Other Medical Problems and Effects

1.7.4 Other Medical Problems and Effects

Ma huang has traditionally been used to treat cough and respiratory infection. However, the latest studies suggest that there may be other reasons for treating respiratory infections with ephedra; it

contains a compound that, in the test tube at least, has antibiotic properties. It is a quinoline alkaloid (4- quinolone-2-carboxylic acid), isolated from the aerial part of Ephedra transitoria by column chromatography, and called transtorine. It inhibits growth of common bacteria, such as Enterobacter cloacae, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus (A1-Khalil et al., 1998). Unfortunately, there have been no clinical trials.

In addition to possessing antibiotic activity, extracts of Ephedra sinica cause a partial inhibition of serum complement activity, specifically inhibiting C2 complement (Ling et al., 1995). Traditional Chinese herbalists have always claimed that ma huang could be used to treat arthritis, and although clinical trials are still lacking, it appears that these claims could have a solid scientific foundation. One problem in establishing efficacy is that traditional herbalists usually combine ephedra with other herbs. In vitro studies have shown that an ephedrine containing remedy called shinpi-to, which also contains Prunus armeniaca. Magnolia obovata, Citrus unshiu, Glycyrrhiza uvalensis, and Bupleurum falcatan, inhibits immunoglobulin E (IgE) mediated leukotriene In addition to possessing antibiotic activity, extracts of Ephedra sinica cause a partial inhibition of serum complement activity, specifically inhibiting C2 complement (Ling et al., 1995). Traditional Chinese herbalists have always claimed that ma huang could be used to treat arthritis, and although clinical trials are still lacking, it appears that these claims could have a solid scientific foundation. One problem in establishing efficacy is that traditional herbalists usually combine ephedra with other herbs. In vitro studies have shown that an ephedrine containing remedy called shinpi-to, which also contains Prunus armeniaca. Magnolia obovata, Citrus unshiu, Glycyrrhiza uvalensis, and Bupleurum falcatan, inhibits immunoglobulin E (IgE) mediated leukotriene

An area of very major interest is weight loss. Appetite control is impaired in the obese, especially when diets are fat rich and energy dense. Many obese people have a lower than expected resting metabolic rate, a deficiency that may be genetically controlled. Agents that stimulate adrenergic neurons inhibit hunger and stimulate energy expenditure, lipolysis, and fat oxidation, which is why combinations of ephedrine and caffeine have been evaluated in clinical trials. In most of the trials, the combination has been shown to induce weight loss (Astrup and Lundsgaard, 1998). The mechanism by which this reduction occurs is not known, but it is believed to involve the stimulation of a family of β -receptors, thereby causing increased energy expenditure (and therefore calorie consumption). The most exciting

new work in this area suggests that stimulation of some β -receptors may lead to the production of a group of proteins (called uncoupling protein, or UCP1,2, and 3) that can uncouple ATP production from mitochondrial respiration, resulting in the dissipation of energy as heat. Studies with Pima Indians have shown that the greater the degree of UCP3 expression, the lower the body mass index (Schrauwen et al., 1999). Obviously, much more needs to be known.