dysentery and diarrhea. It also was used to induce perspiration in order to remove toxins and increase resistance to illness.13 Currently, elderberries are used to treat symptoms associated with colds, flu, and in feverish conditions as a diaphoretic (an agent that increases perspiration).12,15,16 The expressed juice of the berries, as well as extracts and dried juice concentrates, are used as components of oral ingestion products like medicated syrups and tablets, as well as topical application products like lozenges and skincare products.10 The fresh ripe berries are used in juices, jams, marmalades, liqueurs and dessert wines, and also as a coloring agent in beverages, foods, and textiles.10

Elder flowers are used as a diuretic, laxative, and diaphoretic.12,17 Additionally, they are used as an astringent for the skin and in treating rheumatism, usually as an infusion (tea) or in a poultice.18 The dried flowers of elder are used in European traditional herbal medicinal products mainly in the form of herbal teas, liquid extracts, and tinctures.19 The German Commission E approved elder flower — administered as fluid extract, herbal tea, or tincture — for common cold symptoms in 1986.20 In 1992, the British Herbal Medicine Association published an elder flower monograph in its British Herbal Compendium, specifying the forms of herbal tea infusion (drunk hot), liquid extract (1:1, 25% ethanol), and tincture (1:5, 25% ethanol) for treating feverish common cold conditions.21 Elder flower water also has been used in eye and skin moisturizers, and flower extracts are used in perfumery.18

Both elderberry and elder flower extracts are used as flavorings in food products, alcoholic (bitters and vermouth) and nonalcoholic beverages, and confectionary items.18

CURRENT AUTHORIZED USES IN COSMETICS, FOODS, AND MEDICINES

In 2008, the European Medicines Agency (EMA) published a final labeling standards monograph on elder flower (as herbal tea for oral use, liquid extract [1:1, 25% V/V ethanol], or tincture [1:5, 25% V/V ethanol]), which superseded existing monographs of EU national authorities for the registration and marketing authorization of traditional herbal medicinal products that contain elder. The authorized therapeutic indication is “for the relief of early symptoms of common cold.”22

One prerequisite of registration is that the quality of the herbal material complies with the corresponding quality standards monograph of the European Pharmacopoeia (Sambuci flos PhEur), which, for example, requires the dried flowers to contain a minimum of 0.80% flavonoids, expressed as isoquercitroside.23 In European countries, elder flower also is found as an active ingredient of clinically tested polypreparations such as Sinupret® (Bionorica SE, Neumarkt, Germany), a licensed herbal medicinal product sold only in pharmacies and indicated for acute and chronic inflammation of the paranasal sinuses. (Sinupret also contains primrose [Primula veris, Primulaceae] flowers with calyx, common sorrel [Rumex acetosa, Polygonaceae] herb, European vervain [Verbena officinalis, Verbenaceae] herb, and gentian [Gentiana lutea, Gentianaceae] root.24) In the United Kingdom, aqueous liquid extract (1:1) of elder flower is an active ingredient of Cold and Flu Relief by Potter’s Herbals (Wigan, UK; founded by Henry Potter in 1812), a registered traditional herbal medicinal product available without prescription from pharmacies and other retail outlets with the authorized therapeutic indication “used to relieve the symptoms of colds and flu, chills and sore throats.”25 (Potter’s Cold and Flu Relief also contains ethanolic liquid extracts [1:1] of hemlock spruce [Pinus canadensis, Pinaceae] needle and bayberry [Myrica cerifera, Myricaceae] bark.)

In 2011, the EMA called for scientific data to be used by its Committee on Herbal Medicinal Products for assessment work toward the establishment of a community herbal monograph and/or community list entry for elderberries (Sambuci fructus).26 Presently, there are also some elderberry-containing food supplement products in the European market, such as Wellion Diabasic® tablets (MED TRUST; Lichtenwörth, Austria), a dietetic food supplement labeled for special medical needs of diabetic patients with disease-related nutrient deficiencies.27 Another example is the enzyme complex and herbal preparation Snorin® tablets (VitaBasix®; Maastricht, the Netherlands), labeled for chronic snoring whose cause is not determined to be anatomic after other causes (obesity, alcoholism, chronic tonsillitis, or sinusitis) have been excluded.28

Concerning use of elder in cosmetic products, the European Commission Health and Consumers Directorate lists “Sambucus Nigra Fruit Extract” for astringent (contracts the skin) function and “Sambucus Nigra Fruit Juice” for both astringent and skin-conditioning functions. “Sambucus Nigra Flower,” “Sambucus Nigra Flower Juice” (juice expressed from the flower), and “Sambucus Nigra Flower Water” (aqueous solution of the steam distillate obtained from the flowers) are approved for use as skin-conditioning ingredients, while “Sambucus Nigra Flower Extract” is listed for refreshing (imparts a pleasant freshness to the skin), skin-conditioning, soothing (helps lightening discomfort of the skin or of the scalp), and tonic (produces an invigorating sensation on skin and hair) functions.29

In the United States, elder tree leaf is classified as a Generally Recognized as Safe (GRAS) natural flavoring substance, although its use is limited to only alcoholic beverages and not to exceed 25 ppm (parts per million) prussic acid in the natural flavor ingredient.30 The essential oil or natural extractives (including distillates) of elder flower are GRAS flavoring agents in food products.31 Elderberry and elder flower also are permitted as dietary supplement components in the United States, requiring Food and Drug Administration notification within 30 days of marketing a product (if a “structure-function” claim is made). In Canada, they are regulated as active ingredients of licensed natural health products (NHPs) requiring pre-market authorization from the Natural Health Products Directorate. As one example, Sambucol®* Original Lozenges (Healthcare Brands International Ltd., Surrey, UK), an elderberry preparation, is a licensed NHP indicated for reducing severity of flu symptoms (aches and pains, cough, congestion) and shortening duration of influenza A and B viruses.32 Elder flower preparations, such as Gaia Garden Herbals Elder Flowers Tincture (Flora Manufacturing & Distributing Ltd.; Burnaby, Canada), are licensed NHPs with the authorized therapeutic indication “as a diaphoretic in conditions requiring fever management, including the common cold and influenza and for sinusitis and chronic nasal catarrh [inflammation of mucus membranes] with deafness.”33

