Echinacea purpurea: An overview of mechanism, efficacy, and safety in pediatric upper respiratory infections and otitis media


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Authors

DOI:

https://doi.org/10.62313/ijpbp.2024.213

Keywords:

Echinacea purpurea, Pediatric URI, Pediatric OM, Otitis media

Abstract

Pediatric upper respiratory infections (URIs) and otitis media (OM) significantly impact the health of children globally. Echinacea purpurea, known for its immunomodulatory, anti-inflammatory, and antimicrobial properties, has been historically used to treat various ailments, suggesting its potential as an adjunctive treatment in pediatric respiratory conditions. This narrative review synthesizes literature from January 2000 to December 2023 on the efficacy and safety of E. purpurea in treating pediatric URIs, including OM. It focuses on clinical trials and empirical studies that explore the mechanisms of action, such as the modulation of cytokine production, inhibition of NF-κB signaling, and antimicrobial effects. The analysis reveals mixed outcomes regarding the efficacy of E. purpurea in pediatric populations, attributed partly to variability in study designs and lack of standardized treatment protocols. While some studies report reduced severity and duration of respiratory symptoms, others indicate minimal or no significant difference compared to placebo. The review also highlights the need for specifically designed products that cater to the unique physiological and metabolic needs of children. Rigorous, well-designed clinical trials are crucial for establishing clear guidelines on the use of E. purpurea in pediatric respiratory care, ensuring its safe and effective application in improving health outcomes for children.

References

Aarland, R. C., Bañuelos-Hernández, A. E., Fragoso-Serrano, M., Sierra-Palacios, E. D. C., Díaz de León-Sánchez, F., Pérez-Flores, L. J., Rivera-Cabrera, F., & Mendoza-Espinoza, J. A. (2017). Studies on phytochemical, antioxidant, anti-inflammatory, hypoglycaemic and antiproliferative activities of Echinacea purpurea and Echinacea angustifolia extracts. Pharmaceutical Biology, 55(1), 649-656. https://doi.org/10.1080/13880209.2016.1265989 DOI: https://doi.org/10.1080/13880209.2016.1265989

Adebimpe Ojo, C., Dziadek, K., Sadowska, U., Skoczylas, J., & Kopeć, A. (2024). Analytical Assessment of the Antioxidant Properties of the Coneflower (Echinacea purpurea L. Moench) Grown with Various Mulch Materials. Molecules, 29(5), 971. https://doi.org/10.3390/molecules29050971 DOI: https://doi.org/10.3390/molecules29050971

Askari, H., Ghaedi, M., Naghiha, R., & Salehi, A. (2020). In Vitro antibacterial and antifungal studies of Pulicaria undulate and Echinacea purpurea extracts in combination with nanowires (Ni: FeO (OH)) and nanoparticles (NiS). Jundishapur Journal of Natural Pharmaceutical Products, 15(2), e64358. https://doi.org/10.5812/jjnpp.64358 DOI: https://doi.org/10.5812/jjnpp.64358

Aucoin, M., Cooley, K., Saunders, P. R., Carè, J., Anheyer, D., Medina, D. N., Cardozo, V., Remy, D., Hannan, N., & Garber, A. (2020). The effect of Echinacea spp. on the prevention or treatment of COVID-19 and other respiratory tract infections in humans: A rapid review. Advances in Integrative Medicine, 7(4), 203-217. https://doi.org/10.1016/j.aimed.2020.07.004 DOI: https://doi.org/10.1016/j.aimed.2020.07.004

Ávila-Gálvez, M. Á., Giménez-Bastida, J. A., Karadeniz, B., Romero-Reyes, S., Espín, J. C., Pelvan, E., & González-Sarrías, A. (2024). Polyphenolic Characterization and Anti-Inflammatory Effect of In Vitro Digested Extracts of Echinacea purpurea L. Plant Parts in an Inflammatory Model of Human Colon Cells. International Journal of Molecular Sciences, 25(3), 1744. https://doi.org/10.3390/ijms25031744 DOI: https://doi.org/10.3390/ijms25031744

Awortwe, C., Bruckmueller, H., Kaehler, M., & Cascorbi, I. (2021). Interaction of Phytocompounds of Echinacea purpurea with ABCB1 and ABCG2 Efflux Transporters. Molecular Pharmaceutics, 18(4), 1622-1633. https://doi.org/10.1021/acs.molpharmaceut.0c01075 DOI: https://doi.org/10.1021/acs.molpharmaceut.0c01075

