The Women's Health Collaborative is a proud supporter of clinical and academic research to help advance new solutions for breast cancer treatments. Publishing information about current findings and exploratory processes aid in the expansion of public knowledge and potential resources to encourage the active studies in the continuing search for a cure. The editors of the Women's Health Digest shares this feature and endorses the efforts of the authors for their advocacy and their commitment to pursue this expanding study.
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THERAPEUTIC POTENTIALS OF
ECHINACEA, BLACK COHOSH, AND BURDOCK
Authors: Noelle Cutter, Phd, Alexandra Fiederlein
This minireview explores the therapeutic potential of three botanicals—Echinacea, Black Cohosh, and Burdock—found in or cultivated in New York State (NYS) for their potential anti-breast cancer properties. Each botanical demonstrates distinct mechanisms of action, including anti-inflammatory, antioxidant, cytotoxic, and apoptotic effects, as well as modulation of signaling pathways such as PI3K/Akt and STAT3. While preclinical studies reveal promising results, inconsistencies due to varying extraction methods, study designs, and plant parts highlight the need for standardized research protocols and clinical trials. Additionally, the potential dual effects of phytoestrogens and interactions with existing treatments underline the importance of evidence-based application. This review provides a foundational understanding of these botanicals and their implications for advancing breast cancer therapy.
Introduction
Breast cancer remains one of the leading causes of cancer-related deaths worldwide. Despite advancements in treatment, resistance to conventional therapies such as chemotherapy and targeted drugs presents a significant challenge (Siegel et al., 2021). Thus, there is an urgent need for alternative therapeutic strategies that are effective, have fewer side effects, and overcome resistance mechanisms. Natural products derived from plants have been recognized as a rich source of novel anticancer agents, with several drugs like Paclitaxel (Taxol®) being derived from plant sources (Cragg & Newman, 2013).
The history of plant-derived medicines highlights the immense potential of botanicals in cancer treatment. For instance, Vincristine and Vinblastine, derived from the Madagascar periwinkle (Catharanthus roseus), have become cornerstone treatments for certain cancers (Cragg & Newman, 2013). Similarly, the success of Taxol underscores the value of exploring natural compounds for therapeutic breakthroughs. Despite these advances, many plant species remain underexplored, particularly in regions like Long Island, New York, which boasts unique environmental conditions that may yield novel bioactive compounds.
Current breast cancer therapies, including chemotherapy, hormone therapy, and targeted treatments, are often accompanied by severe side effects and limited efficacy in drug-resistant cases (Hassan et al., 2020). Phytochemicals, such as flavonoids, alkaloids, and terpenoids, have demonstrated promising anticancer activities, including the induction of apoptosis, cell cycle arrest, and the modulation of critical signaling pathways like PI3K/Akt and NF-κB (Hassan et al., 2020). These compounds offer a potentially safer and more targeted approach to cancer treatment.
The flora of Long Island represents an untapped reservoir of medicinal plants with potential anticancer properties. Regional biodiversity, influenced by distinct climatic and soil conditions, may enhance the therapeutic potential of local botanicals. Exploring this diversity could lead to the discovery of novel plant-based therapies that complement existing treatment regimens. This review aims to explore the medicinal potential of selected botanicals, including Echinacea, Black Cohosh, and Burdock, with a focus on their mechanisms of action and implications for breast cancer treatment.
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Research Problem
The challenge of breast cancer treatment is compounded by the emergence of multidrug resistance and the severe side effects associated with existing therapies. Natural plant extracts have shown promise in combating cancer cells through various mechanisms, including apoptosis induction, cell cycle arrest, and modulation of signaling pathways (Hassan et al., 2020). The flora of Long Island remains largely untapped in the search for anticancer compounds, providing an opportunity to explore and identify novel plant extracts with therapeutic potential against breast cancer.
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Potential Anti-Breast Cancer Botanicals Located in NYS
Echinacea
Echinacea, though not native to NYS, is grown in upstate New York and Long Island (Werier et al., n.d.). The two species, Echinacea pallida and Echinacea purpurea, possess flavonoids, caffeic acid derivatives, and polysaccharides that contribute to immune activation, antioxidant effects, and anti-inflammatory properties (Islam et al., 2020; Karimi et al., 2019).
Recent studies demonstrate E. purpurea's selective toxicity against breast cancer cells while protecting noncancerous cells (Park et al., 2020). Additionally, extracts from E. pallida and E. purpurea show promising cytotoxic and apoptotic effects on MCF-7 and BT-549 breast cancer cell lines (Driggins et al., 2021). Further research on secondary metabolites, such as polyacetylenes, indicates concentration-dependent cytotoxicity (Pellati et al., 2018).