MODERN RESEARCH

Numerous in vivo and in vitro laboratory studies have assessed elder flowers and berries for antibacterial, anticancer, anti-inflammatory, antimicrobial, antiproliferative, antiviral, antioxidant, and immunomodulating activity, as well as chemopreventive and cytotoxic potential, cellular uptake, burn healing, insulin-simulating and insulin-releasing actions, anti-angiogenic (inhibiting the growth of blood vessels) activity, cardioprotective activity, and antihypertensive properties. Human clinical studies support the traditional use of and laboratory findings on elderberry and flower.

During the 2009 flu season, a short-term, randomized, double-blind, placebo-controlled pilot study was conducted on 64 volunteers suffering from three or more flu-like symptoms (coughing, fever, headache, muscle aches, and/or nasal congestion and mucosal discharge) for less than 24 hours.34 The patients were randomized into two groups of 32 and administered four doses of 175 mg proprietary elderberry extract (HerbalScience Singapore Pte. Ltd.; standardized and enriched in phenolic acids, polyphenolics, and a broad diversity of other flavonoids)35 or placebo daily for two days. After 48 hours, the elderberry group reported a significant reduction in symptoms with 28% of volunteers being symptom free. The symptoms of the patients in the placebo group were either unchanged or worse.

In 2004, a randomized, double-blind, placebo-controlled study (n=60) demonstrated the safety and efficacy of Sambucol in the treatment of influenza.36 Patients with influenza type A or B received 15 ml Sambucol or placebo four times per day. Flu symptoms decreased significantly in the elder group by the third or fourth day versus seven-to-eight days in the placebo group. Treatment was initiated within 48 hours of symptom onset and the authors suggested that the elder preparation might have been even more effective with earlier intervention.

In a previous placebo-controlled, double-blind study conducted in 1995 on 27 patients with influenza symptoms for 24 hours or less, patients received either Sambucol or placebo daily for three days (two tablespoons per day for children five-to-11 years of age and four tablespoons per day for adults 12 years and older).37 Within two days, 93.3% of the elderberry group experienced a significant improvement in symptoms, and complete resolution was achieved by 90% of the group within two to three days. The placebo group did not experience similar improvement or resolution until day six.

A 2004 randomized, double-blind, placebo-controlled study investigated the effect of elderberry juice on cholesterol, triglyceride concentrations, and antioxidant status in young volunteers.38 In the first arm of the study, 34 participants took three daily doses of 400 mg encapsulated spray-dried elderberry juice (Iprona; Lana, Italy; 10% anthocyanins, equal to 5 ml elderberry juice, processed first by ultra filtration after which the liquid extract is spray dried to a powder using maltodextrin as the carrier), or placebo for two weeks. A subgroup continued for another week to test for resistance to oxidation of low-density lipoprotein (LDL) cholesterol. There was a small, statistically insignificant change in cholesterol in the elderberry group (from 199 to 190 mg/dl) compared to placebo (from 192 to 196 mg/dl). Resistance to copper-induced oxidation of LDL did not change within the three weeks. In the second arm of the study, six participants took a single dose of 50 ml elderberry juice with a high-fat breakfast, and no significant post-meal triglyceride concentrations were observed. The authors stated that low-dose, spray-dried elderberry extract has a minor effect on serum lipids and antioxidative capacity, but that further studies employing higher, nutritionally relevant doses might affect significant postprandial serum lipids.

Based on evidence supporting the cardioprotective role of anthocyanins, a 2009 parallel-designed, randomized, placebo-controlled study was conducted to examine the effect of chronic anthocyanin consumption on biomarkers of cardiovascular disease (CVD) risk and kidney function.39 Healthy postmenopausal volunteers (n=52) consumed 500 mg per day elderberry anthocyanins (Artemis International; Fort Wayne, IN; 125 mg cyanidin-3-glucoside, extraction method not stated) or placebo for 12 weeks. No significant change in biomarkers of CVD risk was observed and liver and kidney function remained within clinically acceptable ranges. The authors stated that while their findings are consistent with two previous studies that are not directly comparable (elderberry and cranberry [Vaccinium macrocarpon, Ericaceae] juices), their findings are inconsistent with two previous studies that showed reduction in CVD biomarkers (using Bing cherry [Prunus avium, Rosaceae] anthocyanins) and inflammatory markers (bilberries [Vaccinium myrtillus, Ericaceae] and blackcurrants [Ribes nigrum, Grossulariaceae]). They explained that differences in study design may explain the inconsistent results because the participants in their trial had lower levels of CVD risk than participants in the other study populations. They also suggested that the difference in inflammatory markers could be a result of this study’s examination of high levels of anthocyanin intake over a short period of time rather than long-term intake of anthocyanin-rich foods.

