Filipendula ulmaria / Moerasspirea

Moerasspirea, onze reumaplant, nuchter bekeken

Filipendula ulmaria is een overblijvende plant. Het wortelstelsel bestaat uit een dikke, vlak onder de grond kruipende wortelstok, met daaraan dunne uitlopers. De bladeren zijn samengesteld uit vijf paar ovale, 2-8 cm grote, bladeren. Moerasspirea bloeit van juni tot augustus met grote roomwitte, zoetruikende bloemtrossen, vandaar de Engelse benaming meadowsweet. De bloemetjes zelf zijn klein met 2-5 mm grote kroonblaadjes. Typisch zijn de mooi, gedraaide zaadjes.

Volksgeneeskundig gebruik
Als kruidenmiddel worden vooral de bloemen van Filipendula ulmaria gebruikt. Spiraeae flos, de gedroogde bloemen hebben geel-witte kroonbladeren. Ook wat gesloten bloemknoppen en enkele spiraalvormige vruchtjes worden in het gedroogde materiaal aangetroffen. De bloemen maar vooral de gekneusde stengels ruiken sterk naar methylsalicylaat en zijn door de aanwezigheid van looistoffen samentrekkend, verdrogend op de slijmvliezen. Het voelt aan alsof je heel lang gepraat hebt. In de vorm van een thee worden de bloemen gebruikt als ondersteunende behandeling bij verkoudheid; de bloemen hebben een diaforetische (zweetdrijvende) werking. Aan de bloemen worden ook urinedrijvende eigenschappen toegeschreven. Leclerc bijvoorbeeld, beschrijft het gebruik van moerasspirea bij verschillende vormen van oedeem (waterzucht) waaronder ascites, oedeemvorming in de ledematen en vochtophoping in de gewrichten. Dezelfde auteur meldt tevens gunstige resultaten te hebben verkregen bij verschillende patiënten met acute gewrichtsreuma.

In de volksgeneeskunde oa bij Broeder Aloysius word moerasspirea ook toegepast bij blaas- en nierontstekingen, en bij reuma en jicht. Filipendula ulmaria wordt ook beschouwd als een goede remedie bij verschillende stoornissen van het maag-darm kanaal; ingewandontstekingen en diarree zouden goed reageren op moerasspirea. Tenslotte wordt de plant uitwendig toegepast bij ontstekingen, (brand)wonden en insektenbeten.

Inhoudstoffen van Moerasspirea
De bloemen van moerasspirea zijn veruit het best onderzocht. De belangrijkste verbindingen in de bloemen zijn salicylzuurderivaten, zeg maar aspirinestoffen en flavonoïden. De salicylaten komen voornamelijk in de vorm van glycosiden voor; het zijn monotropitine, spiraeine en isosalicine. De flavonoïden die zijn geïsoleerd uit de bloemen zijn quercetine, rutine, hyperoside (quercetine-3-galactoside), avicularine (quercetine-3-arabinoside), spiraeoside (quercetine-4'-glucoside). In de bloemen is spiraeoside in de hoogste concentratie (3,5 %) aanwezig, in de bloemtoppen (met de nog ongeopende, groene bloemknoppen) is het gehalte aan spiraeoside en hyperoside het hoogst (respectievelijk 0,7 % en 0,6 %). Behalve salicylaten en flavonoïden zijn ook looistoffen aangetroffen in de bloemen. Volgens Steinegger en Casparis bevatten de bloemen 10,3% looistoffen.

Immuunmodulerende en anti-inflammatoire werking van Filipendula ulmaria
Gebaseerd op het volksgeneeskundig gebruik werd F. ulmaria getest in enkele immunologische proeven. Het waterige extract van de gedroogde wortels kenmerkte zich door een sterke remming van het complement systeem en een invloed op sommige leucocyten, witte bloedcellen.

Het complement systeem is een onderdeel van het aspecifieke afweersysteem in ons lichaam. Het bestaat uit meer dan twintig eiwitten in het bloedplasma. Complement-activatie vindt plaats door een cascade-gewijze activering van deze eiwitten, vergelijkbaar met het proces van de bloedstolling. Gedurende dit proces worden verschillende produkten gevormd die een belangrijke rol spelen bij de afweer.

