Natural Medicines Newsletter
Volume 1, Issue 35, 09/17/2009
Question
Which herbs from Australia can inhibit the function of xanthine oxidase and could be used for the treatment of chronic hyperuricemia or gout?
Answer
The mainstay of pharmacologic treatment for most patients with chronic hyperuricemia, or gout, is the reduction of serum uric acid concentrations with inhibitors of xanthine oxidase (XO), such as allopurinol (Zyloprim®; Aloprim®) and febuxostat (Uloric®).(1-3) While the exact reason is unknown, the prevalence of gout is increasing worldwide.(4-6) This may in part be due to the increases in obesity and development of metabolic syndrome. Regardless, gout is a troubling disease for which herbal and natural medicines have been used for many years by patients from all parts of the world. In the last 10-20 years, research on many of these herbs from various parts of the world have revealed that many are able to inhibit the in-vitro activity of XO, which is known to convert hypoxanthine to xanthine and then xanthine to uric acid.
Given the rise in the use of herbal and natural medicines, it would be important for clinicians to be able to recognize which products may confer the same biological effect as other standard medications on the market. This is not only important so that proper education and counseling can be provided to patients, but to also avoid duplicating treatment with agents that exert similar biologic effects and/or that could cause life-threatening drug interactions (such as those that can occur when azathioprine mediated metabolism through XO is inhibited, thereby putting the patient at significant risk for bone marrow suppression).(7,8)
To the surprise of some clinicians there are too many herbs with inhibitory activity on XO to review in this one issue. As such, this issue will focus on those herbs derived from Australia.(9) Based on the inhibitory concentration (IC50) and the percent inhibition of XO at the concentration used for each herb, it would appear that the following herbs would have the greatest potential for a therapeutic effect in the treatment of hyperuricemia or gout....
The full answer to this issue contains a table summarizing all of the Australian herbs and their pharmacokinetic characteristics in the inhibition of xanthine oxidase.
.......To read the full answer please LOGIN or SUBSCRIBE NOW.