Studies have been conducted on elder in combination with other plant materials investigating their usefulness in a variety of conditions. A 2009 monograph by the American Botanical Council on Sinupret concluded that the “scientific and clinical literature supported [its] pharmacological mechanisms of mucolytic, secretolytic, anti-inflammatory, antibacterial, antiviral, and immunological activity, some of which has been documented in open-label and randomized, controlled human clinical trials.”24

A small, randomized, crossover, placebo-controlled, single-blinded study performed in 2010 evaluated the laxative efficacy of a combination product that has been available in Brazil since 1926.40 The product contains fruits of anise (Pimpenella anisum, Apiaceae) and fennel (Foeniculum vulgare, Apiaceae), as well as flowers of elder and senna (Cassia angustifolia, Fabaceae) (Laboratórios Klein; Porto Alegre, Brazil; described only as a “homogeneous mixture of dried botanicals”). Each of the 20 patients with chronic constipation who participated in the study received the compound as a tea (15 g infused for five minutes in 1,500 ml boiling water) or placebo for five days. Following a washout period of nine days during which the patients were free to use other laxatives, the treatment was reversed in the two groups. The number of evacuations in the group receiving the combination tea increased during the use of the tea and significant differences were observed as of the second day of treatment. No adverse effects were observed.

In 2008, authors of an observational study sought to obtain information on the compounds in a food supplement sold as a weight reduction aid to determine its short-term effectiveness and safety as an initiator of lifestyle change.41 While the name of the supplement was not stated, it consisted of elderberry juice supplemented with elder flower juice (concentrate based on 120 g fresh berries and extract of 3.9 g dried flowers), elder tablets (225 mg berry powder and 600 mg flower extract) three times per day, psyllium (Plantago arenaria, Plantaginaceae) two to three teaspoons each morning, and a dose of asparagus (Asparagus officinalis, Asparagaceae) tablets equivalent to 40.5 g dried asparagus per day. Participants (n=80) followed a 13-to-15 day protocol after which time their mean body mass index (BMI), weight, blood pressure, physical and emotional wellbeing, and quality of life had improved significantly. The authors stated that it remained to be established if any of the chemical constituents in the supplements contributed to the efficacy of the diet.

FUTURE OUTLOOK

For generations, European elder flower and elderberry preparations have been labeled and marketed as non-prescription herbal medicinal products available at most pharmacies and drugstores throughout Europe, as well as in countries where traditional European herbal medicines are licensed, listed, or registered (in particular, Australia, Canada, and New Zealand). In the United States, elder preparations are offered mainly as dietary supplements, although some, such as Sambucol Cold & Flu Relief, are listed homeopathic drug products. In recent years, new demand for elder is being driven, in part, by several alcoholic beverage brands offering certified organic elder flower and elderberry liqueurs, schnapps, spirits, and wines that have become trendy in both Europe and America. Moreover, non-alcoholic drinks — including the certified organic BIONADE® (Peter Bier, Ostheim vor der Rhön) Elderberry flavor (entered EU market in 1996) — are sold in conventional, natural, and organic grocery stores throughout Europe and are popular on the menus of cafes, clubs, and bars. The elderberries used in BIONADE products are organically grown in Germany’s Rhön region (State of Hesse) and in Lower Franconia (State of Bavaria).

Elder (as elderberry) was the 18th top-selling herbal dietary supplement in the Food, Drug, and Mass Market channel in the United States for 2011.42 A reported total of $797,915.00 in elderberry products was sold in that channel of trade, down almost 15 percent from 2010.

In a 2003 report, the estimated annual quantity of dried elder flowers wild-collected in Bosnia-Herzegovina was about 44 tons (five percent used domestically and 95 percent exported), and in Romania about 150 tons of elder flowers and 40 tons of elder fruits are wild-harvested annually.5 A 2010 report by the European Herb Growers Association (Europam) states that elder flowers and fruits remain among the highest volume wild-collected medicinal plants in both Bulgaria and Romania for export trade as well as for domestic herbal tea and phyto-pharmaceutical production.43 An International Trade Centre study on certified organic wild-collected plants estimated that, in 2005, about 472 tons of elderberries, 19 tons of elder flowers, and six tons of elder leaves were collected according to an organic wild-crop harvesting practice standard.44 Demand for European elder flower and fruit with sustainability certifications (e.g., Organic Wild and FairWild) appears to be increasing as evidenced by the fact that wild-collection firms are implementing ecological and social standards for elder harvesting in a number of countries, including Albania, Bosnia-Herzegovina, Hungary, Macedonia,6 Croatia, and the Ukraine.45 In Croatia, about 75 percent of the wild-harvested elder flowers are traded in the local and national markets, and about 25 percent are exported.5

* Sambucol was the initial trade name for the elderberry extract made by Razei Bar Industries in Jerusalem, Israel. Razei Bar was purchased by Health Brands International Ltd. (a private equity company based in the United Kingdom) in 2007. Health Brands International sold the Sambucol rights to PharmaCare Labortories, a Sydney, Australia company, which now markets the brand in the United States.

REFERENCES

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2. Bown D. New Encyclopedia of Herbs and Their Uses. London: Dorling Kindersley Ltd.; 2001.

3. Gilman EF, Watson DG. Sambucus Canadensis American Elder. Available at: http://edis.ifas.ufl.edu/pdffiles/ST/ST57800.pdf. Accessed November 16, 2012.

4. Torres-Londoño P, Doka D, Becker H. Die Wildsammlung von Arznei- und Gewürzpflanzen in Albanien, untersucht an Beispielen aus dem Umland von Peshkopi (Region Dibër). Zeitschrift für Arznei & Gewürzpflanzen. 2008;13(4):153-160.

5. Kathe W, Honnef S, Heym A. Medicinal and Aromatic Plants in Albania, Bosnia-Herzegovina, Bulgaria, Croatia and Romania. Bonn, Germany: German Federal Agency for Nature Conservation. 2003. Available at: www.bfn.de/fileadmin/MDB/documents/skript91.pdf. Accessed November 17, 2012.

6. FairWild Foundation. FairWild-certified ingredients under production. Weinfelden, Switzerland, FairWild Foundation. December 2011. Available at: www.fairwild.org/publication-downloads/other-documents/FairWild_species_products_Dec2011.pdf. Accessed November 17, 2012.