Balčiūnaitė-Murzienė, G., Miknienė, Z., Ragažinskienė, O., Juodžiukynienė, N., Savickas, A., Savickienė, N., & Pangonytė, D. (2021). Echinacea purpurea L.(Moench) Hemagglutinin Effect on Immune Response In Vivo. Plants, 10(5), 936. https://doi.org/10.3390/plants10050936 DOI: https://doi.org/10.3390/plants10050936

Balciunaite, G., Haimi, P. J., Mikniene, Z., Savickas, G., Ragazinskiene, O., Juodziukyniene, N., Baniulis, D., & Pangonyte, D. (2020). Identification of Echinacea purpurea (L.) moench root LysM lectin with nephrotoxic properties. Toxins, 12(2), 88. https://doi.org/10.3390/toxins12020088 DOI: https://doi.org/10.3390/toxins12020088

Barrett, B. (2004). Efficacy and safety of Echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. The Journal of Pediatrics, 145(1), 135-136. https://doi.org/10.1016/j.jpeds.2004.04.039 DOI: https://doi.org/10.1016/j.jpeds.2004.04.039

Basa, M., & Sovtić, A. (2022). Treatment of the most common respiratory infections in children. Archives of Pharmacy, 72(Notebook 3), 275-299. https://doi.org/10.5937/arhfarm72-37857 DOI: https://doi.org/10.5937/arhfarm72-37857

Batista, J. A., de Aguiar Magalhães, D., Sousa, S. G., dos Santos Ferreira, J., Pereira, C. M. C., do Nascimento Lima, J. V., de Albuquerque, I. F., Bezerra, N. L. S. D., de Brito, T. V., & da Silva Monteiro, C. E. (2020). Polysaccharides derived from Morinda citrifolia Linn reduce inflammatory markers during experimental colitis. Journal of Ethnopharmacology, 248, 112303. https://doi.org/10.1016/j.jep.2019.112303 DOI: https://doi.org/10.1016/j.jep.2019.112303

Bellussi, L., Passali, F., Ralli, M., Vincentiis, M., Greco, A., & Passali, D. (2019). An overview on upper respiratory tract infections and bacteriotherapy as innovative therapeutic strategy. European Review for Medical and Pharmacological Sciences, 23(1), 27-38.

Burlou-Nagy, C., Bănică, F., Jurca, T., Vicaș, L. G., Marian, E., Muresan, M. E., Bacskay, I., Kiss, R., Feher, P., & Pallag, A. (2022). Echinacea purpurea (L.) Moench: Biological and pharmacological properties. A review. Plants, 11(9), 1244. https://doi.org/10.3390/plants11091244 DOI: https://doi.org/10.3390/plants11091244

Burlou-Nagy, C., Bănică, F., Negrean, R. A., Jurca, T., Vicaș, L. G., Marian, E., Bácskay, I., Kiss, R., Fehér, P., & Vicaș, S. I. (2023). Determination of the Bioactive Compounds from Echinacea purpurea (L.) Moench Leaves Extracts in Correlation with the Antimicrobial Activity and the In Vitro Wound Healing Potential. Molecules, 28(15), 5711. https://doi.org/10.3390/molecules28155711 DOI: https://doi.org/10.3390/molecules28155711

Cheng, Z. Y., Sun, X., Liu, P., Lin, B., Li, L. Z., Yao, G. D., Huang, X. X., & Song, S. J. (2020). Sesquiterpenes from Echinacea purpurea and their anti-inflammatory activities. Phytochemistry, 179, 112503. https://doi.org/10.1016/j.phytochem.2020.112503 DOI: https://doi.org/10.1016/j.phytochem.2020.112503

Cohen, H. A., Varsano, I., Kahan, E., Sarrell, E. M., & Uziel, Y. (2004). Effectiveness of an herbal preparation containing echinacea, propolis, and vitamin C in preventing respiratory tract infections in children: a randomized, double-blind, placebo-controlled, multicenter study. Archives of Pediatrics & Adolescent Medicine, 158(3), 217-221. https://doi.org/10.1001/archpedi.158.3.217 DOI: https://doi.org/10.1001/archpedi.158.3.217

Daley, E. (2019). A phytochemical and antibacterial analysis of Echinacea purpurea (L.) Moench throughout seasonal development. Université d'Ottawa/University of Ottawa, http://dx.doi.org/10.20381/ruor-23054

