Herbal Medicines

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Angelica Information - Drug Interactions, Uses and Benefits

Taxonomic Class

Apiaceae

Common Trade Names

The species Angelica sinensis, from which this agent gets its name, is known as dong quai or tang-kuei.

Common Forms

Available as cut, dried, or powdered root; essential oil; liquid extract; or tincture.

Source

Active compounds are derived from the fruits, leaves, rhizomes, and roots of many species of Angelica, a perennial in the parsley family that includes A. acutiloba, A. archangelica, A. astragalus, A. atropurpurea, A. dahurica, A. edulis, A. gigas, A. japonica, A. keiskei, A. koreana, A. polymorpha, A. pubescens, A. radix, and A. sinensis.

Chemical Components

Various coumarins (angelicin, bergapten, imperatorin, oreoselone, osthol, oxypeucedanin, umbelliferone, xanthotoxol, and xanthotoxin) have been isolated from different Angelica species. The phenolic compound ferulic acid has been obtained from A. sinensis. Decursinol angelate is purified from the root of A. gigas. Two chalcones (xanthoangelol and 4-hydroxyderricin) have been isolated from A. keiskei.

Other compounds have been isolated from the roots and fruits of A. archangelica, such as terpene hydrocarbons, alcohols, esters, lactones, aliphatic carbonyls, and other aromatic compounds. Polysaccharides, palmitic acid, and the flavonoid archangelenone have also been isolated. Other compounds found in the volatile oils include alpha- and beta-phellandrene, alpha-pinene, alpha-thujene, limonene, beta­carophyllene, linalool, borneol, acetaldehyde, and some macrocyc1ic lactones.

Actions

Antitumorigenic properties have been noted in several animals. Decursinol angelate has cytotoxic and protein kinase C-activating activities. In mice with skin cancer, chalcones from the root extract of A. keiskei exhibited potent antitumorigenic properties. Extracts from A. archangelica reduced the mutagenic effects of thiotepa in mouse bone marrow cells, and A. radix increased the production of tumor necrosis factor in mice. Several furanocoumarin compounds extracted from the root of A. japonica showed inhibitory activity against human adenogastric carcinoma (MK-1) cell growth .

Immunostimulatory properties were observed in vitro with angelan, a polysaccharide isolated from A. gigas. Angelan increased expression of interleukin (IL)-2, IL-4, IL-6, and interferongamma, resulting in activation of macrophages and natural killer cells involved in nonspecific immunity.

Anti-inflammatory and analgesic properties have also been noted.

Compounds isolated from the roots of A. pubescens inhibited centrally and peripherally mediated inflammatory substances. In vitro data show prominent inhibitory effects on both 5-lipoxygenase and cyclooxygenase .

Coumarin osthole inhibits platelet aggregation in vivo and in vitro . A. sinensis significantly inhibited thromboxane A 2 formation and mildly affected prostaglandin 1 2 production in animals compared with aspirin.

Angelica polysaccharide has been shown to promote the proliferation and differentiation of hematopoietic progenitor cells in healthy and anemic mice .

Coumarins and ferulic acid from A. dahurica root have antimicrobial actions . Two chalcones isolated from A. keiskei also showed antibacterial activity against gram-positive bacteria.

The aqueous extract of A. sinensis given LV. decreased myocardial injury and the incidence of premature ventricular contractions and arrhythmias induced by myocardial reperfusion. Puranocoumarins inhibited the in vitro binding of diazepam to CNS benzodiazepine receptors in rat cells .

A. sinensis and nifedipine improved pulmonary function and decreased mean arterial pulmonary pressures in chronic obstructive pulmonary disease patients with pulmonary hypertension. A. polymorpha has been found to selectively inhibit the production of allergic antibodies in asthmatics.

Uterine stimulant effects in the mouse and relaxation of the trachea in animals have been documented.

Polysaccharides isolated from the root of A. sinensis demonstrated dose-dependent protective effects on G1 mucosa in rats administered the gastric irritants ethanol and indomethacin.

Antihypertensive effects were observed in rats administered an ACE inhibitor compound extracted from A. keiskei .

A. astragalus reduced serum levels of total cholesterol and triglycerides to the same extent as pravastatin and further lowered levels of LDL cholesterol and apolipoprotein B in rats with puromycin aminonucleoside-induced nephrotic syndrome. Attenuation of renal injury also was observed, as evidenced by a reduction of the glomerular sclerosing index value in treated rats .

Reported Uses

This Chinese herb has been claimed to be of therapeutic usefulness for many disorders. It has been called a "cure-all" for gynecologic disorders and been promoted for such conditions as anemia, menstrual discomfort, and postmenopausal symptoms as a result of its purported estrogen-like effects and erythropoietic potential. No controlled studies have corroborated these benefits.

In a study of young women with leukorrhagia and insufficient luteal function, angelica root extract. in combination with several other Chinese herbs, regulated the menstrual cycle and reduced the severity of leukorrhagia.

Other claims include angelica's ability to improve circulation in the extremities; to treat anemia, backaches, and headaches; and to relieve asthma, eczema, hay fever, and osteoporosis.

Most studies of angelica have been conducted on animals, making it difficult to determine therapeutic benefits in humans.

Dosage

No consensus exists. Studies conducted with angelica used various concentrations of extracts, aqueous solutions, and powders, making identification of standardized dosage difficult.

Adverse Reactions

• CV: hypotension (from coumarins derived from A. pubescens).

• Hematologic: increased risk of bleeding (when used with such drugs as heparin and warfarin).

• Skin: phototoxicity (effect of furanocoumarins).

• Warfarin: Significantly prolonged PT when A. sinensis is administered with warfarin. Avoid use with angelica.

Contraindications And Precautions

Avoid using angelica in pregnant or breast-feeding patients because of potential stimulant effects on the uterus.

Special Considerations

Monitor the patient taking angelica for signs of bleeding, especially if he is also taking an anticoagulant.

Inform the patient that using angelica may increase the risk of cancer.

Urge the patient to promptly report signs of allergic reactions.

Advise the patient to take precautions against direct sun exposure while taking angelica preparations.

Points of interest

A atropurpurea last appeared in the USP around 1860.

Concerns have been raised regarding the potential carcinogenic risk of angelica, which led the International Fragrance Commission to recommend a limit of O. 78% angelica root in commercial preparations of suntan lotions.

Commentary

Although angelica is widely used in traditional Chinese medicine, its efficacy appears to be supported only by anecdotal evidence. The herb has been studied extensively in animal models, but scientifically valid human studies are lacking. Until more conclusive data are available, it is difficult to justify the therapeutic use of angelica for specific disorders.