7. Łuczaj L, Szymański WM. Wild vascular plants gathered for consumption in the Polish countryside: a review. Journal of Ethnobiology and Ethnomedicine. 2007;3:17. doi:10.1186/1746-4269-3-17. Available at: www.ethnobiomed.com/content/pdf/1746-4269-3-17.pdf. Accessed November 17, 2012.

8. Wichtl M, ed. Brinckmann JA, Lindenmaier MP, trans. Herbal Drugs and Phytopharmaceuticals, 3rd ed. Stuttgart: Medpharm GmbH Scientific Publishers; 2004

9. Donnelly R, Helberg U. Balkans Herbal Development Initiative—Phase 1 Final Summary Report—Serbia and Montenegro. Southeastern Europe Enterprise Development and The Corporate Citizenship Facility. 2003. Available at: www.ifc.org/ifcext/enviro.nsf/AttachmentsByTitle/art_CCF-HDISerbMont/$FILE/HDI%2BReport%2BSerbia%2Band%2BMontenegro.pdf. Accessed November 17, 2012.

10. Möhler M, Blaschek W, Lohwasser U, Walther E. Holunder (Sambucus nigra L.). In: Hoppe B, et al. Handbuch des Arznei- und Gewürzpflanzenbaus, Band 4. Bernburg, Germany: Verein für Arznei- und Gewürzpflanzen SALUPLANTA e.V. ; 551-561.

11. Mumcuoglu M. Wonderful Sambucus: The Black Elderberry. Jerusalem: Shmuel Tal Printing Service; 1998.

12. Grieve M. A Modern Herbal. Vol. 2. New York: Dover Publications; 1971.

13. Lehman, H. Mathemathisch-naturwisssenschalichen Abteilung der Philosophischen Fakultät der Universität Basel. Zofingen: Graphische Anstalt Zofinger Tagblatt; 1935.

14. Blochwich M. Anatomi Sambuci: The Anatomy of the Elder. Rev. ed. Jacobs A, Stipps F (eds.), Freund S (trans.). Lana, Italy: BerryPharma AG; 2010.

15. Hoffman D. Medical Herbalism: The Science and Practice of Herbal Medicine. Rochester, VT: Healing Arts Press; 2003.

16. Elliman W. Elderberry, flu contrary. Hadassah Magazine. 1994 Dec;40-41.

17. Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Austin, TX: American Botanical Council; Newton, MA: Integrative Medicine Communications; 2000.

18. Leung A, Foster S. Encyclopedia of Common Natural Ingredients Used in Food Drugs, and Cosmetics, 2nd ed. New York: John Wiley & Sons; 1996.

19. European Medicines Agency (EMA) Committee on Herbal Medicinal Products (HMPC). Community Herbal Monograph on Sambucus nigra L., flos. London, UK: EMA. 2008. Available at:www.ema.europa.eu/docs/en_GB/document_library/Herbal_-_Community_herbal_monograph/2009/12/WC500018233.pdf. Accessed November 17, 2012.

20. Blumenthal M, Busse WR, Goldberg A, Gruenwald J, Hall T, Riggins CW, Rister RS, eds. Klein S, Rister RS, trans. The Complete German Commission E Monographs¾Therapeutic Guide to Herbal Medicines. Austin, TX: American Botanical Council; Boston: Integrative Medicine Communication; 1998.

21. Bradley PR, ed. British Herbal Compendium: A Handbook of Scientific Information on Widely Used Plant Drugs, Vol. 1. Bournemouth, UK: British Herbal Medicine Association. 1992;84-86.

22. European Medicines Agency (EMA) Committee on Herbal Medicinal Products (HMPC). Community Herbal Monograph on Sambucus nigra L., flos. London, UK: EMA. 2008. Available at:www.ema.europa.eu/docs/en_GB/document_library/Herbal_-_Community_herbal_monograph/2009/12/WC500018233.pdf. Accessed November 17, 2012.

23. European Pharmacopoeia Commission. European Pharmacopoeia, 7th ed. (PhEur 7.0). Strasbourg, France: European Directorate for the Quality of Medicines. 2011;1117-1118.

24. Oliff HS, Blumenthal M. American Botanical Council Proprietary Botanical Product Scientific and Clinical Monograph for Sinupret®. Austin, Texas: American Botanical Council; 2009.

25. Medicines and Healthcare products Regulatory Agency (MHRA). Potter’s Cold and Flu Relief – THR: 00250/0224. London, UK: MHRA; May 8, 2012. Available at:www.mhra.gov.uk/home/groups/par/documents/websiteresources/con171949.pdf. Accessed November 17, 2012.

26. European Medicines Agency (EMA) Committee on Herbal Medicinal Products (HMPC). Call for scientific data for use in HMPC assessment work on Sambucus nigra L., fructus. London, UK: EMA. October 15, 2011. Available at: www.ema.europa.eu/docs/en_GB/document_library/Herbal_-_Call_for_data/2011/10/WC500116585.pdf. Accessed November 17, 2012.

27. Weißenbacher SM. Edelholunder - Gesundheit durch die Kraft der Pflanzenstoffe. Wellbion Journal für Diabetiker und Fachpersonal. 2006;1:24-25. Available at:www.wellion.at/_pdf/4c3b2508200c2.pdf. Accessed November 17, 2012.

28. VitaBasix® by LHP Inc. Product Information: Snorin®. Maastricht, The Netherlands: LHP Inc. July 2011. Available at:www.vitabasix.com/fileadmin/content/produktInfoPDFs/enPDF/Produktinfo_Snorin_EN.pdf. Accessed November 17, 2012.

