Treatment Review No. 12; June 1994

Skin Disorders (psoriasis): For the treatment of severe psoriasis, a skin disorder, in people with HIV infection, a drug called acitretin is being studied. Acitretin is a pill. To participate in this study, you must have psoriasis covering at least 10% of your body surface. The study coordinators will measure the extent of your psoriasis.

Decision-making by Women: An information gathering study is looking for volunteers to participate in an NIH funded psycho-social study of treatment decision making of women who are HIV positive. Participants are paid $30 for their time and travel and the interview is strictly confidential. The interview is approximately 2 hours. A second study, starting in June, will be for women with AIDS. Participants will be seen for 3 visits, and paid $25 per visit for their time and travel. Call The Network for more information.

Echinacea

Echinacea is a native American medicinal plant. It is also called purple cone- flower. It looks like a colorful daisy and grows in many people's gardens. Echinacea has been used as a folk remedy throughout history and is well- known to Native Americans as an all-purpose medicine. Today, many people use echinacea to fight colds and flu viruses. Echinacea has been studied in Europe and research shows that it has antiviral, antibacterial, antifungal, and anticancer properties.

In the early 17th century, the Plains Indians used echinacea to treat respiratory illness, snakebites, wounds and smallpox. In 1870, a Nebraska doctor patented a medicine containing the herb called Meyer's Blood Purifier. He used it to treat chronic nasal congestion, cholera, leg ulcers and bee stings. After antibiotics were discovered in the early 1930s, the herb was virtually forgotten until the 1970s when it became popular in Europe again. The American Medical Association, as early as 1910, denounced echinacea as worthless. But in Germany alone there are more than 140 echinacea products on the market. These include not only tinctures and other liquid extracts similar to those sold here, but also salves for sores and wounds, tablets, combination immune enhancers, and injectable formulas for more serious conditions.

Today, a researcher in Germany is studying echinacea's immune stimulating qualities. Echinacea has molecules that appear to boost T-cells. T-cells are immune system cells that fight off bacteria and viruses. Echinacea also contains a chemical called echinacein which helps strengthen cell membranes, which may help keep cells from being invaded by an infection.

In a 1986 study, researchers treated 203 women with recurrent candidiasis (yeast infections) with echinacea by injection or orally. At the end of the six month study, 60 percent of the women treated with anti-fungal ointment experienced recurrences, while only 16 percent of those treated with echinacea had repeat yeast infections. Following other tests, the researchers found that the effectiveness of the herb against candidiasis was due to the immune-enhancing effects of echinacea.

Echinacea also helps with inflammation. In 1957, a study using echinacea extract as a treatment for arthritis caused a 22 percent reduction in inflammation. Although this is only half as effective as steroids, steroids have many side effects, toxicities and contraindications. Steroids also suppress the immune system. Echinacea, on the other hand, is nontoxic, and adds immunestimulating properties to its antiinflammatory effect.

No toxicity or side effects have been reported, with the possible exception of rare allergic reactions in sensitive individuals. Echinacea formulas are sold fresh, dried, freeze-dried, as an alcohol extract, and in tablets and liquid form at health food stores. Like many other plant derived substances (some of which have been recreated chemically), such as Curcumin, licorice root derivatives and St. John's Wort extracts, clinical trials are needed to determine whether this herb is a reliable and safe treatment alternative. Taken in very small amounts, it is unlikely, although not guaranteed, that it will be harmful.

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