Cochrane Crash in Influenza: New Chance for Phytotherapy?

Near­ly 25 years ago, Prof. Dr. James B. Hud­son, Vancouver/​Canada, one of the world-renow­ned viro­lo­gists and well-known pro­mo­ter of phy­to­the­ra­py, wro­te: “In view of the world­wi­de dis­tri­bu­ti­on of influ­en­za viru­s­es among many spe­ci­es of mammals and birds, and their poten­ti­al for recom­bi­na­ti­on and per­sis­tence, the­re does not appear to be much pro­s­pect for their era­di­ca­ti­on or con­trol. … It would seem wort­hwhile recon­side­ring the use of anti­vi­ral che­mi­cal for emer­gen­ci­es” [1]. Seve­ral pan­de­mi­as later, it is ine­vi­ta­ble, that influ­en­za con­ti­nues to be a major thre­at for glo­bal health. Moreo­ver, with the last publi­ca­ti­on of Tom Jef­fer­son and his Coch­ra­ne Group col­le­agues it beca­me clear, that “anti­vi­ral che­mi­cals” as the neu­r­a­mi­ni­da­se inhi­bi­tors are of no meaningful use in any kind of human influ­en­za [2].

? Prof. Hud­son, would you agree that the bil­li­ons of dol­lars that have been spent for the world­wi­de stock­pi­ling of Osel­ta­mi­vir and other anti­vi­ral drugs could have been uti­li­sed for more reasonable anti-influ­en­za pro­jects? E. g. – cor­re­spon­ding to the WHO cla­im in their public health rese­arch agen­da for influ­en­za – for the inclu­si­on of natu­ral pro­ducts, both in terms of pro­phy­la­xis and the­ra­py [3].

Prof. Hud­son: Yes, I agree that stock­pi­ling the­se inhi­bi­tors has been a futi­le was­te of money and time. The main pro­blem with the­se anti­vi­rals is that they are desi­gned to work against a spe­ci­fic viral gene or pro­te­in, and con­se­quent­ly resistant mutants of the virus are bound to emer­ge – that’s basic virology.

The advan­ta­ges of cer­tain natu­ral pro­ducts is that they usual­ly con­tain more than one anti­vi­ral ingre­di­ent, and they gene­ral­ly tar­get more than one type of virus, e.g. viru­s­es with mem­bra­nes, thus redu­cing the risk of sel­ec­ted mutants. In addi­ti­on many anti­vi­ral her­bal pre­pa­ra­ti­ons also pos­sess anti-inflamm­a­to­ry pro­per­ties, and this can be bene­fi­ci­al to infec­ted indi­vi­du­als in which the virus has over-sti­mu­la­ted the immu­ne respon­se. Most of the pre­pa­ra­ti­ons advo­ca­ted are also safe to use in humans.

? Your review artic­le about the use of her­bal extra­cts in the con­trol of influ­en­za [4] com­pri­ses plants from many count­ries in the world. What about tra­di­tio­nal­ly used plants ori­gi­na­ting in Euro­pe, e.g. the Red Rock­ro­se (Cis­tus inca­nus L.). Could extra­cts from Cis­tus, Gera­ni­um or other sol­ve our sus­tained medi­cal pro­blems during sea­so­nal or even upco­ming pan­de­mic influ­en­za? What is the mecha­nism of actions of this herb accor­ding to the actu­al knowledge?

Prof. Hud­son: Yes, I belie­ve that some of the­se her­bal medi­ci­nes, many of which have been used in humans for hundreds of years, have poten­ti­al appli­ca­ti­ons in ‘flu infec­ted individuals.

They are also eco­no­mic­al to use; but of cour­se they do not appeal to phar­maceu­ti­cal com­pa­nies becau­se they are not so pro­fi­ta­ble and can­not be patented.

Per­so­nal­ly I think this repres­ents a short­sigh­ted atti­tu­de on their part, becau­se com­pa­nies could gain a lar­ge mar­ket oppor­tu­ni­ty if they made cer­tain brands that were pro­per­ly stan­dar­di­zed in terms of bota­ni­cal source, stan­dar­diza­ti­on of con­tents and pre­pa­ra­ti­on, and demons­tra­ble bio-activities.

? Echinacea or Cis­tus in topi­cal appli­ca­ti­on have – bes­i­de their poten­ti­al sys­te­mic actions – direct anti­vi­ral acti­vi­ties in terms of blo­cking the pri­ma­ry infec­tion. Is this also true regar­ding to an inhi­bi­ti­on of a secon­da­ry infec­tion spread (intern­al­ly and extern­al­ly)?Prof. Hud­son: Yes, their direct anti­vi­ral acti­vi­ties would ope­ra­te in any situa­ti­on whe­re the virus is accessible.

? Should the future natio­nal pan­de­mic plans include stock-piling of her­bal extra­cts as means of influ­en­za con­trol? And if yes, which herbs would you pri­ma­ri­ly recommend?

Prof. Hud­son: I am not sure about “stock-piling”, becau­se I would have to learn more about their sta­bi­li­ty during sto­rage. More rese­arch on this topic is nee­ded. Which herbs? My first choice would be Echinacea (not sur­pri­sin­gly!), becau­se of its mul­ti­func­tion­al pro­per­ties. Howe­ver, other well known herbs would pro­ba­b­ly also be useful, alt­hough pan­de­mics would requi­re very lar­ge amounts of the herbs, which could be a draw­back for some of them if avai­la­bi­li­ty is limited.