29. European Commission Health & Consumers Directorate. Cosmetic Ingredients and Substances (CosIng®) Database. Brussels, Belgium: European Commission. Available at:http://ec.europa.eu/consumers/cosmetics/cosing/. Accessed November 17, 2012.

30. Food and Drug Administration. 21CFR §172.510 Natural flavoring substances and natural substances used in conjunction with flavors. In: Code of Federal Regulations. Washington, DC: National Archives and Records Administration; 2012. Available at: www.gpo.gov/fdsys/pkg/CFR-2012-title21-vol3/pdf/CFR-2012-title21-vol3-sec172-510.pdf. Accessed November 17, 2012.

31. Food and Drug Administration. 21CFR §582.20: Essential oils, oleoresins (solvent-free), and natural extractives (including distillates). In: Code of Federal Regulations. Washington, DC: National Archives and Records Administration; 2012. Available at: www.gpo.gov/fdsys/pkg/CFR-2012-title21-vol6/pdf/CFR-2012-title21-vol6-sec582-20.pdf. Accessed November 17, 2012.

32. Health Canada Natural Health Products Directorate (NHPD). Sambucol® Original Lozenges, Natural Product Number (NPN): 80026276. In: Health Canada Licensed Natural Health Products Database. July 8, 2011. Available at: http://webprod3.hc-sc.gc.ca/lnhpd-bdpsnh/index-eng.jsp. Accessed November 17, 2012.

33. Health Canada Natural Health Products Directorate (NHPD). Gaia Garden Herbals Elder Flowers Tincture, Natural Product Number (NPN): 80006307. In: Health Canada Licensed Natural Health Products Database. June 26, 2008. Available at: http://webprod3.hc-sc.gc.ca/lnhpd-bdpsnh/index-eng.jsp. Accessed November 17, 2012.

34. Kong FK. Pilot clinical study on a proprietary elderberry extract: efficacy in addressing influenza symptoms. OJPK. 2009;5:32-43.

35. Roschek W, Alberte RS. Pharmacokinetics of cyanidin and anti-Influenza phytonutrients in an elder berry extract determined by LC-MS and DART TOF-MS. Online Journal of Pharmacology and Pharmacokinetics. 2008;4:1-17.

36. Zakay-Rones Z, Thom E, Wollan T, Wadstein J. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res.2004;32(2):132-140.

37. Zakay-Rones Z, Farsano N, Zlotnik M, et al. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Alt Comp Med. 1995;1(4):361-369.

38. Murkovic M, Abuja PM, Bergmann AR, et al. Effects of elderberry juice on fasting and postprandial serum lipid and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study. Eur J Clin Nutr. 2004;58:244-249.

39. Curtis PJ, Kroon PA, Hollands WJ, et al. Cardiovascular disease risk biomarkers and liver and kidney function are not altered in postmenopausal women after ingesting an elderberry extract rich in anthocyanins for 12 weeks. J Nutr. 2009;139:2266-2271.

40. Picon PD, Picon RV, Costa AF. Randomized clinical trial of a phytotherapic compound containing Pimpinella anisum, Foeniculum vulgare, Sambucus nigra, and Cassia augustifolia [sic] for chronic constipation. BMC Complementary and Alternative Medicine. 2010;10:17. doi:10.1186/1472-6882-10-17.

41. Chrubasik C, Maier T, Dawid C, et al. An observational study and quantification of the actives in a supplement with Sambucus nigra and Asparagus officinalis used for with reduction. Phyto Res.2008;22:913-918.

42. Blumenthal M, Lindstrom A, Ooyen C, Lynch ME. Herb supplement sales increase 4.5% in 2011. HerbalGram. 2012;95:60-64.

43. European Herb Growers Association (Europam). Production of Medicinal and Aromatic Plants in Europe Status 2010. Vienna, Austria: Europam. 2010. Available at: www.europam.net/index.php?option=com_content&view=article&id=6&Itemid=11. Accessed November 17, 2012.

44. Censkowsky U, Helberg U, Nowack A, Steidle M. Overview of World Production and Marketing of Organic Wild Collected Products. Geneva, Switzerland: International Trade Centre UNCTAD/WTO. 2007. Available at:www.intracen.org/uploadedFiles/intracenorg/Content/Exporters/Sectors/Fair_trade_and_environmental_exports/Biodiversity/Overview_World_Production_Marketing_Organic_Wild_Collected_Products.pdf. Accessed November 17, 2012.

45. Institut für Marktökologie (IMO). List of certified operators 2011/2012. Weinfelden, Switzerland: IMO. September 24, 2012. Available at:www.imo.ch/logicio/client/imo/file/clients/EU_List_of_certified_IMO_clients.pdf. Accessed November 17, 2012.

Potent Purple Pigments in Sambucus

Analytical research conducted in Europe shows that elderberries are concentrated sources of anthocyanins, potent purple pigments that appear to benefit health in several ways. Ongoing research in Europe is focusing on these anthocyanins to determine what other health-imbuing powers they may possess, and how they work.

Antioxidant activity. In Karlsruhe at Germany’s Bundesforschungsanstalt research center for food, scientists conduct studies on dietary agents that can reduce oxidation and protect cells. According to research led by the center’s director Dr. Gerhard Rechkemmer, anthocyanins found in elderberries possess appreciably more antioxidant capacity than either Trolox (antioxidant, Aldrich Chemical Co., Milwaukee, WI) or vitamin C.5 The work conducted at Bundesforschungsanstalt supports previous research conducted in Graz, Austria showing that anthocyanins possess significant free radical scavenging capacity.6

Immune enhancement. Rechkemmer’s investigations also show that elderberry anthocyanins enhance immune function by boosting the production of cytokines.7 These unique proteins act as messengers in the immune system to help regulate immune response, thus helping to defend the body against disease. When asked if further research will reveal additional health benefits, Rechkemmer responded, "I believe so. But the anthocyanins are extremely hard to track in blood plasma, so we do not know exactly what they are doing in the body. We must discover their mode of action and go beyond belief to certain knowledge." He added that discoveries at the center help to fashion national food policy in Germany. If elderberry studies continue to be positive, Rechkemmer says that he will recommend increased intake of the berries and their juice.