Salicylaten in Moerasspirea
In de literatuur wordt de therapeutische activiteit van Moerasspirea toegeschreven aan de aanwezigheid van salicylzuurderivaten. Inderdaad vertonen salicylaten farmacologische activiteiten die de voor F. ulmaria beschreven therapeutische effecten kunnen verklaren . Salicylaten werken koortsverlagend. Dit antipyretische effect wordt veroorzaakt door een werking op het centrale zenuwstelsel (i.e. het temperatuur-regulerende centrum in de hypothalamus) en door een bloedvatenverwijdend effect op de bloedvaten met als resultaat een verhoogde warmte-afgifte. De koortsverlagende werking van salicylaten verklaart mogelijk het gebruik bij verkoudheid en griep. Behalve een antipyretisch effect bezitten salicylaten pijnstillende en anti-inflammatoire activiteiten. Deze kwaliteiten worden toegeschreven aan een remming van de prostaglandine-aanmaak. Daarnaast remmen salicylaten onder meer de histamine aanmaak en verminderen ze de opslag van leukocyten (witte bloedcellen) in het ontstekingsgebied. Deze analgetische en anti-inflammatoire eigenschappen van salicylaten zouden van betekenis kunnen zijn voor de toepassing van moerasspirea bij reumatische aandoeningen.

Een eenvoudige en smakelijke reumathee
  • Moerasspirea bloemen 50 gram
  • Berkenblad 25 gram
  • Zwarte besblad 25 gram
Bereidingswijze:
1 eetlepel per kopje, kokend water opgieten en 5 minuten laten trekken voor een smakelijke thee, of 10 minuten laten trekken voor een straffere werking. Werking is licht pijnstillend en ontstekingswerend, te gebruiken bij reumatische klachten.



Food Chem. 2013 Jun 1;138(2-3):1551-6. doi: 10.1016/j.foodchem.2012.10.074. Epub 2012 Nov 12.Inhibitory activity of Filipendula ulmaria constituents on recombinant human histidine decarboxylase. Nitta Y1, Kikuzaki H, Azuma T, Ye Y, Sakaue M, Higuchi Y, Komori H, Ueno H.
Histidine decarboxylase (HDC) catalyses the formation of histamine, a bioactive amine. Agents that control HDC activity are beneficial for treating histamine-mediated symptoms, such as allergies and stomach ulceration. We searched for inhibitors of HDC from the ethyl acetate extract of the petal of Filipendula ulmaria, also called meadowsweet. Rugosin D, rugosin A, rugosin A methyl ester (a novel compound), and tellimagrandin II were the main components; these 4 ellagitannins exhibited a non-competitive type of inhibition, with K(i) values of approximately 0.35-1 μM. These K(i) values are nearly equal to that of histidine methyl ester (K(i)=0.46 μM), an existing substrate analogue inhibitor. Our results show that food products contain potent HDC inhibitors and that these active food constituents might be useful for designing clinically available HDC inhibitors.

Bull Exp Biol Med. 2015 Mar;158(5):659-63. doi: 10.1007/s10517-015-2841-9. Epub 2015 Mar 17.
Nootropic effect of meadowsweet (Filipendula vulgaris) extracts.Shilova IV1, Suslov NI.
The effects of the extracts of the aboveground parts of Filipendula vulgaris Moench on the behavior and memory of mice after hypoxic injury and their physical performance in the open-field test were studied using the models of hypoxia in a sealed volume, conditioned passive avoidance response (CPAR), and forced swimming with a load. The extracts improved animal resistance to hypoxia, normalized orientation and exploration activities, promoted CPAR retention after hypoxic injury, and increased physical performance. Aqueous extract of meadowsweet had the most pronounced effect that corresponded to the effect of the reference drug piracetam. These effects were probably caused by modulation of hippocampal activity.

Eksp Klin Farmakol. 2008 Sep-Oct;71(5):32-6. [Effect of Filipendula ulmaria extract on immune system of CBA/CaLac and C57Bl/6 mice].
[Article in Russian]Churin AA, Masnaia NV, Sherstoboev EIu, Shilova IV.
Extract of Filipendula ulmaria (L.) Maxim administered intragastrically in doses 10, 50, 150 and 500 mg/kg stimulated both inductive and productive phases of the humoral immunity response in CBA/CaLac and C57BL/6 mice. The extract also exhibited pronounced antiinflammatory effect, which was manifested by a decrease in the synthesis of interleukin-2 by splenocytes and by suppression of proinflammatory cytokines production in delayed-type hypersensitivity reaction. At the same time, Filipendula ulmaria extract did not influence the functional activity of peritoneal macrophages.

