Oxymatrine: medicinal herb for treating hepatitis C & B
In response to several published studies being distributed over the internet recently, an inquiry regarding safety was sent to the company making oxymatrine and here is the response from the company. Following the letter is additional information on oxymatrine. The study results are posted & archived in articles in the Hepatitis c section on the NATAP website.
In the interests of hearing both sides of the story I contacted the manufacturer of the Chinese herbal product in the studies we have been discussing on list and this is his response to the points Daniel makes: Hello: Thanks for your reply and your questions. It constantly amazes me how much mis-information there can be on the web these days. Is everyone out to make money the fast and easy way? I hope not. This is a very serious disease and, frankly, I do not play games with people's health. Now to the questions. The matrines (oxymatrine and matrine) were first isolated and identified in 1958. They are only found in the Sophora species thus far. Intensive investigations have gone on for decades regarding the pharmacology and clinical applications of these alkaloids. The crude herb and extracts have been available in the West for over 25 years. Any herb can become toxic in the right quantity. Water can nourish the body, but an overabundance of water can flood the blood and one can drown. In several studies the effects of oxymatrine were comparable to those attained with interferon therapy, except that adverse reactions were avoided. Yes, the inhibition of fibrosis appears to be a separate and additional function of sophora alkaloids. China is still a 'developing' country and "drugs" are not widely affordable by the masses. Yet the Chinese people have been able to survive all these years without 'western type' drugs by using what nature has given them, natural plants and herbs. In China the herbs are "cheap" because they grow there. Here in America, we take these "cheap" herbs and plants, turn them into drugs ( i.e. aspirin, digitalis etc) and charge a fortune for them. Ah yes, the good old American ingenuity and entrepreneurship ( or to put it mildly, greed). Do you think for a minute, that the medical profession will passively stand by and watch their entire monetary empire crumble with the use of 'cheap' natural products? Do you realize that there is a bill in Congress right now to prevent natural substances from being produced and marketed? That's right. Enzymes, herbs, vitamins, minerals and the like would, according to this bill, now have to be registered, controlled, and doled out in prescription form. Think it can't happen. Just look at Canada, the United Kingdom (as you probably already know) and Australia. We are applying to these countries for permits to allow Nu-Liver to be imported. We are going thru hoops and more hoops, because all 'natural health products' including herbs and vitamins and the like are now classified as a subset of drugs. That's right...drugs. Do you think there is no money in it for the medical profession if they get their hands on this billion dollar segment? The pharmaceutical industry just can't wait to be the only ones producing the stuff. There are many natural treatments for nasty diseases like cancer, aids and hepatitis being used in Japan, Germany, Russia, China that are not allowed into the United States, some for fear that they may actually help people at a nominal cost. What would happen to all the oncologists and cancer specialists, all the radiation and chemotherapy, all the hospital and clinic visits, all the drugs and pharmaceuticals if natural substances could replace them. The medical profession has a deep interest in preventing natural substances from coming to market in America. Drugs are just too profitable. I don't know if anything presently clears the virus in hepatitis c individuals, including interferon. I do know that about 15% of individuals who contract hepatitis c, spontaneously clear it in its acute stage. The body just decides that the virus is an invader and takes action against the virus. But, the point to be made is that all humans carry viruses within them. Some have names ( hepatitis); others don't. Since viruses were around long before man came onto the scene, we will have to learn to live peacefully with them in some sort of mutualistic or symbiotic relationship. As we continually build up our immune systems, we can keep all viruses from doing harm. Hope this information helps-- Best of Health-- Jack Bloom
MATRINE AND OXYMATRINE
Subjects Of Chinese Research
by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
Matrine and oxymatrine are the two major alkaloid components found in sophora roots. They are obtained primarily from Sophora japonica (kushen), but also from Sophora subprostrata (shandougen), and from the above ground portion of Sophora alopecuroides. The matrines were first isolated and identified in 1958; they are unique tetracyclo-quinolizindine alkaloids (see Figure 1) found only in Sophora species thus far. An intensive investigation into the pharmacology and clinical applications of these alkaloids has gone on for the past decade and remains one of the focal points of Chinese medical research. The main clinical applications are treatment of people with cancer, viral hepatitis, cardiac diseases (such as viral myocarditis), and skin diseases (such as psoriasis and eczema).
