Zur antientzündlichen Wirksamkeit von Pulver aus der Hagebutte

Zusammenfassung

In der traditionellen deutschen Medizin wurden Zubereitungen aus der Hagebutte bei rheumatischen Beschwerden eingesetzt. Hierfür gibt es inzwischen eine rationale Grundlage. Das Wirkspektrum der Hagebutte ist dem synthetischer Entzündungshemmer vergleichbar. Ein Teil der antientzündlichen Inhaltsstoffe wurde kürzlich identifiziert. Zur Evidenz der Wirksamkeit liegen 5 explorative Studien mit dem Hagebuttenpulver Litozin^® vor. Danach muss die Wirksamkeit des Pulvers bei Arthrosebeschwerden als »mäßig« eingestuft werden, bei entzündlichem Rheuma und bei Rückenbeschwerden sogar als »schlecht«. Um das Ausmaß der Wirksamkeit definieren zu können, ist die Durchführung von Studien mit einem konfirmativen Studiendesign dringend erforderlich. Gelegentlich kam es unter Einnahme von Litozin^® zu einer allergischen Reaktion. Gastrointestinale Beschwerden lassen sich meist durch Anpassung der Flüssigkeitszufuhr beheben. Mit dem Auftreten schwerwiegender unerwünschter Ereignisse ist nicht zu rechnen.

Summary

The anti-inflammatory efficacy of powdered rose hip – a review In the traditional German medicine, preparations of rose hip were used for the treatment of rheumatic conditions. In the meantime, there is a rationale behind that indication. The mechanism of action of rose hip is similar to that of synthetic anti-inflammatory drugs. Part of the anti-inflammatory acting ingredients have recently been identified. The evidence for the effectiveness is based on 5 exploratory studies; the evidence is “moderate” for osteoarthritis and “poor” for rheumatoid arthritis and low back pain. In order to quantify the effect size, clinical trials with a confirmatory study design are urgently warranted. Occasionally, allergic reactions have been observed during intake of the rose hip and seed powder Litozin^®. Gastrointestinal complaints may be counteracted by regulation of liquid supply. There is no evidence for the occurrence of severe adverse events.

Hagebutte - Rosa canina - Rückenschmerzen - Arthroseschmerzen - Schmerzlinderung - Studienqualität

Rose hip - Rosa canina - low back pain - osteoarthritic pain - pain relief - study quality