In vitro immunomodulatory activity of Filipendula ulmaria
S. B. A. Halkes,C. J. Beukelman,B. H. Kroes,A. J. J. van den Berg,R. P. Labadie,H. van Dijk
First published: November 1997
Extracts of the roots, herb and flowers of Filipendula ulmaria (L.) Maxim. were investigated for in vitro immunomodulatory properties. Strong inhibitory activity was found towards the classical pathway of complement in the ethyl acetate extracts of roots and flowers, in all methanol extracts and in the aqueous root extract. Except for the light-petroleum extracts, all fractions tested inhibited the production of reactive oxygen species by human polymorphonuclear leukocytes. The diethyl ether root extract was found to be most potent in inhibiting lymphocyte proliferation. The role of tannins and other constituents in these processes are discussed. 



Meadowsweet
Native to Europe and Western Asia, Filipendula ulmaria has been called many different names over the years – Meadow Queen, Pride of the Meadow, Bridewort, Meadsweet, Dollof, Lady of the Meadow, Meadow-Wort, Queen of the Meadow, Mead Wort – but is it most commonly known as meadowsweet.
Originally appreciated due to its fragrant smell and pleasant flavor, this wild flower has traditionally been used for inflammation, pain, rheumatic arthritis, and colds and flu Typically the delicate white flower itself is used, but there are also some references to using the root. Today, research has been done which supports the use of meadowsweet as an anti- inflammatory. This may also make it an effective therapy for pain, fever, and arthritis.

Anti-Inflammatory Properties of Meadowsweet: Salicylates
The primary components in meadowsweet are salicylates: salicin, salicylaldehyde, and methyl salicylate.1 These compounds are oxidized in the digestive tract, forming salicylic acid, which is similar to aspirin (acetylsalicylic acid). It is believed that this may be the reason for its anti- inflammatory effects, as well as its ability to reduce fevers and provide relief from the aches and pains associated with the common cold. And, since inflammation is often a factor for rheumatoid arthritis, it may be effective as a support agent as well.
One study by the UCD Institute of Food and Health in Ireland looked at three different European herbs and detected effective anti-inflammatory concentrations in meadowsweet as well as a protective effect against oxidative damage.2 Since oxidative stress is a common feature in nearly every single human disease (including cancer and cardiovascular disease), this is an incredibly useful effect to have, and could have implications that medical science hasn’t uncovered yet.
A Russian study looked at water-alcohol extracts from meadowsweet and also confirmed that it showed that it was able to inhibit the development of the symptoms of inflammation – exudation, pain, fever – in a way similar to non-steroidal anti-inflammatory drugs (NSAIDS), such as aspirin. They believe that meadowsweet may be used to develop new therapies for different inflammatory conditions associated with severe pain syndrome.3

Arthritis and Salicylates
Salicylates are often prescribed as therapy for inflammatory arthritis, a group of diseases that includes rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and other types of spondyloarthritis. These diseases make your joints swollen, stiff, and painful. With rheumatoid arthritis, the joints in your hands and feet are particularly affected, and with ankylosing spondylitis, the joints of the spine are typically the main target.
Unfortunately, there is no cure for these diseases at this time so the goal is to improve patients’ ability to move by relieving pain and stiffness. Salicylates such as aspirin are still preferred by many doctors.4 They can reduce inflammation and relieve joint pain safely 5 by decreasing the production of prostaglandins which cause the pain and inflammation.
Since salicylates are main components of meadowsweet, they may be an effective alternative therapy to the traditionally prescribed aspirin.

Recommended Use of Meadowsweet
The German Commission E, an agency which regulates the medicinal use of herbs similar to how the FDA regulates drugs in the United States, recommends daily use of 4 to 5 grams of the herb or 2.5 to 3.5 grams of the flower, usually in a tea or infusion.6
Due to its similarities to the drug, those who have sensitivity to aspirin should avoid using meadowsweet, and it should also not be used by children since it may lead to Reye’s syndrome.

1 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press, 1996,
2 Drummond, Harbourne, Marete, Martyn, Jacquier, O'Riordan, Gibney, Inhibition of Proinflammatory Biomarkers in THP1 Macrophages by Polyphenols Derived From Chamomile, Meadowsweet and Willow bark, 2012. http:// www.ncbi.nlm.nih.gov/pubmed?term=meadowsweet%20arthritis
3 Nesterova, Povet'eva, Aksinenko, Suslov, Gai(damovich, Nagorniak, Popova, Kravtsova, Andreeva, Evaluation of anti-inflammatory activity of extracts from Siberian plants, 2009. http://www.ncbi.nlm.nih.gov/pubmed/20017405


