Review Article

Echinacea purpurea - A potent medicinal herb

Daniel Silas Samuel1, S. Pavithra Priyadarshoni*2

ABSTRACT

Echinacea purpurea, a plant used by native Americans to treat respiratory infections, was evaluated for its ability to stimulate
the production of cytokines by normal human peripheral blood macrophages in vitro. The high levels of IL-1, tumor necrosis
factor-α (TNF-α), and IL-10 induced by very low levels of Echinacea are consistent with an immune-activated group of
herbaceous flowering plants in the daisy family, Asteraceae. The nine species it contains are commonly called coneflowers.
Echinacea is a potent immune booster. E. purpurea is one of the most well-known medicinal plants in the world, belonging
to the Asteraceae (composite) family. The plant is widely cultivated for its medicinal purposes in this species, which has
been mainly used in chemopreventive and chemotherapy for infectious diseases in both upper and lower respiratory systems.
This species has been used for the treatment of toothache, bowel pain, snake bite, skin disorders, seizure, chronic arthritis,
and cancer. Alkamides, caffeic acid derivatives, and polysaccharides (PS) have been important constituents of the plant.
Several studies revealed that alkamides are involved in the immunomodulatory properties of Echinacea extracts in vitro and
in vivo. The PS play an important role in the anti-inflammatory effect. Taxonomic, chemical, pharmacological, and clinical
characteristics of some species of the Echinacea genus include Echinacea angustifolia, Echinacea pallida, and E. purpurea
are reviewed in previous papers. This paper is a review about E. purpurea, its phytochemical contents, and pharmacological
and biological activities, along with the common methods of plant extract analysis which is reviewed in this review. In
addition, the psychoactive and mosquitocidal effects of purpurea are mentioned in this paper.

KEY WORDS: Active components, Echinacea and its species, History, Introduction, Medicinal uses, Pharmacological
actions

INTRODUCTION
Echinacea is a traditional herbal plant used from
ancient times.[1] It is a nature’s wonder which is used to
treat cough and several infections from ancient times
when modern medicines were not available. Even
now it is useful in various treatments due to its limited
side effects and contraindications. It is commonly
called as English medicine as it was used initially by
Americans.[2]
ECHINACEA ANATOMY
Echinacea is herbaceous species which is drought-
tolerant perennial plants growing up to 140 cm or
possibly 4 feet in height.[3] They grow from taproots,
except E. purpurea, which grows from a short caudex
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along with fibrous roots. They have erect stems which
are unbranched in most echinacea species. Both the
basal and cauline leaves are arranged alternatively.[4]
The leaves are normally hairy with a rough texture,
having uninervate trichomes (1–4 rings of cells), but
sometimes they lack hairs. The basal leaves and the
lower stem leaves have petioles, as the leaves progress
up the stem, the petioles often decrease in length. The
leaf blades of different species may have one, three, or
five nerves. Some species have linear- to lanceolate-
shaped leaves, and others have elliptic- to ovate-
shaped leaves, often the leaves decrease in size as they
progress up the stems, and the flowering structure is of
composite inflorescence, with purple (rarely yellow or
white) florets arranged in prominent manner, somewhat
cone-shaped, because the petals of the outer ray florets
tend to point downward once the flower head opens,
thus forming a cone.[5] Plants are generally long-lived,
with distinctive flowers and also called as sea urchin
because it resembles the shape of a plant.

1
Department of Public Health Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical
Sciences, Saveetha University, Chennai, Tamil Nadu, India, 2Department of Public Health Dentistry, Saveetha Dental
College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India

*Corresponding authors: S. Pavithra Priyadarshoni, Department of Public Health Dentistry, Saveetha Dental College,
Saveetha Institute of Medical and Technical Sciences, Saveetha University, 162, Poonamallee High Road, Vellapanchavadi,
Chennai - 600 077, Phone:+91-9176222104. E-mail: drpavithraphd88@gmail.com