Dawit, G., Mequanent, S., & Makonnen, E. (2021). Efficacy and safety of azithromycin and amoxicillin/clavulanate for otitis media in children: a systematic review and meta-analysis of randomized controlled trials. Annals of Clinical Microbiology and Antimicrobials, 20(1), 28. https://doi.org/10.1186/s12941-021-00434-x DOI: https://doi.org/10.1186/s12941-021-00434-x

de Oliveira, B. G., Santos, L. F. F., Pianetti, G. A., & César, I. C. (2021). A rapid UPLC method for the simultaneous quantitation of caffeic acid derivatives in dried extracts of Echinacea purpurea. Journal of Chromatographic Science, 59(5), 439-444. https://doi.org/10.1093/chromsci/bmab001 DOI: https://doi.org/10.1093/chromsci/bmab001

Declerck, K., Novo, C. P., Grielens, L., Van Camp, G., Suter, A., & Vanden Berghe, W. (2021). Echinacea purpurea (L.) Moench treatment of monocytes promotes tonic interferon signaling, increased innate immunity gene expression and DNA repeat hypermethylated silencing of endogenous retroviral sequences. BMC Complementary Medicine and Therapies, 21(1), 141. https://doi.org/10.1186/s12906-021-03310-5 DOI: https://doi.org/10.1186/s12906-021-03310-5

Dobrange, E., Peshev, D., Loedolff, B., & Van den Ende, W. (2019). Fructans as immunomodulatory and antiviral agents: The case of Echinacea. Biomolecules, 9(10), 615. https://doi.org/10.3390/biom9100615 DOI: https://doi.org/10.3390/biom9100615

Dosoky, N. S., Kirpotina, L. N., Schepetkin, I. A., Khlebnikov, A. I., Lisonbee, B. L., Black, J. L., Woolf, H., Thurgood, T. L., Graf, B. L., & Satyal, P. (2023). Volatile composition, antimicrobial activity, and in vitro innate immunomodulatory activity of Echinacea purpurea (L.) Moench essential oils. Molecules, 28(21), 7330. https://doi.org/10.3390/molecules28217330 DOI: https://doi.org/10.3390/molecules28217330

Durmaz, B., Abdulmajed, O., Durmaz, R., Koroglu, M., Arı, O., Celik, S., & Kalcioglu, M. T. (2021). Respiratory viruses in the healthy middle ear and middle ear with otitis media with effusion. Journal of Medical Virology, 93(11), 6140-6147. https://doi.org/10.1002/jmv.27151 DOI: https://doi.org/10.1002/jmv.27151

Folino, F., Bosi, P., Torretta, S., Gaffuri, M., & Marchisio, P. (2022). Recurrent acute otitis media environmental risk factors: A literature review from the microbiota point of view. Applied Microbiology, 2(3), 594-613. https://doi.org/10.3390/applmicrobiol2030046 DOI: https://doi.org/10.3390/applmicrobiol2030046

Fonseca, F. N., Papanicolaou, G., Lin, H., Lau, C. B., Kennelly, E. J., Cassileth, B. R., & Cunningham-Rundles, S. (2014). Echinacea purpurea (L.) Moench modulates human T-cell cytokine response. International Immunopharmacology, 19(1), 94-102. https://doi.org/10.1016/j.intimp.2013.12.019 DOI: https://doi.org/10.1016/j.intimp.2013.12.019

Furman, D., Campisi, J., Verdin, E., Carrera-Bastos, P., Targ, S., Franceschi, C., Ferrucci, L., Gilroy, D. W., Fasano, A., & Miller, G. W. (2019). Chronic inflammation in the etiology of disease across the life span. Nature Medicine, 25(12), 1822-1832. https://doi.org/10.1038/s41591-019-0675-0 DOI: https://doi.org/10.1038/s41591-019-0675-0

Hohmann, J., Rédei, D., Forgo, P., Szabó, P., Freund, T. F., Haller, J., Bojnik, E., & Benyhe, S. (2011). Alkamides and a neolignan from Echinacea purpurea roots and the interaction of alkamides with G-protein-coupled cannabinoid receptors. Phytochemistry, 72(14-15), 1848-1853. https://doi.org/10.1016/j.phytochem.2011.06.008 DOI: https://doi.org/10.1016/j.phytochem.2011.06.008

Hou, R., Xu, T., Li, Q., Yang, F., Wang, C., Huang, T., & Hao, Z. (2020). Polysaccharide from Echinacea purpurea reduce the oxidant stress in vitro and in vivo. International Journal of Biological Macromolecules, 149, 41-50. https://doi.org/10.1016/j.ijbiomac.2020.01.129 DOI: https://doi.org/10.1016/j.ijbiomac.2020.01.129

