Elderberry and Cytokine Storm
20th May, 2020

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Elderberry

 

Elderberry (Sambucas spp) and Cytokine storm

 

Uses and properties

Elderberry has traditionally been used for the common cold and influenza. It is known for its diuretic, laxative and diaphoretic properties and for stimulating the immune function (1).

 

Other uses include (1)

  • Cardiovascular disease
  • Headache
  • Sinusitis
  • Obesity
  • HIV/AIDS
  • Chronic fatigue syndrome
  • Neuralgia
  • Sciatica
  • Hyperlipidaemia             
  • Toothache
  • Gingivitis (topically as a mouth rinse)
  • Allergic rhinitis

 

Latest research

Concerns have been raised over the pro-cytokine effect of elderberry.

Limited evidence exists supporting the role of elderberry in inducing a cytokine storm. Evidence is based on two small in vitro studies with conflicting results.

Cytokine storms are associated with a wide variety of infectious and non-infectious diseases. The term was popularised largely in the context of avian H5N1 influenza virus infection (2).

Cytokines  play an important role in normal immune responses, but a severe overproduction of cytokines  in the blood can be harmful. Signs and symptoms include high fever, inflammation (redness and swelling), severe fatigue and nausea. Cytokine storms can sometimes be severe or life threatening and lead to multiple organ failure.

A small in vitro study showed that the studied elderberry extracts increased the production of both inflammatory and anti-inflammatory cytokines  (3).

Other research showed elderberry’s modulatory effect. The results of an in vitro study found that elderberry has anti-inflammatory potential based on the reduction of both inflammatory cytokines , expression of NF-kB and the up-regulation of IL-10, an anti-inflammatory mediator (4). One of the main components of elderberry (S. australis Cham. & Schltdl) is ursolic acid (UA). UA is a pentacyclic triterpene with antitumor and anti-inflammatory activity due to the inhibitory effect on NF-κB activation. It also has antioxidant and antibacterial effects. This study proposes S. australis Cham. & Schltdl may have immunomodulatory effect due to the presence of UA (4).

 

Summary

To date, there is no strong evidence that elderberry can cause cytokine storm syndrome in humans. 

It is important to note that elderberry has not been evaluated for the treatment or prevention of COVID-19.

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References
1TRC Healthcare Inc. Natural Medicines Monographs - elderberry [Internet]. TRC Healthcare. 2020 [cited 2020 May 1]. Available from: https://www.vital.ly/trc/monographs/clear
2Tisoncik JR, Korth MJ, Simmons CP, Farrar J, Martin TR, Katze MG. Into the eye of the cytokine storm. Microbiol Mol Biol Rev. 2012;76(1):16‐32.
3Barak V, Birkenfeld S, Halperin T, Kalickman I. The effect of herbal remedies on the production of human inflammatory and anti-inflammatory cytokines. Isr Med Assoc J. 2002 Nov;4(11 Suppl):919-22.
4Carneiro NV, Silva HB, Silva RR, Carneiro TC, Costa RS, Pires AO, Marques CR, Velozo ES, Conceicao AS, Silva T, Silva TM. Sambucus australis Modulates Inflammatory Response via Inhibition of Nuclear Factor Kappa B (NF-kB) in vitro. An Acad Bras Cienc. 2019;91(1).