Received on: 22-11-2018; Revised on: 18-12-2018; Accepted on: 16-01-2019

448 Drug Invention Today | Vol 11 • Issue 2 • 2019

 Daniel Silas Samuel and S. Pavithra Priyadarshoni
SPECIES
There are nine species under Echinacea [6]
•E. angustifolia - Narrow-Leaf Coneflower.
•Echinacea atrorubens - Topeka Purple Coneflower.
•Echinacea laevigata - Smooth Coneflower and
Smooth Purple Coneflower.
•E. pallida - Pale Purple Coneflower.
•Echinacea paradoxa - Yellow Coneflower and
Bush’s Purple Coneflower.
•Echinacea purpurea - Purple Coneflower and
Eastern Purple Coneflower.
•Echinacea sanguinea - Sanguine purple Coneflower.
•Echinacea simulata - Wavyleaf Purple Coneflower.
•Echinacea tennesseensis - Tennessee Coneflower.
HISTORY
E. angustifolia was widely used by the North American
since 1600 and Plains Indians for its general medicinal
qualities.[7] The term Echinacea was derived from
“Echinos” which was of Greek origin. Echinacea was
one of the antimicrobial herbs for eclectic medicine. It
was mainly used as an alternate for snake bite, anthrax,
and to relieve pain. Although Native American tribes
did not use Echinacea to prevent common cold,
some Plains tribes did use Echinacea to treat some
of the symptoms that could be caused by common
cold, the Kiowa used it for purpose of coughs and
sore throats, the Cheyenne for sore throats, and the
Pawnee for headaches. Native Americans learned that
E. angustifolia was consumed by the elk when sick or
wounded and so identified those plants as elk root.[8]
Echinacea is also called as perennial herbs, Indian head,
comb flower, and hedgehog. It is available in tablets,
liquids, capsules, and spray dried powder forms.
ACTIVE COMPONENTS
The active components of Echinacea include three
major groups and one minor group which are as follows:
• Caffeic acid derivatives.
• Polysaccharides (PS).
• Lipophilic components.
• Volatile oil.
Caffeic Acid Derivatives
Echinacoside is a caffeic acid derivative which
was extracted from the root of E. angustifolia and
E. pallida. Another derivative cichoric acid had been
extracted from the roots of E. pallida, E. purpurea, and
E. angustifolia. These are water-soluble components
with weak antibacterial and weak immunological
activity. Cichoric acid stimulates phagocytosis and
was a stable component in E. purpurea.[9]
PS
Two immune stimulatory PS I and PS II were isolated
from the aerial parts of E. purpurea. The former
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was composed of glucuronic acid and sugars such
as arabinose and xylose-4-o-methyl glucurono-
arabinoxylan, whereas the latter was composed of
acidic arabino rhamnogalactan and sugars such as
arabinose, rhamnose, and galactose. Xyloglucan
(glucose xylose polymer) was also isolated from
the leaves and stems of E. purpurea. Their chemical
components were of two types such as primary and
secondary metabolites. The primary metabolites were
essential for life processes and provide important
structural element for plants and the secondary one
plays a defensive or adaptive role for plants in its
natural environment.[9]
Lipophilic Components
They include two main groups, namely polyacetylenes
and alkylamines. E. pallida has high levels of unique
polyacetylenes mainly ketoalkenes and alkenes which
gives earthy metallic taste to the plant. Alkyl amides
isolated from roots and aerial parts of E. angustifolia
and Purpurea are absent in Pallida, which is
responsible for the tingling sensation on the tongue.
Echinacea was composed of highly unsaturated
carboxylic acid often with triple carbon-carbon bonds
and an amine compound either isobutyl amine or
2-methyl butylamine which is broken during digestion.
Echinacea powders derived from roots should not be
stored for prolonged periods due to the oxidation of
polyacetylenes and alkylamines.[10]
Volatile Oil
Above ground parts of Echinacea have less oils
and pyrrolizidine alkaloids such as tussilagine and
isotussilagine than root parts. It also contains borneol,
bornyl acetate, pentadeca 8-(z)-en-2-one, germacrene
D, caryophyllene, and caryophyllene epoxide.[11]
PHARMACOLOGICAL ACTIONS
Anti-Inflammatory
Echinacea derived from alkamides have
immunomodulatory and anti-inflammatory activity.
Alcohol extracts of Echinacea inhibit thje production