Huang, Q., Li, L., Chen, H., Liu, Q., & Wang, Z. (2019). GPP (Composition of Ganoderma lucidum poly-saccharides and polyporus umbellatus poly-saccharides) enhances innate immune function in mice. Nutrients, 11(7), 1480. https://doi.org/10.3390/nu11071480 DOI: https://doi.org/10.3390/nu11071480

Jamal, A., Alsabea, A., Tarakmeh, M., & Safar, A. (2022). Etiology, Diagnosis, Complications, and Management of Acute Otitis Media in Children. Cureus, 14(8), e28019. https://doi.org/10.7759/cureus.28019 DOI: https://doi.org/10.7759/cureus.28019

Jiang, W., Zhu, H., Xu, W., Liu, C., Hu, B., Guo, Y., Cheng, Y., & Qian, H. (2021). Echinacea purpurea polysaccharide prepared by fractional precipitation prevents alcoholic liver injury in mice by protecting the intestinal barrier and regulating liver-related pathways. International Journal of Biological Macromolecules, 187, 143-156. https://doi.org/10.1016/j.ijbiomac.2021.07.095 DOI: https://doi.org/10.1016/j.ijbiomac.2021.07.095

Jin, X., Ren, J., Li, R., Gao, Y., Zhang, H., Li, J., Zhang, J., Wang, X., & Wang, G. (2021). Global burden of upper respiratory infections in 204 countries and territories, from 1990 to 2019. EClinicalMedicine, 37, 100986. https://doi.org/10.1016/j.eclinm.2021.100986 DOI: https://doi.org/10.1016/j.eclinm.2021.100986

Kakouri, E., Talebi, M., & Tarantilis, P. A. (2024). Echinacea spp.: The cold-fighter herbal remedy? Pharmacological Research-Modern Chinese Medicine, 10, 100397. https://doi.org/10.1016/j.prmcm.2024.100397 DOI: https://doi.org/10.1016/j.prmcm.2024.100397

Khalaf, A. A., Hussein, S., Tohamy, A. F., Marouf, S., Yassa, H. D., Zaki, A. R., & Bishayee, A. (2019). Protective effect of Echinacea purpurea (Immulant) against cisplatin-induced immunotoxicity in rats. DARU Journal of Pharmaceutical Sciences, 27, 233-241. https://doi.org/10.1007/s40199-019-00265-4 DOI: https://doi.org/10.1007/s40199-019-00265-4

Khattab, H. A., Abounasef, S. K., & Bakheet, H. L. (2019). The biological and hematological effects of Echinacea purpurea L. Roots extract in the immunocompromised rats with cyclosporine. Journal of Microscopy and Ultrastructure, 7(2), 65-71. https://doi.org/10.4103/JMAU.JMAU_62_18 DOI: https://doi.org/10.4103/JMAU.JMAU_62_18

Kilani-Jaziri, S., Mokdad-Bzeouich, I., Krifa, M., Nasr, N., Ghedira, K., & Chekir-Ghedira, L. (2017). Immunomodulatory and cellular anti-oxidant activities of caffeic, ferulic, and p-coumaric phenolic acids: A structure–activity relationship study. Drug and Chemical Toxicology, 40(4), 416-424. https://doi.org/10.1080/01480545.2016.1252919 DOI: https://doi.org/10.1080/01480545.2016.1252919

Kim, H. R., Kim, Y. S., Lee, D. R., Choi, B. K., Kwon, K. B., & Bae, G. S. (2021). Echinacea purpurea alleviates cyclophosphamide-induced immunosuppression in mice. Applied Sciences, 12(1), 105. https://doi.org/10.3390/app12010105 DOI: https://doi.org/10.3390/app12010105

Kim, H. R., Moon, S., Lee, H. K., Kang, J. L., Oh, S., & Seoh, J. Y. (2012). Immune dysregulation in chronic stress: a quantitative and functional assessment of regulatory T cells. Neuroimmunomodulation, 19(3), 187-194. https://doi.org/10.1159/000331586 DOI: https://doi.org/10.1159/000331586

Kurkin, V., Akushskaya, A., Avdeeva, E., Velmyaikina, E., Daeva, E., & Kadentsev, V. (2011). Flavonoids from Echinacea purpurea. Russian Journal of Bioorganic Chemistry, 37, 905-906. https://doi.org/10.1134/S1068162011070120 DOI: https://doi.org/10.1134/S1068162011070120

Kusel, M. M., De Klerk, N., Holt, P. G., Landau, L. I., & Sly, P. D. (2007). Occurrence and management of acute respiratory illnesses in early childhood. Journal of Paediatrics and Child Health, 43(3), 139-146. https://doi.org/10.1111/j.1440-1754.2007.01033.x DOI: https://doi.org/10.1111/j.1440-1754.2007.01033.x