Cardiovascular protection. At the scientific heart of the elderberry boom, Doctors Werner Pfannhauser and Michael Murkovic at Austria’s University of Graz research the biological activity of elderberry anthocyanins. Their studies show that elderberry anthocyanins are absorbed into plasma and possess in vitro antioxidant activity.8 These findings corroborate the work of Cao and Prior at Tufts University, who have tracked anthocyanins in human plasma after ingestion.9 Pfannhauser and Murkovic have further found that elderberry extract reduces oxidation of LDL cholesterol.6 While cholesterol is an essential component manufactured in the liver, oxidation of LDL cholesterol is implicated in atherogenesis, thus contributing to cardiovascular disease, especially heart attacks and strokes. Both researchers express optimism that elderberry and its extracts may be used for cardioprotective purposes in the future. Additional research conducted at Tufts University shows that elderberry anthocyanins protect vascular epithelial cells against oxidative insult, thereby helping to prevent changes in these cells which are associated with vascular disease.10

Anti-viral activity. An oft-cited Israeli study on the anti-viral activity of elderberry extract found that in vitro elderberry extract reduced hemagglutination of red blood cells and inhibited replication of a number of strains of influenza A and B in cell cultures.11 In the same paper, administration of elderberry extract to 27 patients with influenza, shortened the duration of flu symptoms. In a Swiss study, elderberry extract inhibited replication of avian influenza virus in a human breast cancer cell line.12 And in vitro studies conducted by the Southern Research Institute using elderberry extracts from Artemis International showed inhibition of herpes virus in cell cultures.13

Stress Reduction. Of all discoveries related to elderberry, the most surprising is the apparent capacity of elderbery and its anthocyanin-rich extract to reduce stress. This effect was discovered by Austrian endocrinologist Dr. Sepp Porta, who conducted stress studies using elderberry concentrate on a group of volunteers.14 He described this discovery, "We gave these people the elderberry for only 10 days. We put them through typical stress tests, all the usual physical challenges, and the results were so remarkable, I checked them over and over." In the study, various bio-markers of stress, including glucose, magnesium and other plasma chemical levels, were analyzed. "What we found," he said, "was that elderberry has this extraordinary effect for reducing stress." Most notably, oral ingestion of elderberry extract resulted in increased glucose uptake, a pointed fall in ionized magnesium, and a significant increase in basal granulocytes. Porta also found that daily intake of elderberry extract significantly shortened recovery time from physical exertion.

Dr. Porta’s research into the stress-reducing effects of elderberry has attracted strong interest on the part of the U.S. Air Force. In a novel collaboration, cadets on loan now work with Dr. Porta to conduct follow-up tests, process data, and advance his findings. Dr. David Westmoreland of the U.S. Air Force Academy, commented that if elderberry is as potent a stress buster as it appears, it could be valuable to jet pilots whose stress load is daunting.

As word of positive research findings spreads into the trade and popular media, the status of elderberry continues to rise. Kurt Kaufmann of Beerenfrost said that health findings have fueled significant interest in elderberry from the food and beverage sector. "Companies want to sell healthy products, especially if they taste good. It’s a good thing for everybody."

References

1. Pfannhauser W, Peters S. Das Vunder von Holunder. Sweden: Arcturus Verlag, 1999.

2. DeFeo V, Aquino R, Menghini A, Ramundo E, Senatore F. Traditional phytotherapy in the Penensula Sorrentina, Campania, Southern Italy. J Ethnopharmacol 1992; 36:113-25.

3. Novaretti, R, Lemordant D. Plants in the traditional medicine of the Ubaye valley. J Ethnopharmacol 1990; 30:1-34.

4. Al-Khalil S. A survey of plants used in traditional Jordanian medicine. Int J of Pharmacognosy 1995; 33(4):317-23.

5. Pool-Zobel BL, Bub A, Schroder N, Rechkemmer G. Anthocyanins are potent antioxidants in model systems but do not reduce endogenous oxidative DNA damage in human colon cells. Eur J Nutr 1999; 38:227-34.

6. Abuja P, Murkovic M, Pfannhauser W. Antioxidant and Prooxidant Activities of Elderberry (Sambucus nigra) in Low-Density Lipoprotein Oxidation. J of Ag Food Chem 1998; 46:4091-96.

7. Watzl B, Roller M, Barth SW, Rechkemmer G. Anthocyanines Stimulate Cytokine Production (TNF-Alpha, IL-2) in Human Mononuclear Cells. Paper presented at: International Workshop on Immunonutrition; June 24-25, 2000; at Schloss Rauischholzhausen, Austria.

8. Murkovic M, Adam U, Pfannhauser W. Analysis of anthocyane glucosides in human serum. Fresenius J of Anal Chem 2000; 366:379-81.

9. Cao G., Prior RL. Anthocyanins are detected in human plasma after oral administration of an elderberry extract. Clin Chem 1999; 45(4):574-6.

10. Youdim K, Martin A, Joseph J. Incorporation of The Elderberry Anthocyanins By Endothelial Cells Increases Protection Against Oxidative Stress. Free Radical Biology & Medicine 2000; 29(1):51-60.

11. Zakay-Rones Z, Varsano N, Zlotnik M, Manor O, Regev L, Schlesinger M, Mumcuoglu M. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Alt Comp Med 1995; 1(4):361-9.