of inflammatory mediators such as tumor necrosis
factor and nitric oxide. Prostaglandin E2 (PGE2) plays
an important role as a critical inflammatory mediator
through cyclooxygenase (COX)-1 and COX-2 by
suppressing the activation of PGE2 by enzyme
phospholipase A. Arachidonic acid acts as a catalyst
in this mechanism. Wager reported that lipoxygenase-
inhibiting anti-inflammatory activity was attributable
to E. purpurea’s isobutyl amide and decatetraene
acid.[12]
Antioxidant
Caffeic acid derivative is effective antioxidants in
generating free radicals and have anti-hyaluronidase
activity. Hu and Kitts investigated antioxidant and free
449
 Daniel Silas Samuel and S. Pavithra Priyadarshoni
radical scavenging activity including suppression of
oxidation of human low-density lipoprotein.[13]
Anti-Immunosuppressant
Echinacea stimulates immune function by enhancing
T-lymphocytes activity. It stimulates neutrophils and
macrophage-induced phagocytosis. It also possesses
short-term, non-specific immune system stimulant
properties. The expression of cytokines gene and
some of their properties in bronchial epithelial cells
can be reversed by E. purpurea, and it stimulates the
release of interleukin IL-1.[14]
Anti-Fungal Activity
E. purpurea had been used in the treatment of
fungal infections caused by candida species, various
Saccharomyces cerevisiae, and Candida albicans. The
root and herbal extracts are used for the treatment.
Phagocytosis of candida by human macrophages
and natural killer cells is increased on exposure to E.
purpurea. It also decreases the recurrence of vaginal
candidiasis over 6 months’ period.[15]
Antiviral Activity
Benzalkonium chloride and photochemical derived from
E. purpurea have antiviral activity against herpes virus
and influenza virus by inhibiting viral replication. It also
prevents and controls upper respiratory tract infection
(URTI) and turner has recently reviewed a human trial,
testing the efficacy of Echinacea in preventing colds,
induced by a cultured rhinovirus. Furthermore, there
are no reports on Echinacea. purpurea in relation to
human immuno deficiency virus.
MEDICINAL EFFECTS
Marketed and analyzed medicinal products contain
different species (E. purpurea, E. angustifolia, and
E. pallida), different parts (roots and herbs), and
different preparations (extracts and expressed juice).
Each has their own chemical compositions.[16,17,9]
In cold:
There is no firm evidence that Echinacea products
provide any benefit in treating or preventing the
common cold, although there is some possibility
of weak benefit.[17]
In cancer:
Some therapists believe that Echinacea can help
relieve side effects from cancer treatments caused
by chemotherapy and radiotherapy. However, this
has not been proved either.[18]
In chronic obstructive pulmonary disease (COPD):
E. purpurea combined with zinc, selenium, and
Vitamin C may reduce exacerbation of symptoms
caused by URTI in COPD.
450
In dentistry:
Used to treat toothaches, gum infection, and
inflammation.[19]
Immune booster:
Effective against flu, urinary tract infection (UTI)
(gives immediate relief to burning sensation),
genital herpes, bloodstream infection, tonsillitis,
streptococcus infection, syphilis, diphtheria, typhoid
and malaria.
According to MedicinePlus, Echinacea signals the
immune system to attack infection and flush the
bacteria out of the body by speeding up the urine flow
in UTI.[20]
POPULAR USE OF ECHINACEA
Echinacea is popularly believed to be an immune-
stimulator, stimulating the body’s non-specific immune
system and warding off infections and being used as a
laxative. A study commonly used to support this belief
is a 2007 meta-analysis from “The lancet infectious
diseases.” It was commonly used for treating colds,
toothaches, snakebites, headache, and wound infection.
Chemical Substances
Like most unrefined drugs derived from plant or
animal origin, the constituent for Echinacea is complex
consisting of a wide variety of chemicals of variable
effect and potency. Some chemicals are directly
antimicrobial, while others may work at stimulating
or modulating different parts of the immune system.
All species have chemical compounds mainly the
phenols, which are common to many other plants.