Lee, T. T., Huang, C. C., Shieh, X. H., Chen, C. L., Chen, L. J., & Yu, B. (2010). Flavonoid, phenol and polysaccharide contents of Echinacea purpurea L. and its immunostimulant capacity in vitro. International Journal of Environmental Science and Development, 1(1), 5-9. DOI: https://doi.org/10.7763/IJESD.2010.V1.2

Li, Q., Yang, F., Hou, R., Huang, T., & Hao, Z. (2020). Post-screening characterization of an acidic polysaccharide from Echinacea purpurea with potent anti-inflammatory properties in vivo. Food & Function, 11(9), 7576-7583. https://doi.org/10.1039/D0FO01367F DOI: https://doi.org/10.1039/D0FO01367F

Maleki, S. J., Crespo, J. F., & Cabanillas, B. (2019). Anti-inflammatory effects of flavonoids. Food Chemistry, 299, 125124. https://doi.org/10.1016/j.foodchem.2019.125124 DOI: https://doi.org/10.1016/j.foodchem.2019.125124

Manayi, A., Vazirian, M., & Saeidnia, S. (2015). Echinacea purpurea: Pharmacology, phytochemistry and analysis methods. Pharmacognosy Reviews, 9(17), 63-72. https://doi.org/10.4103%2F0973-7847.156353 DOI: https://doi.org/10.4103/0973-7847.156353

Marchisio, P., Galli, L., Bortone, B., Ciarcià, M., Motisi, M. A., Novelli, A., Pinto, L., Bottero, S., Pignataro, L., & Piacentini, G. (2019). Updated guidelines for the management of acute otitis media in children by the Italian society of pediatrics: treatment. The Pediatric Infectious Disease Journal, 38(12S), S10-S21. https://doi.org/10.1097/INF.0000000000002452 DOI: https://doi.org/10.1097/INF.0000000000002452

Meeran, M. N., Javed, H., Sharma, C., Goyal, S. N., Kumar, S., Jha, N. K., & Ojha, S. (2021). Can Echinacea be a potential candidate to target immunity, inflammation, and infection-The trinity of coronavirus disease 2019. Heliyon, 7(2), e05990. https://doi.org/10.1016/j.heliyon.2021.e05990 DOI: https://doi.org/10.1016/j.heliyon.2021.e05990

Miller, S. C., & Yu, H. C. (2004). Echinacea: the genus Echinacea: CRC Press. DOI: https://doi.org/10.1201/9780203022696

Nguyen-Van-Tam, J. S., O'Leary, M., Martin, E. T., Heijnen, E., Callendret, B., Fleischhackl, R., Comeaux, C., Tran, T. M. P., & Weber, K. (2022). Burden of respiratory syncytial virus infection in older and high-risk adults: a systematic review and meta-analysis of the evidence from developed countries. European Respiratory Review, 31(166), 220105. https://doi.org/10.1183/16000617.0105-2022 DOI: https://doi.org/10.1183/16000617.0105-2022

Nitsch-Osuch, A., Gyrczuk, E., Wardyn, A., Życinska, K., & Brydak, L. (2016). Antibiotic prescription practices among children with influenza. In M. Pokorski (Ed.), Respiratory Contagion: Advances in Experimental Medicine and Biology (pp. 25-31): Springer, Cham. DOI: https://doi.org/10.1007/5584_2015_198

Nyalambisa, M., Oyemitan, I., Matewu, R., Oyedeji, O., Oluwafemi, O., Songca, S., Nkeh-Chungag, B., & Oyedeji, A. (2017). Volatile constituents and biological activities of the leaf and root of Echinacea species from South Africa. Saudi Pharmaceutical Journal, 25(3), 381-386. https://doi.org/10.1016/j.jsps.2016.09.010 DOI: https://doi.org/10.1016/j.jsps.2016.09.010

Ogal, M., Johnston, S. L., Klein, P., & Schoop, R. (2021). Echinacea reduces antibiotic usage in children through respiratory tract infection prevention: a randomized, blinded, controlled clinical trial. European Journal of Medical Research, 26, 33. https://doi.org/10.1186/s40001-021-00499-6 DOI: https://doi.org/10.1186/s40001-021-00499-6

Oláh, A., Szabó-Papp, J., Soeberdt, M., Knie, U., Dähnhardt-Pfeiffer, S., Abels, C., & Bíró, T. (2017). Echinacea purpurea-derived alkylamides exhibit potent anti-inflammatory effects and alleviate clinical symptoms of atopic eczema. Journal of Dermatological Science, 88(1), 67-77. https://doi.org/10.1016/j.jdermsci.2017.05.015 DOI: https://doi.org/10.1016/j.jdermsci.2017.05.015