12. Sauter C, Wolfensberger C. Anticancer Activities as well as Antiviral and Virus-enhancing Properties of Aqueous Fruit Extracts from Fifty-six European Plant Species. Eur J Clin Oncology 1989; 25(6):987-90.

13. Turpin, J. et al. Antiviral evaluation of elderberry extracts and standardized powder. Southern Research Inst. Frederick, MD. Unpublished 2000.

14. Porta S. Impact of Rubini treatment upon workload induced selected stress effects in human probands. Abstract of the pilot study. Unpublished 1999.

Vlierbesextract en vogelgriepvirus

In januari dit jaar werd op een persconferentie in Londen het resultaat van een experiment gepresenteerd naar de in vitro-effectiviteit van een gestandaardiseerd en gepatenteerd extract van de vlierbes (Sambucus nigra L.), Sambucolâ, tegen het vogelgriepvirus NIBRG-14 (H5N1). De persconferentie ging vooraf aan de wetenschappelijke presentatie tijdens The International Conference on Bird Flu in het St. Bartholomew’s Hospital te Londen. De persconferentie werd gehouden door de fabrikant van Sambucol, Razei Bar Industries te Jeruzalem, in het statige gebouw van The Royal Society of Medicine te Londen. Het experiment werd uitgevoerd in de laboratoria van Retroscreen Virology, St. Bartholomew’s and The Royal London School of Medicine and Dentistry van de Universiteit van Londen. Retroscreen Virology is een toonaangevende onderzoeksinstelling gericht op de ontwikkeling van nieuwe antivirale middelen en vaccins.

Aan het experimentele onderzoek namen S. Balasingam, R. Lambkin en J.S. Oxford (Retroscreen Virology en Universiteit Londen) en M. Mumcuoglu en D. Safirman (Razei Bar Indstrustries) deel. Eerdere experimentele studies aan de Hebreeuwse Universiteit te Jeruzalem toonden een activiteit aan van Sambucol tegen vogelgriepvirusstammen. Activiteit tegen tien andere influenza-stammen, waaronder het humane influenza type A en type B, werden al meer dan tien jaar geleden in vitro aangetoond. Ook klinisch onderzoek bij een beperkt aantal patiënten liet een effect zien van het vlierbespreparaat. Het klinische effect bestond uit een aanzienlijk kortere ziekteduur met minder ernstige symptomen en de in-vitro-experimenten toonden een verminderde infectiviteit (verhindering van penetratie in de gastheercel door verhindering van haemagglutinatie) en verhindering van replicatie van diverse humane en dierlijke griepvirussen aan, waaronder een kalkoenenvirus (A/Tur/Ger 3/91). Een onderzoek bij gezonde mensen toonde een immuunstimulerende werking aan. De resultaten werden gepresenteerd door Dr Madeleine Mumcuoglu. Zij doet al jaren onderzoek naar het werkingsmechanisme van het vlierbesextract. Mumcuoglu is de ontwikkelaar van Sambucolâ en is oprichtster en president van Razei Bar Industries. Het onderzoek vertoonde een 99% activiteit tegen het H5N1-virus in een kweek van een hondencellijn die standaard toegepast wordt bij antiviraal onderzoek (Madin-Darby Canine Kidney Epithelial cells, MDCK-cellen).

Bepaald werd de virustiter van MDCK-cellen die drie dagen lang geïnfecteerd waren met NIBRG-14 (H5N1), dat van tevoren gedurende een verschillend aantal minuten, oplopend van een half tot 60 minuten, was geïncubeerd met bepaalde verdunningen van Sambucol. Verder werd aangetoond dat het extract, in de gebruikte concentraties, niet toxisch is voor de gastheercellen. Niet gerapporteerd werd of onderzoekers van Retroscreen Virology ook hebben gekeken naar remming van haemagglutinatie. De gevonden resultaten moeten nog bevestigd worden in verder onderzoek met proefdieren en in klinische studies.

Bronnen:

Mythologie van de vlier / De Gids. P.N. van Kampen & zoon, Amsterdam 1881

Geen struik staat in het volksgeloof zoo hoog aangeschreven als de vlier. Een Noord-Sleeswijker deelde in het jaar 1703 mede, dat in zijne jeugd geen tak van den vlierstruik genomen mocht worden, voordat blootshoofds, met gebogen knie en gevouwen handen, verlof was gevraagd op deze wijze: ‘Frau Elhorn, geef mij wat van uw hout, dan zal ik u van het mijne ook geven, wanneer er wat in het bosch groeit.’

In Thuringen mocht het hout niet verbrand worden en in Westfalen gaat nog het gezegde, dat ieder voor de vlier den hoed moet afnemen.

Om toverij af te weren werd de struik gepoot bij stallen, putten en schuren. Metalen keukengereedschappen, met de bladeren gewreven, roesten niet en nemen geen vergif aan; hout, er mee gewassen, wordt niet wormstekig.

Schilt men den binnensten bast van beneden naar boven, dan is hij een braakmiddel, doch van boven naar beneden een purgans. Kinderen, die pijn in de keel hebben, moeten door hun vlieren proproer drinken. Groote kracht tegen het hangen van den huig en waterzucht zit in een bruinzwart oorzwam, dat in het voorjaar op verrotte vlierstronken groeit en Judasoor genoemd wordt, omdat Judas zich aan een vlierstruik opgehangen zou hebben. Voegt men hierbij, dat de jonge wortels, de knoppen, de bladeren en de bloemen tegen verkoudheid als thee gedronken worden, dat, zoo als Dodonaeus mededeelt, ‘de flier bekwaam is om alle taeije oft slijmachtige overvloedigheden ende alle waterachtige overvloedigheden af te jagen: dat de bessen, met wat kaneel en wijn ingenomen, vette menschen mager maakt; dat het merg, in de wonden van fistelen gestoken, die wijder maakt,’ dan kan men zeggen dat de vlierstruik een geheele apotheek in zich bevat.