Phenyl propanoic constituents such as cichoric acid
and caftaric acid are present in E. purpurea, and other
phenols include echinoid, a caffeic acid glycoside,
which is found in greater levels within E. angustifolia
and E. pallida roots than in other species. Many
caffeic acid derivatives are ubiquitous plants which
produce specific effects other than antioxidant
activity. Although the phenolic constituents are poorly
absorbed and have no dose-response relationship in
clinical settings, their relative proportions can serve as
markers for species identification and quality control
of herbal remedies. Other chemical constituents that
are important in Echinacea health effects include alkyl
amides and PS. As with herbal preparation, individual
doses may vary significantly in active chemical
composition. Also, poor process control may affect
inter-and intra-batch homogeneity, extraction methods
and contamination among products.[21]
Side Effects
Echinacea has no side effects when consumed by
mouth. One of the most extensive and systematic
studies to review the safety of Echinacea has adverse
Drug Invention Today | Vol 11 • Issue 2 • 2019
 Daniel Silas Samuel and S. Pavithra Priyadarshoni
events which are rare, mild, and reversible, with
the most common symptoms being gastrointestinal
and skin related. Such side effects include nausea,
abdominal pain, diarrhea, itch, and rash. Echinacea has
rare allergic reactions, including asthma, shortness of
breath, and one case of anaphylaxis. Muscle and joint
pain have been associated with Echinacea, but it may
have been caused by cold or flu symptoms, for which
the Echinacea products were administered.[22] There
are isolated case reports of rare and idiosyncratic
reactions including thrombocytopenic purpurea,
leukopenia, hepatitis, renal failure, and atrial
fibrillation. The use in children below 1 year of age is
contraindicated, because of possible undesirable side
effect on immature immune system. The use in children
between 1 and 12 years of age is not recommended
because efficacy has not been sufficiently documented
and specific risks are not documented.
OTHER USES
Some species of Echinacea, notably E. purpurea,
E. angustifolia, and E. pallida, are grown as ornamental
plants in gardens.[23] Many cultivars exist, and many of
them are asexually propagated to keep them true to
type. Echinacea extracts inhibited the growth of three
species of trypanosomiasis: Leishmania donovani,
Leishmania major, and Trypanosoma brucei.
CONTRAINDICATIONS
It is contraindicated in leukemia, collagen disorders,
multiple sclerosis, and autoimmune diseases. Some
Echinacea products are strictly contraindicated in
HIV-infected patients.[24]
Combined Marketing Products
• These include authorized Echinacea products
marketed in UK, the Europe, and other states.
These contain a combination of purple coneflower
herb tincture (dry extract) from E. purpurea, herba
recens.
• Extraction solvent-ethanol 65% v/v (1:12) and
tincture from E. purpurea and radix recens-ethanol
(65%) v/v (1:11) 95:5, in tablet, oral drops and
solutions.
INDICATIONS
Treatment and prevention of common cold symptoms
such as coughing, lacrimation, sore throat, headache
and muscle pain, flu accompanied by recurring
infection, and fever.[25]
• Tincture from E. purpurea, herba recens (extraction
solvent: ethanol 65% v/v DER 1:12), tincture form
E. purpurea, radix recens (extraction solvent-
ethanol 65% v/v, DER 1:11), tincture from Salvia
Drug Invention Today | Vol 11 • Issue 2 • 2019
officinalis, and folium recens (extraction solvent-
ethanol 68% v/v DER 1:17) are used as or mucosal
spray.
Indications: Symptomatic treatment of inflammation
in mouth and pharynx.[26]
CONCLUSION
Even though Echinacea has numerous medicinal value,
it is only used to treat symptoms but not the cause of
a disease. Numerous researches are still undergoing
to understand the pharmacological actions and uses
of Echinacea. Its uses in AIDS remain a puzzle. Still,
Echinacea is considered as nature’s treasure from
ancient times. It was mostly taken by people to treat
cold.
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Source of support: Nil; Conflict of interest: None Declared
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