The crude herb and crude hot-water extracts of sophora have been available in the West for more than 25 years. An alkaloid fraction of sophora roots containing a standardized level of oxymatrine and matrine (20%) was first introduced by the Institute for Traditional Medicine, and made available to practitioners in tablet form under the name Oxymatrine (White Tiger) in 1998. It has been used without reported side effects. In China, the alkaloids are often given by injection, but this method of administration is not acceptable in the West, so oral dosing is used here instead. When taken orally, much of the oxymatrine is converted to matrine; to get high blood levels of oxymatrine, it must be given by injection. However, it is unclear whether oxymatrine is clinically more effective than matrine. Chinese researchers have also used the alkaloids in capsule form, with results that appear similar to the injection. Sophora is also administered in complex formulas made as decoctions and taken orally.
Sophora japonica contains about a dozen alkaloids, with matrine and oxymatrine being by far the highest, together comprising about 2% of the dried root stock (most of it in the form of oxymatrine), followed by closely related alkaloids: mainly sophocarpine, but also minute amounts of sophoranol, sophoramine, sophoridine, allomatrine, isomatrine, and others (see Figure 2). These alkaloids were first reported as constituents of kushen in a series of publications from 1958-1978.
An overview of recent research on the pharmacology and clinical applications of the sophora alkaloids is presented below. In general, the dosage of the sophora alkaloids administered clinically is in the range of 400-600 mg per day.
As described by Chen Yanxi and his colleagues at the Shanghai Second Medical University (1):
In recent years, oxymatrine has been recommended for treating chronic hepatitis B and chronic hepatitis C and has been shown effective in clinical practice. It has been utilized for these applications broadly, but the factors affecting its efficacy have not yet been determined.
Chen and his group gave oxymatrine injection to patients with hepatitis B. He confirmed that the viral load declined by this treatment, suggesting that oxymatrine served to inhibit the viral replication, not just reduce liver damage, which is the primary and more limited effect of many herbs used for hepatitis. Antiviral activity, for hepatitis C virus, was confirmed by the same group in cell culture tests (2). Clinical effectiveness for patients with hepatitis C had been reported earlier, including reduction of viral load (3). Oxymatrine may reduce death of liver cells damaged by means other than by inhibiting viral activity, as indicated in a pharmacology study of liver protective effects in immune-based liver damage (4).
Kang Junjie and Kang Suqiong, at the Treatment Center for Hepatic Diseases of the Amoy Municipal Hospital, reported that oxymatrine injection did not cause side effects other than rare local reactions at the injection site (5). They used this injection along with oral administration of complex Chinese herb formulas designed to match symptom-sign complexes and claimed that the effects were comparable to those attained with interferon therapy, except that adverse reactions were avoided. In particular, they claimed that the use of oxymatrine and Chinese herb formulas inhibited liver fibrosis (for further information on Chinese herbs for this purpose, see: Treatment and prevention of liver fibrosis). The inhibition of fibrosis appears to be a separate for additional function of sophora alkaloids beyond inhibiting viral activity. In laboratory animal studies carried out by Chen Weizhong and his colleagues at the Changzheng Hospital in Shanghai, matrine was shown to reduce the formation of liver fibrosis that was caused by chemical damage to the liver (6).
Thus, in relation to viral hepatitis, the sophora alkaloids appear to inhibit the viral replication, reduce destruction of liver cells, and protect against fibrosis. It has also been suggested that the alkaloids promote the flow of bile.
Sophora subprostrata has long been regarded an anticancer herb in China. According to cancer specialist Chang Minyi (7), "Sophora subprostrata works through stimulating the anticancer immune mechanism of the patient and reinforcing his resistance against the growth of the tumor." In 1998, Xu Xiangru and Jiang Jikai, working at the Congqing University of Medical Sciences, published a review of anticancer activity of sophora alkaloids (8). They relayed pharmacology studies indicating the alkaloids could inhibit growth of tumor cells directly, and could also affect immune functions. In clinical work, they described the use of sophora alkaloids for treating the side effect of leukopenia caused by cancer chemotherapy or radiation therapy and for treating certain cancers, notably uterine cervical cancer and leukemia. The herb is also considered an important ingredient in treatment of esophageal and laryngeal cancer. In a recent pharmacology study, it was reported that matrine could help leukemia cells differentiate into mature and normal white blood cells (9). Nonetheless, sophora alkaloids should not be relied upon as a sole treatment for cancer, but as an adjunct therapy, as there is no proof that the herb or these compounds are curative.