Literatur

• 1 Blumenthal M. The complete German Commission E Monographs. Austin, Texas, USA; American Botanical Council 1998: 368-369
• 2 Christensen R, Sorensen LB, Bartels EM, et al.. Rose-hip in osteoarthritis (IA): a meta-analysis.  Ann Rheum Dis. 2007;  66 (Suppl. 2) 495
• 3 Christensen R, Bartels EM, Altman RD, et al.. Does the hip powder ofRosa canina (rosehip) reduce pain in osteoarthritis patients? A meta-analysis of randomized controlled trials.  Osteoarthritis Cartilage. 2008;  16 965-972
• 4 Chrubasik S, Conradt C, Black A. The quality of clinical trials with Harpagophytum procumbens. .  Phytomedicine. 2003;  10 613-623
• 5 Chrubasik S, Conradt C, Roufogalis B. Effectiveness of Harpagophytum extracts and clinical efficacy.  Phytotherapy Res. 2004;  18 187-189
• 6 Chrubasik S, Künzel O, Thanner J, et al.. A one-year follow-up after a pilot study with Doloteffin^® for low back pain.  Phytomedicine. 2005;  11 470-477
• 7 Chrubasik C, Duke RK, Chrubasik S. The evidence for clinical efficacy of rose hip and seed: a systematic review.  Phytother Res. 2006;  20 1-3
• 8 Chrubasik JE, Roufogalis BD, Chrubasik S. Evidence of effectiveness of herbal anti-inflammatory drugs in the treatment of painful osteoarthritis including chronic low back pain.  Phytother Res. 2007;  21 675-683
• 9 Chrubasik S, Chrubasik C, Künzel O, Black A. Patient-perceived benefit during one year of treatment with Doloteffin^® .  Phytomedicine. 2007;  14 371-376
• 10 Chrubasik C, Wiesner L, Black A, et al.. A oneyear survey on the use of a powder from Rosa canina lito in acute exacerbations of chronic pain.  Phytother Res. 2008;  22 1141-1148
• 11 Daels-Rakotoarison DA, Gressier B, Trotin F, et al.. Effects of Rosa canina fruit extract on neutrophil respiratory burst.  Phytother Res. 2002;  16 157-161
• 12 Deliorman Orhan D, Hartevioğlu A, Küpeli E, Yesilada E. In vivo anti-inflammatory and antinociceptive activity of the crude extract and fractions from Rosa canina L. fruits.  J Ethnopharmacol. 2007;  112 394-400
• 13 Gagnier JJ, Chrubasik S, Manheimer E. Harpgophytum procumbens for osteoarthritis and low back pain: A systematic review.  BMC Complement Altern Med. 2004;  4 13
• 14 Jäger AK, Eldeen IM, Staden van J. COX-1 and -2 activity of rose hip.  Phytother Res. 2007;  21 1251-1252
• 15 Jäger AK, Petersen KN, Thomasen G, Christensen SB. Isolation of linoleic and alpha-linolenic acids as COX-1 and -2 inhibitors in rose hip.  Phytother Res. 2008;  22 982-984
• 16 Kharazmi A, Winther K. Rose hip inhibits chemotaxis and chemoluminescence of human peripheral blood neutrophiles in vitro and reduces certain inflammatory parameters in vivo.  Immunopharmacology. 1999;  7 377-386
• 17 Larsen E, Kharazmi A, Christensen LP, Christensen SB. An anti-inflammatory galactolipid from rose hip (Rosa canina) that inhibits chemotaxis of human peripheral blood neutrophils in vitro.  J Nat Prod. 2003;  66 994-995
• 18 Lleonart R, Corominas M, Lombardero M. Tea infusion, another source of Rosaceae allergy.  Allergy. 2007;  62 89-90
• 19 Pham T, Heijde van der D, Lassere M, et al.. OMERACT-OARSI. Outcome variables for osteoarthritis clinical trials: The OMERACTOARSI set of responder criteria.  J Rheumatol. 2003;  30 1648-1654
• 20 Pham T, Heijde van der D, Altman RD, et al.. OMERACT-OARSI initiative. Osteoarthritis Research Society International set of responder criteria for osteoarthritis clinical trials revisited.  Osteoarthritis Cartilage. 2004;  12 389-399
• 21 Rein E, Kharazmi A, Winther K. A herbal remedy, Hyben Vital (stand. powder of a subspecies of Rosa canina fruits), reduces pain and improves general wellbeing in patients with osteoarthritis. A double-blind, placebocontrolled, randomised trial.  Phytomedicine. 2004;  11 383-391
• 22 Rein E, Kharazmi A, Thamsborg G, Winther K. A herbal remedy made from a subspecies of rose-hip Rosa canina, reduces symptoms of knee and hip osteoarthritis.  Osteoarthritis Cartilage. 2004;  12 (Suppl. 2) 80
• 23 Rennert B, Melzig MF. Free fatty acids inhibit the activity of Clostridium histolyticum collagenase and human neutrophil elastase.  Planta Med. 2002;  68 767-769
• 24 Rossnagel K, Roll S, Willich SN. The clinical effectiveness of rosehip powder in patients with osteoarthritis.  Münch Med Wschr. 2007;  149 51-56
• 25 Rossnagel K, Roll S, Wagner A, et al.. Can patients with rheumatoid arthritis benefit from the herbal remedy rose-hip?.  Ann Rheum Dis. 2007;  66 (Suppl. 2) 603
• 26 Warholm O, Skaar S, Hedman E, et al.. The effects of a standardized herbal remedy made from a subtype of Rosa canina in patients with osteoarthritis: a double-blind, randomized, placebo-controlled clinical trial.  Curr Ther Res Clin Exp. 2003;  64 21-31
• 27 Wenzig EM, Widowitz U, Kunert O, et al.. Phytochemical composition and in vitro pharmacological activity of two rose hip (Rosa canina L.) preparations.  Phytomedicine. 2008;  15 826-835
• 28 Winther K, Rein E, Kharazmi A. The anti-inflammatory properties of rose-hip.  Immunopharmacology. 1999;  7 63-68
• 29 Winther K, Kharazmi A. powder prepared from seeds and shells of subtype of rose-hip Rosa canina reduces pain in patients with osteoarthritis of the hand – a doubleblind, placebo-controlled study.  Osteoarthritis Cartilage. 2004;  12 (Suppl. 2) 145
• 30 Winther K, Apel K, Thamsborg G. A powder made from seeds and shells of a rose-hip subspecies (Rosa canina) reduces symptoms of knee and hip osteoarthritis: a randomized, double-blind, placebocontrolled clinical trial.  Scand J Rheumatol. 2005;  34 302-308

1 Rossnagel K, persönliche Auskunft