Ostrzyżek-Przeździecka, K., Panczyk, M., Bronikowski, M., Gąsior, J. S., & Feleszko, W. (2023). Association of low physical activity with higher respiratory tract infections frequency among pre-school children. Pediatric Research, 94(2), 594-602. https://doi.org/10.1038/s41390-022-02436-7 DOI: https://doi.org/10.1038/s41390-022-02436-7

Park, S. J., Lee, M., Kim, D., Oh, D. H., Prasad, K. S., Eun, S., & Lee, J. (2021). Echinacea purpurea extract enhances natural killer cell activity in vivo by upregulating MHC II and Th1-type CD4+ T cell responses. Journal of Medicinal Food, 24(10), 1039-1049. DOI: https://doi.org/10.1089/jmf.2021.K.0064

Paulovičová, E., Paulovičová, L., Pawlaczyk-Graja, I., Gancarz, R., Kopáčová, M., & Capek, P. (2022). Effectivity of polyphenolic polysaccharide-proteins isolated from medicinal plants as potential cellular immune response modulators. Biologia, 77(12), 3581-3593. https://doi.org/10.1007/s11756-022-01200-w DOI: https://doi.org/10.1007/s11756-022-01200-w

Petkova, N., Petrova, A., Ivanov, I., Hambarlyiska, I., Tumbarski, Y., Dincheva, I., Ognyanov, M., & Denev, P. (2023). Chemical Composition of Different Extracts from Echinacea purpurea (L.) Moench Roots and Evaluation of Their Antimicrobial Activity. ChemEngineering, 7(5), 94. https://doi.org/10.3390/chemengineering7050094 DOI: https://doi.org/10.3390/chemengineering7050094

Petrova, A., Ognyanov, M., Petkova, N., & Denev, P. (2023). Phytochemical characterization of purple coneflower roots (Echinacea purpurea (L.) Moench.) and their extracts. Molecules, 28(9), 3956. https://doi.org/10.3390/molecules28093956 DOI: https://doi.org/10.3390/molecules28093956

Pires, C., Martins, N., Carvalho, A. M., Barros, L., & Ferreira, I. C. (2016). Phytopharmacologic preparations as predictors of plant bioactivity: A particular approach to Echinacea purpurea (L.) Moench antioxidant properties. Nutrition, 32(7-8), 834-839. https://doi.org/10.1016/j.nut.2016.01.005 DOI: https://doi.org/10.1016/j.nut.2016.01.005

Principi, N., & Esposito, S. (2020). Unsolved problems and new medical approaches to otitis media. Expert Opinion on Biological Therapy, 20(7), 741-749. https://doi.org/10.1080/14712598.2020.1740677 DOI: https://doi.org/10.1080/14712598.2020.1740677

Ren, D., Xu, Q., Almudevar, A. L., & Pichichero, M. E. (2019). Impaired proinflammatory response in stringently defined otitis-prone children during viral upper respiratory infections. Clinical Infectious Diseases, 68(9), 1566-1574. https://doi.org/10.1093/cid/ciy750 DOI: https://doi.org/10.1093/cid/ciy750

Ren, W., Ban, J., Xia, Y., Zhou, F., Yuan, C., Jia, H., Huang, H., Jiang, M., Liang, M., & Li, Z. (2023). Echinacea purpurea-derived homogeneous polysaccharide exerts anti-tumor efficacy via facilitating M1 macrophage polarization. The Innovation, 4(2), 100391. https://doi.org/10.1016/j.xinn.2023.100391 DOI: https://doi.org/10.1016/j.xinn.2023.100391

Schoop, R. (2020). Exploring In Vitro and In Vivo Pharmacology of Echinacea Purpurea (L.) Moench. University of Westminster, https://doi.org/10.34737/v402v

Sharifi‐Rad, M., Mnayer, D., Morais‐Braga, M. F. B., Carneiro, J. N. P., Bezerra, C. F., Coutinho, H. D. M., Salehi, B., Martorell, M., del Mar Contreras, M., & Soltani‐Nejad, A. (2018). Echinacea plants as antioxidant and antibacterial agents: From traditional medicine to biotechnological applications. Phytotherapy Research, 32(9), 1653-1663. https://doi.org/10.1002/ptr.6101 DOI: https://doi.org/10.1002/ptr.6101

Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, 104, 333-339. https://doi.org/10.1016/j.jbusres.2019.07.039 DOI: https://doi.org/10.1016/j.jbusres.2019.07.039

Spasov, A., Ostrovskij, O., Chernikov, M., & Wikman, G. (2004). Comparative controlled study of Andrographis paniculata fixed combination, Kan Jang® and an Echinacea preparation as adjuvant, in the treatment of uncomplicated respiratory disease in children. Phytotherapy Research, 18(1), 47-53. https://doi.org/10.1002/ptr.1359 DOI: https://doi.org/10.1002/ptr.1359

Spoială, E. L., Stanciu, G. D., Bild, V., Ababei, D. C., & Gavrilovici, C. (2021). From evidence to clinical guidelines in antibiotic treatment in acute otitis media in children. Antibiotics, 10(1), 52. https://doi.org/10.3390/antibiotics10010052 DOI: https://doi.org/10.3390/antibiotics10010052

Sun, Y., Chen, X., Zhang, L., Liu, H., Liu, S., Yu, H., Wang, X., Qin, Y., & Li, P. (2019). The antiviral property of Sargassum fusiforme polysaccharide for avian leukosis virus subgroup J in vitro and in vivo. International Journal of Biological Macromolecules, 138, 70-78. https://doi.org/10.1016/j.ijbiomac.2019.07.073 DOI: https://doi.org/10.1016/j.ijbiomac.2019.07.073

Taylor, J. A., Weber, W., Standish, L., Quinn, H., Goesling, J., McGann, M., & Calabrese, C. (2003). Efficacy and safety of Echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. JAMA, 290(21), 2824-2830. https://doi.org/10.1001/jama.290.21.2824 DOI: https://doi.org/10.1001/jama.290.21.2824

Thomsen, M. O., Christensen, L. P., & Grevsen, K. (2018). Harvest strategies for optimization of the content of bioactive alkamides and caffeic acid derivatives in aerial parts and in roots of Echinacea purpurea. Journal of Agricultural and Food Chemistry, 66(44), 11630-11639. https://doi.org/10.1021/acs.jafc.8b03420 DOI: https://doi.org/10.1021/acs.jafc.8b03420

Truong, T. T. Q., Thuyb, T. T. D., Khiemc, P. V., Thiend, N. V., Anhb, H. H., Quỳnha, T. T. D., Thùyb, T. T. D., Khiêmc, P. V., Thiênd, N. V., & Anhb, H. H. (2023). Phytochemical profiling of Echinacea Genus: A mini review of chemical constituents of selected species. DTU Journal of Science and Technology, 5(60), 123–131. https://doi.org/10.13140/RG.2.2.25841.45926/1

Tsai, Y. L., Chiou, S. Y., Chan, K. C., Sung, J. M., & Lin, S. D. (2012). Caffeic acid derivatives, total phenols, antioxidant and antimutagenic activities of Echinacea purpurea flower extracts. LWT-Food Science and Technology, 46(1), 169-176. https://doi.org/10.1016/j.lwt.2011.09.026 DOI: https://doi.org/10.1016/j.lwt.2011.09.026

van Doorn, H. R., & Yu, H. (2020). Viral respiratory infections. In A. Magill & T. Solomon (Eds.), Hunter's Tropical Medicine and Emerging Infectious Diseases (pp. 284-288): Elsevier. https://doi.org/10.1016/C2009-0-51934-4 DOI: https://doi.org/10.1016/B978-0-323-55512-8.00033-8

Venekamp, R. P., Schilder, A. G., van den Heuvel, M., & Hay, A. D. (2020). Acute middle ear infection (acute otitis media) in children. BMJ, 371, m4238. https://doi.org/10.1136/bmj.m4238 DOI: https://doi.org/10.1136/bmj.m4238

Vieira, S. F., Gonçalves, S. M., Gonçalves, V. M., Llaguno, C. P., Macías, F., Tiritan, M. E., Cunha, C., Carvalho, A., Reis, R. L., & Ferreira, H. (2023). Echinacea purpurea fractions represent promising plant-based anti-inflammatory formulations. Antioxidants, 12(2), 425. https://doi.org/10.3390/antiox12020425 DOI: https://doi.org/10.3390/antiox12020425

Vieira, S. F., Gonçalves, V. M., Llaguno, C. P., Macías, F., Tiritan, M. E., Reis, R. L., Ferreira, H., & Neves, N. M. (2022). On the bioactivity of Echinacea purpurea extracts to modulate the production of inflammatory mediators. International Journal of Molecular Sciences, 23(21), 13616. https://doi.org/10.3390/ijms232113616 DOI: https://doi.org/10.3390/ijms232113616