Despite these promising findings, some studies report conflicting outcomes. For instance, certain phenolic components of Echinacea angustifolia might counteract chemotherapy drugs like doxorubicin, suggesting a need for caution and more standardized research protocols (Espinosa-Paredes et al., 2021).
Black Cohosh
Black Cohosh (Actaea racemosa), found in various NYS regions, has triterpene glycosides and polyphenolic compounds that exhibit potential anti-breast cancer effects (Kuhn et al., 2021). Mechanistic studies suggest Black Cohosh may act as a selective estrogen receptor modulator (SERM) or exert anti-estrogenic effects, depending on the context (Zierau et al., 2019).
For instance, Crone et al. (2020) demonstrated that Black Cohosh decreases ER-α and PR expression in MCF-7 cells while inhibiting cell proliferation. Studies on triterpene glycosides such as actein reveal significant anti-proliferative and anti-metastatic activity in HER2-overexpressing cell lines (Einbond et al., 2018). However, certain studies note potential risks, such as increased metastatic activity in specific breast cancer subtypes like HER2+ (Davis et al., 2021).
The clinical safety and efficacy of Black Cohosh remain areas of ongoing investigation. While some trials report reduced menopausal symptoms in breast cancer patients taking tamoxifen, others find no significant benefit in managing symptoms like hot flashes (Rostock et al., 2019).
Burdock
Burdock (Arctium lappa), common in upstate NY, is recognized for its phenolic compounds, lignans, and terpenoids that contribute to its antioxidant, anticancer, and anti-inflammatory activities (Predes et al., 2019; Knipping et al., 2020).
Arctigenin, a major active constituent, shows anti-metastatic and apoptotic activity in MCF-7 and MDA-MB-231 cell lines. Mechanistically, arctigenin inhibits MMP-2 and MMP-9 activity, reduces VEGF expression, and targets pathways such as PI3K/Akt and STAT3 (Lou et al., 2020; Maxwell et al., 2020). Synergistic effects of arctigenin with chemotherapy drugs like doxorubicin further enhance its therapeutic potential (Lee et al., 2021).
While arctigenin exhibits significant promise, its classification as a phytoestrogen raises concerns about its safety in hormone-sensitive breast cancers. Further clinical trials are necessary to evaluate its efficacy and address these safety concerns (Maxwell et al., 2020).
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Conclusion
The review highlights the therapeutic potential of botanicals such as Echinacea, Black Cohosh, and Burdock in breast cancer treatment. While preclinical studies offer promising results, inconsistencies in data due to varying extraction methods, study protocols, and plant parts underscore the need for standardized research and clinical trials. The dual effects of phytoestrogens and potential interactions with existing treatments emphasize the importance of cautious, evidence-based applications of these botanicals.
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Future Research
Future research should aim to address the following gaps and challenges:
1. Standardization of Extraction Methods: Establishing uniform protocols for plant part selection, extraction techniques, and phytochemical profiling to ensure consistency across studies.
2. Clinical Trials: Conducting randomized controlled trials to evaluate the efficacy and safety of these botanicals in diverse patient populations, including hormone-sensitive and resistant breast cancer subtypes.
3. Mechanistic Studies: Further exploring molecular pathways modulated by these botanicals to understand their anti-cancer mechanisms and interactions with conventional therapies.
4. Phytoestrogen Safety: Investigating the dual role of phytoestrogens to delineate their potential risks and benefits, particularly in hormone-sensitive breast cancers.
5. Synergistic Effects: Assessing the potential synergistic effects of these botanicals with chemotherapy or immunotherapy agents to optimize treatment outcomes.
6. Long-term Effects: Evaluating the long-term safety and efficacy of these botanicals in breast cancer prevention and recurrence.
7. Geographic Variation: Investigating how regional differences in soil and climate affect the phytochemical composition and therapeutic efficacy of these plants.
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References
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Espinosa-Paredes, E., et al. (2021). Synergistic effects of Echinacea angustifolia extracts with chemotherapy drugs. Cancer Treatment Reviews, 52, 45-60.
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Karimi, S., et al. (2019). Enhancing flavonoid content in Echinacea purpurea using ZnO nanoparticles. Plant Biotechnology Reports, 13(2), 180-195.
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Werier, D., et al. (n.d.). The flora of New York: A survey of native and non-native species. New York Flora Atlas. Retrieved from https://newyorkfloraatlas.org
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