Ook na den dood bewijst de vlierstruik dienst: de timmerman meet de lengte van het lijk met een rechten scheut, welken de voerman, die het ten kerkhove rijdt, als zweep gebruikt.

Le sureau noir

Sureau noir Sambucus nigra L ; Caprifoliaceae Sambuc, Arbre de Judas, Aoussier

Occitan : lo seu, lo soec GB : Elder, Judas-tree D : Holunder, Flieder

Connaître : Le Sureau est le digne compagnon de la fabuleuse ortie. Comme elle, ce petit arbre (2 à 10 mètres de haut) à feuilles caduques affectionne les terres riches en azote du voisinage de l’homme. Il est le premier arbre dont les bourgeons éclosent, avant même le printemps, défiant souvent le gel et la neige.

Ses branches à l’écorce crevassée claire sont creuses, remplies d’une moelle blanchâtre très tendre. Sa ramure offre un site de nidification à de nombreux passereaux, ainsi qu’un formidable espace de jeux et de découverte à des générations « d’indiens en culotte courte ».

Les feuilles sont grandes (20 à 25 cm de longueur), composées de cinq à sept folioles ovales pointus et dentés, au parfum assez désagréable.

Les fleurs, blanc crème, s’épanouissent en mai juin, en ombelles grandes (jusqu’à 20 cm de diamètre) et odorantes (parfum capiteux un peu musqué).

Les fruits, mûrs en septembre, sont noirs et luisants, en lourdes grappes pendantes

Confusions :

Vous veillerez à le distinguer du Sureau Yèble (Sambucus ebulus L.)

, plante toxique. Ce dernier possède des feuilles et des fleurs ressemblantes, mais au parfum très différent et peu agréable. Même si le Yèble peut facilement atteindre 2 mètres de hauteur, ses tiges sont herbacées : elles restent vertes, sans écorce, jusqu’à leur base. Les fruits du Sureau yèble sont noirs, en grappes comme ceux du Sureau noir, mais ces grappes sont droites, dressées vers le ciel et non pendantes.

Il existe également le Sureau à grappes (Sambucus racemosa L.)

, petit arbre forestier plutôt montagnard (au-dessus de 500 mètres d’altitude), dont les grappes florales et fruitières (rouges à maturité, en juillet) sont ovoïdes, et non en ombelles comme les deux autres.

Cueillir :

C’est exclusivement du Sureau noir dont il est question ici pour la cueillette. Les feuilles se récoltent à la main avant la floraison. On peut facilement ramasser 3 kg par heure. Le séchage est aisé (le rapport frais/sec est de 4/1).

On cueille les fleurs en juin, de préférence avant que les étamines ne lâchent leur pollen abondant en nuage jaune. Après séchage, elles seront de meilleure qualité, d’un beau blanc crémeux, et vous éviterez certainement un « bon rhume des foins » ! Plutôt que de prélever l’ombelle entière, vous pouvez pincer juste sous les fleurs pour ne garder que les ombellules et laisser les plus gros pédoncules sur l’arbre. Vous obtiendrez ainsi une récolte qui sèchera plus facilement, et qui sera aussi plus facile à utiliser en petites pincées. Avec un peu d’habitude vous ramasserez facilement 6 kg par heure (soit 1,5 kg sec). Ne ramassez surtout pas les fleurs humides, elles bruniraient au séchage et perdraient ainsi beaucoup de leurs qualités.

Les fruits se récoltent à maturité, début septembre, de la même manière que les fleurs. On ramasse aisément 30 kg par heure.

Utiliser :

Omniprésent comme sa compagne l’ortie près des habitations, le Sureau a trouvé depuis des temps immémoriaux de très nombreux emplois en cuisine, médecine, artisanat, magie, jeux...

Les fleurs sont le remède populaire des états grippaux et infectieux. Et pour cause ! Sudorifiques et fébrifuges, elles stimulent le système immunitaire. Elles sont également émollientes ; c’est pourquoi elles ont souvent été utilisées dans les campagnes en compresses imbibées d’infusion pour faire mûrir les abcès et les panaris.

En cuisine, ces mêmes fleurs ont parfois été appelées « vanille du pauvre » en raison de leur parfum de muscat. On en fait de délicieux beignets, en les trempant tout simplement dans la pâte comme les fleurs d’acacia (Robinia pseudacacia L.) ou de courgettes (Cucurbita melo L.). Elles servent à parfumer desserts, liqueurs, vins, sirops ou limonades. Crues, elles agrémentent salades et plats sucrés.

Les feuilles ont été utilisées comme analgésique, purgatif et laxatif. Cependant, leur odeur un peu nauséabonde a limité leur emploi, sinon en usage externe. Leur suc stoppe les petits saignements, il soulage les brûlures de l’ortie et les douleurs hémorroïdaires.

Elles teignent la laine et le coton en jaune (assez solide), avec 200 grammes de feuilles fraîches pour 100 grammes de fibre. Enfin, leur macération prolongée (2 à 3 semaines) dans de l’eau constitue un répulsif efficace à verser dans les galeries des campagnols (également répulsif pour les narines sensibles !).

Les fruits crus sont laxatifs. Diurétiques, très riches en vitamine C et A, ils sont consommés en Europe depuis la préhistoire (Delluc, Roques). (photo 56) Ils sont délicieux en confiture ou gelée (mélangés à la mûre à 50/50). Leur jus a servi à colorer le vin (en particulier le Porto). En Angleterre, elles étaient mises à fermenter pour fabriquer un vin très populaire (Bois). Leur jus teint la laine et le coton en violet lilas et donne brillance et reflets aux chevelures brunes.

Bibliographie :