Sophora and its alkaloids are commonly used in China for treatment of heart arrhythmias (10). A possible mechanism of action is to help block sodium and calcium channels, a mechanism relied on by several antiarrhythmic pharmaceuticals. In a review of sophora alkaloid effects on the heart, Li Yan and He Liren, at the Affiliated Yueyang Hospital of Shanghai University of TCM, reported that:
1.. sophora total alkaloids or matrine could counteract arrhythmia induced by many causes;
2.. the total alkaloids or oxymatrine could regulate heart contractility;
3.. the total alkaloids could dilate the coronary artery, increase blood flow, and improve oxygen delivery to cardiac cells; and
4.. sophora root could counteract the coxsackie virus that causes myocarditis.
Li and He also relayed a clinical report from the Third Clinical Medical College of Beijing Medical University, about treatment of 167 patients with fast arrhythmia. The patients received each day 3-10 sophora root tablets (extract of 2 grams crude herb/tablet). The results indicated positive effects on various kinds of arrhythmia, such as premature systole, paroxysmal ventricular tachycardia, atrial fibrillation, and sinus tachycardia; the efficacy for premature systole appeared to be the best. This Beijing study and others were described also by Niu Kuizhi in his review (12) of clinical applications of sophora (kushen).
Sophora is frequently used in treatment of skin diseases, applied topically and consumed orally. One of the primary uses for topical therapy is treatment of vaginitis, particularly that due to candida infection (13). Recently, a topical liniment was developed combining sophora's matrine with the anti-inflammatory flavonoid baicalin from scute (huangqin) for treatment of eczema, neurodermatitis, and psoriasis (14). This treatment was reported to be highly effective, especially for eczema, though the number of cases was small, so that further research must be done. The use of sophora for psoriasis is a promising new area (15). Zhang Junling and his colleagues at the Department of Dermatology, Tianjin Changzheng Hospital, studied the mechanism by which sophora alkaloids reduce psoriasis patches (16). They found that the alkaloids could inhibit keratinocytes, the cells that reproduce continuously to produce the characteristic scales.
1.. Chen Yanxi, et al., Relationship between serum load of HBV-DNA and therapeutic effect of oxymatrine in patients with chronic hepatitis B, Chinese Journal of Integrated Traditional Chinese and Western Medicine 2002; 22 (5): 335-336.
2.. Chen YX, et al., The inhibitory effect of oxymatrine on hepatitis C virus in vitro, Chinese Journal of Liver Diseases 2001; 9 (Supplement): 12-14.
3.. Li Jiqiang, et al., A preliminary study on therapeutic effect of oxymatrine in treating patients with chronic hepatitis C, Chinese Journal of Integrated Traditional and Western Medicine, 1998; 18(4): 227-229.
4.. Xiang X, et al., Effect of oxymatrine on murine fulminant hepatitis and hepatocye apoptosis, Chinese Journal of Medicine, 2002; 115(4); 593-596.
5.. Kang Junjie and Kang Suqiong, 30 cases of chronic hepatitis B treated with oxymatrine injection combined with syndrome differentiation of Traditional Chinese Medicine, Journal of Traditional Chinese Medicine, 2002; 43(1): 53.
6.. Chen Weizhong, et al., Effect of matrine on experiment rat liver fibrosis, Chin Journal of New Drugs, 2000; 19(5): 410-412.
7.. Chang Minyi, Anticancer Medicinal Herbs, 1992 Hunan Science and Technology Publishing House, Changsha.
8.. Xu Xiangru and Jiang Jikai, Recent progress in anticancer bioactivity study of Sophora flavescens and its alkaloids, Chinese Journal of Integrated Traditional Chinese and Western Medicine 1998; 4 (3): 235-239.