Wahl, R. A., Aldous, M. B., Worden, K. A., & Grant, K. L. (2008). Echinacea purpurea and osteopathic manipulative treatment in children with recurrent otitis media: a randomized controlled trial. BMC Complementary and Alternative Medicine, 8, 56. https://doi.org/10.1186/1472-6882-8-56 DOI: https://doi.org/10.1186/1472-6882-8-56

Wang, C. Y., Chiao, M. T., Yen, P. J., Huang, W. C., Hou, C. C., Chien, S. C., Yeh, K. C., Yang, W. C., Shyur, L. F., & Yang, N. S. (2006). Modulatory effects of Echinacea purpurea extracts on human dendritic cells: a cell-and gene-based study. Genomics, 88(6), 801-808. https://doi.org/10.1016/j.ygeno.2006.08.011 DOI: https://doi.org/10.1016/j.ygeno.2006.08.011

Wang, L., Oh, J. Y., Hwang, J., Ko, J. Y., Jeon, Y. J., & Ryu, B. (2019). In vitro and in vivo antioxidant activities of polysaccharides isolated from celluclast-assisted extract of an edible brown seaweed, Sargassum fulvellum. Antioxidants, 8(10), 493. https://doi.org/10.3390/antiox8100493 DOI: https://doi.org/10.3390/antiox8100493

Weber, W., Taylor, J. A., Stoep, A. V., Weiss, N. S., Standish, L. J., & Calabrese, C. (2005). Echinacea purpurea for prevention of upper respiratory tract infections in children. Journal of Alternative & Complementary Medicine: Research on Paradigm, Practice, and Policy, 11(6), 1021-1026. https://doi.org/10.1089/acm.2005.11.1021 DOI: https://doi.org/10.1089/acm.2005.11.1021

Weishaupt, R., Bächler, A., Feldhaus, S., Lang, G., Klein, P., & Schoop, R. (2020). Safety and dose-dependent effects of Echinacea for the treatment of acute cold episodes in children: A multicenter, randomized, open-label clinical trial. Children, 7(12), 292. https://doi.org/10.3390/children7120292 DOI: https://doi.org/10.3390/children7120292

Woelkart, K., & Bauer, R. (2007). The role of alkamides as an active principle of Echinacea. Planta Medica, 73(7), 615-623. https://doi.org/10.1055/s-2007-981531 DOI: https://doi.org/10.1055/s-2007-981531

Wustrow, T. (2004). Alternative versus conventional treatment strategy in uncomplicated acute otitis media in children: a prospective, open, controlled parallel-group comparison. International Journal of Clinical Pharmacology and Therapeutics, 42(2), 110-119.

Xu, W., Zhu, H., Hu, B., Cheng, Y., Guo, Y., Yao, W., & Qian, H. (2021). Echinacea in hepatopathy: A review of its phytochemistry, pharmacology, and safety. Phytomedicine, 87, 153572. https://doi.org/10.1016/j.phymed.2021.153572 DOI: https://doi.org/10.1016/j.phymed.2021.153572

Zahid, A., Wilson, J. C., Grice, I. D., & Peak, I. R. (2024). Otitis media: recent advances in otitis media vaccine development and model systems. Frontiers in Microbiology, 15, 1345027. https://doi.org/10.3389/fmicb.2024.1345027 DOI: https://doi.org/10.3389/fmicb.2024.1345027

Zhang, H., Lang, W., Wang, S., Li, B., Li, G., & Shi, Q. (2020). Echinacea polysaccharide alleviates LPS-induced lung injury via inhibiting inflammation, apoptosis and activation of the TLR4/NF-κB signal pathway. International Immunopharmacology, 88, 106974. https://doi.org/10.1016/j.intimp.2020.106974 DOI: https://doi.org/10.1016/j.intimp.2020.106974

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16.06.2024

How to Cite

Vu, T.-M.-H., Hoang, T.-V., Nguyen, T.-Q.-H., Doan, P.-M.-K., Nguyen, T.-T.-D., Bui, T.-T.-T., Nguyen, C.-C., Tran, H.-D., Pham, T.-P.-T., & Ha, H.-A. (2024). Echinacea purpurea: An overview of mechanism, efficacy, and safety in pediatric upper respiratory infections and otitis media. International Journal of Plant Based Pharmaceuticals, 4(2), 90–100. https://doi.org/10.62313/ijpbp.2024.213

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Reviews
Received 2024-03-20
Accepted 2024-05-25
Published 2024-06-16