It would also be important to ensu­re pro­per stan­dar­diza­ti­on of sel­ec­ted herbs.

Per­haps an ave­nue of rese­arch wort­hwhile inves­ti­ga­ting is the pos­si­bi­li­ty of estab­li­shing “plan­ta­ti­ons” of sel­ec­ted herbs, as has been accom­plished for other natu­ral phar­maceu­ti­cals such as Tea-tree oil.

Revolutions in microbiology

? Sin­ce 2007, the US-NIH fun­ded Human Micro­bio­me Pro­ject (HMP) pro­vi­des a ple­tho­ra of new, in parts revo­lu­tio­na­ry insights in the under­stan­ding of the “super­or­ga­nism” for­med by the cells of man and micro­or­ga­nism. Do you think – as micro­bio­lo­gist – that the­se new views at the “invi­si­ble rea­li­ty” could replace fun­da­men­tals of micro­bio­lo­gy? E.g., “the ever­las­ting fight against micro­bes” by “a com­men­sal or sym­bio­tic life tog­e­ther”.Prof. Hud­son: Abso­lut­e­ly!! The­re is curr­ent­ly, or at least I hope the­re is, a para­digm shift in our under­stan­ding of the micro­bi­al world and its inter­re­la­ted­ness to us. I ela­bo­ra­ted on this the­me in my recent book [5]. I point out that viru­s­es and micro­bes are com­mon con­sti­tu­ents of our bodies, and some of them are essen­ti­al to our lives. Con­se­quent­ly we should not be obses­sed about des­troy­ing them all. Simi­lar­ly, viral genes are found in our own geno­mes, and they could have important roles to play in chro­nic diseases.

? In terms of influ­en­za – how would our basic under­stan­dings of influ­en­za chan­ge resul­ting from such a chan­ge of para­digms?Prof. Hud­son: We have to stop thin­king that all the viru­s­es we encoun­ter, such as influ­en­za virus, are out to des­troy us. I belie­ve that the glo­bal thre­at of ‘flu pan­de­mics, such as avi­an flu strains and the next suc­cessful human strain, are encou­ra­ged by human acti­vi­ties, such as inten­si­ve far­ming of ani­mals, unrest­ric­ted glo­bal trade in ani­mals. Fur­ther­mo­re, our life­styl­es ensu­re that we are sub­jec­ted to more inten­si­ve stres­sors, which in turn sup­press our immu­ne defen­ces and allow more viru­s­es to mul­ti­ply and spread. This results in more fre­quent virus mutants with increased patho­ge­nic pro­per­ties. My cur­rent book ela­bo­ra­tes on this topic [6].

? The late Sir Edgar Hope-Simpson cri­ti­ci­zed 1992 the miss­ing sci­en­ti­fic dis­cus­sion regar­ding many influ­en­za rela­ted phe­no­me­na like the “per­sis­tence of non-infec­tious virus after the influ­en­zal ill­ness, sea­so­nal reac­ti­va­ti­on to infec­tious­ness, and laten­cy of the geno­me of the first infec­tion with an influ­en­za A virus” [7]. Espe­ci­al­ly the “rhyth­mic” epi­de­mic swin­ging of influ­en­za from the nor­t­hern hemi­sphe­re to the tro­pic regi­ons and back, as Hope-Simpson men­tio­ned, is not descri­bed for any other infec­tious dise­a­se. Could his obser­va­tions widen hori­zons regar­ding the real natu­re of influ­en­za, per­haps as an inher­ent phe­no­me­non of glo­bal human life?Prof. Hud­son: They could, but most viro­lo­gists igno­re such pos­si­bi­li­ties becau­se they can­not at pre­sent envi­sa­ge an appro­pria­te con­di­ti­on for a latent/​persistent ‘flu virus. Its RNA geno­me makes it har­der to spe­cu­la­te on this. Most latent viru­s­es we are fami­li­ar with, such as her­pes viru­s­es, have DNA geno­mes, and the­se are easier to envi­sa­ge in a latent state.

? The eclec­tic phy­to­phar­maceu­ti­cals in the USA as pro­du­ced by the Lloyd brot­hers and others were used in rather high doses, as the noted Sou­thwes­tern her­ba­list Micha­el Moo­re often repor­ted in his lec­tures, not least in tre­at­ment of influ­en­za. How would this trans­la­te in exis­tent her­bal drugs on the market?

Prof. Hud­son: The inte­res­t­ing aspect of their pre­pa­ra­ti­ons was that ever­y­thing was based on empi­ri­cal obser­va­tions. If some­thing work­ed then it could be tried on other peo­p­le, some­ti­mes I belie­ve suc­cessful­ly. Regar­ding their dosa­ges, it is dif­fi­cult to compa­re with modern medi­ci­nes becau­se cur­rent phar­maceu­ti­cals such as anti­bio­tics are used in very lar­ge con­cen­tra­ti­ons that are very effec­ti­ve and gene­ral­ly safe over a short time. The actu­al con­cen­tra­ti­ons of “acti­ve ingre­di­ents” in her­bal pre­pa­ra­ti­ons may be very low, but still effective.

! Prof. Dr. Hud­son, many thanks for your time and your exten­si­ve answers!