Wormwood in Crohn's disease.
Article Type: Report
Subject: Crohn's disease (Care and treatment)
Wormwood (Health aspects)
Wormwood (Usage)
Tumor necrosis factor (Properties)
Medicine, Botanic (Research)
Medicine, Herbal (Research)
Herb-drug interactions (Observations)
Author: Finney-Brown, Tessa
Pub Date: 06/22/2010
Publication: Name: Australian Journal of Medical Herbalism Publisher: National Herbalists Association of Australia Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 National Herbalists Association of Australia ISSN: 1033-8330
Issue: Date: Summer, 2010 Source Volume: 22 Source Issue: 2
Topic: Event Code: 310 Science & research Canadian Subject Form: Tumour necrosis factor
Geographic: Geographic Scope: Australia Geographic Code: 8AUST Australia
Accession Number: 232178431
Full Text: Krebs S, Omer T, Omer B. 2010. Wormwood (Artemisia absinthium) suppresses tumour necrosis factor alpha and accelerates healing in patients with Crohn's disease--a controlled clinical trial. Phytomed 17:5;305-9.

Increased levels of cytokines including tumour necrosis factor (TNF) alpha play an important role in the inflammatory process in Crohn's disease (CD). Accordingly TNF-alpha inhibitor drugs are now being utilised in conventional treatment of the condition. Although perhaps better known for its anthelmintic role, Artemisia absinthium (wormwood) has also been shown to suppress TNF-alpha and other interleukins in vitro.

In this pilot study participants in the active group included 10 randomly selected patients suffering from CD and another 10 CD patients selected as a control group. CD was previously verified by coloscopy with a minimum score of 200 on the Crohn's Disease Activity Index (CDAI) required at baseline for inclusion. Patients treated with infliximab or other TNF-alpha inhibitors were excluded. No patients had active parasitic, fungal or viral infections.

The active group were administered 250 mg dried powdered wormwood (dried leaves and stem) three times daily for 6 weeks in addition to their basic CD therapy. Control patients maintained their CD medications at baseline values. TNF-alpha was measured in serum at baseline after three and six weeks.

TNF-alpha fell significantly in the treatment group from 24.5 [+ or -] 3.5 pg/mL to 8.0 [+ or -] 2.5 pg/mL after six weeks. Levels in control group were 25.7 [+ or -] 4.6 pg/mL and 21.1 [+ or -] 3.2 pg/mL at the corresponding times. Clinically CDAI scores also fell by 70 points in the treatment group and only two points in the control. Wormwood administration was correlated with improved mood in CD patients as measured on the Hamilton Depression Scale. There were no dropouts and no adverse effects attributed to the wormwood.

As patients were almost refractory to treatment when entering the trial, such significant results are highly unusual. The researchers suggest that perhaps results are not simply due to TNF-alpha suppression, as drug treatments which also suppress this cytokine have not shown clinical improvements in refractory CD. Antiviral immunomodulation may have had an effect. Improvements in mood may have been attributable to TNF-alpha suppression as well as a direct antidepressant effect of Artemisia absinthium.

Wormwood may be a highly effective treatment in refractory CD, although further clinical studies are required to substantiate the results of this trial. Results may potentially be extrapolated to treatment of other TNF-alpha mediated disaesaes.

Tessa Finney-Brown mnhaa

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