9.. Zhu Ningxi, et al., Study on inducing and differentiating function and mechanism of matrine on leukemia cells, ACTA Traditional Chinese Medicine and Pharmacology (Shanghai), 2001; 15(1): 43-44.
10.. Ding Guangsheng, Anti-arrhythmia agents in traditional Chinese medicines, Abstracts of Chinese Medicine 1987; 1(2): 287-308.
11.. Li Yan and He Liren, Pharmacological study of Sophora alkaloid actions on the cardiovascular system, Chinese Traditional and Herbal Drugs, 2000; 31(3): 227-229.
12.. Niu Kuizhi, Pharmacology and clinical application of sophora flavescentis, International Journal of Oriental Medicine 1997; 22(1): 75-81.
13.. Li Xiuying, et al., Treatment of 50 patients with candida albicans vaginitis by cortex sophorae, Chinese Journal of Integrated Traditional Chinese and Western Medicine 2000; 6 (2): 146-147.
14.. Ding Ting, et al., The preparing and clinical applications of Complex Matrine Liniment, ACTA Chinese Medicine and Pharmacology, 2002; 30(2): 47-48.
15.. Zhang Yaolong, Clinical study on matrine for the treatment of psoriasis, Hebei Journal of Medical Science, 1996; 69 (2): 590-591.
16.. Zhang Junling, et al., Study on Apoptosis induced by oxymatrine in cultured keratinocytes, Chinese Journal of Dermatology and Venereology, 2000; 14(6): 367-368.
Flavescent sophora root (Kushen)
Pharmaceutical Name : Radix Sophorae flavescentis
Botanical Name : Sophora flavescens Ait.
Common Name : Flavescent sophora root
Source of Earliest Record : Shennong Bencao Jing
Part Used & Method for Pharmaceutical Preparations : The roots are dug in spring or autumn. After the fibrous roots have been removed, the roots are cleaned, cut into slices and dried in the sun.
Properties & Taste : Bitter and cold
Meridians : Heart, liver, stomach, large intestine and urinary bladder
1. To clear heat and dry dampness;
2. To promote urination;
3. To disperse wind and stop itching
Indications & Combinations :
1. Damp-heat syndrome: a) damp-heat jaundiceFlavescent sophora root (Kushen) is used with Phellodendron bark (Huangbai), Capejasmine (Zhizi), Chinese gentian (Longdancao) and Oriental wormwood (Yinchenhao); b) damp-heat diarrhea and dysenteryFlavescent sophora root (Kushen) is used with Costus root (Muxiang) and Licorice root (Gancao); c) damp-heat leukorrhea and eczema of the genitalsFlavescent sophora root (Kushen) is used with Phellodendron bark (Huangbai), Cnidium fruit (Shechuangzi) and Chinese gentian (Longdancao).
2. Skin diseases, including itching of the skin, scabies and impetigo. Flavescent sophora root (Kushen) can be used internally and externally. The herb is combined with Chinese angelica root (Danggui), Dittany bark (Baixianpi), Broom cypress fruit (Difuzi) and Red peony (Chishao).
3. Painful urination caused by damp-heat. Flavescent sophora root (Kushen) is used with Dandelion herb (Pugongying) and Pyrrosia leaf (Shiwei).
Dosage: 3-10 g
Cautions & Contraindications: This herb should never be used with the herb Black false bellebore (Lilu). It is contraindicated in cases with weakness and cold in the spleen and stomach.
Oxymatrine is a substance found in sophora roots. In a comparison of oxymatrine versus vitamins in one study, nearly half of 43 patients had reduced their viral load to non-detectable levels, compared to only one patient taking vitamins, researchers at the University of Shanghai in China reported.17
However, while liver enzyme levels were higher in the treatment group after two months of treatment, they were generally the same between both groups after 3 months, the researchers reported.
In the end, Coon and Frist "identified several promising complementary therapies", but definitive conclusions couldn't be drawn because of questionable designs of the studies they had researched.
"More research is warranted to establish the role of these and other therapies in the treatment of hepatitis C," they wrote.