Assessment report on Filipendula ulmaria (L.) Maxim., herba and Filipendula ulmaria (L.) Maxim., flos 

1.1. Description of the herbal substance(s), herbal preparation(s) or combinations thereof

Herbal substance(s)
Filipendulae ulmariae herba consists of the whole or cut, dried flowering tops of Filipendula ulmaria (L.) Maxim. (syn.: Spiraeae ulmaria (L.)). The material complies with the Ph. Eur. 6th ed. monograph (ref.:01/2008:1868).
For Filipendulae ulmariae flos, no Ph. Eur. monograph is available. Descriptions are derived from Wichtl (1994) and the Complete German Commission E. (Blumenthal et al., 1998). Wichtl defines Spiraeae flos as the dried flowers of Filipendula ulmaria (L.) Maxim. and provides extensive macroscopic and microscopic descriptions. According to the Commission E monograph, Spiraeae flos consists of the dried flower of Filipendula ulmaria (L.) Maxim. (syn.: Spiraeae ulmaria (L.)) as well as its preparations in effective dosage (Blumenthal et al., 1998).
In the European countries, Filipendula ulmaria is designated as follows: English: Meadowsweet, Bittersweet, Bridewort, Goat’s beard, Honey-sweet, Queen of the meadows, Sweet hay; French: Reine des prés, Barbe de bouc, Barbe de chèvre, Belle des prés, Ulmaire; German: Echtes Mädesüβ, Bocksbart, Geiβbart, Spierstaude, Sumpfkraut, Wiesenkönigin; Dutch: Moerasspiraea, Bloeiende olm, Geitenbaard, Kamerkruid, Koningin der weide, Olmkruid, Torkruid (Halkes, 1998).

Constituents: (Wichtl, 1994; Zeylstra, 1998; ESCOP, 2003; Barnes et al., 2007):
The European Pharmacopoeia requires minimum 1 ml/kg of steam-volatile substances for Filipendulae ulmariae herba.
  • Salicylates are the main components of the volatile oil, mainly salicylaldehyde (up to 70%). According to ESCOP monograph, “Steam distillation of the dried flowers yields a small amount (0.2%) of volatile  oil arising from the phenolic glycosides during drying and storage.”
  • The amount of salicylates, mostly present in the form of glycosides, is assumed to be less than 0.5% (Zeylstra, 1998; ESCOP, 2003).
  • Flavonoids: from 3-4% in the flowering herb up to 6% in the fresh flowers, in particular spiraeoside (quercetin-4’-glucoside), also hyperoside, other quercetin and kaempferol derivatives, as kaempferol- 4’-glucoside.
  • Tannins: hydrolysable type, ranging from 1% in ethanolic extracts to 12% in aqueous extracts, predominantly the dimeric compound rugosin D.
  • Miscellaneous: coumarin (trace), mucilage, carbohydrates, ascorbic acid.

Herbal preparation(s)
Herb1:
a1) Comminuted herbal substance for tea preparation
a2) Powdered herbal substance
b1) Dry extract (DER unknown), water

1
 For details please refer to ‘Qualitative and quantitative composition in the Monograph on Filipendula ulmaria herba or
indications 1-4 as specified under section 2.2, page 10 and section 2.3, page 11/12 of this AR. 
Assessment report on Filipendula ulmaria (L.) Maxim., herba and Filipendula ulmaria
(L.) Maxim., flos
EMA/HMPC/434892/2010 Page 4/18
b2) Dry extract (DER unknown), water (may be identical to b1)
b3) Liquid extract (1:1; ethanol 25% V/V)
c) Tincture (1:5; ethanol 45% V/V)
Flowers2:
a1) Comminuted herbal substance for tea preparation
b) Dry extract (DER unknown), ethanol (concentration unknown)
 Combinations of herbal substance(s) and/or herbal preparation(s) including a description ofvitamin(s) and/or mineral(s) as ingredients of traditional combination herbal medicinal products assessed, where applicable.
A ccording to the British Herbal Pharmacopoeia (1974/1983), Filipendulae ulmariae herba is used incombinations with Althaea officinalis and Melissa (for gastric conditions), and with Ballota (antiemetic).
At present, combination products containing Filipendulae ulmariae herba are on the market in several EU Member States, amongst others: Czech Republic (combinations with Salicis cortex, Violae tricoloris herba, Harpagophyti radix, Equiseti herba, Solidaginis herba, Callunae herba, herbal tea for oral use; indications 1) as an adjuvant for inflammatory and degenerative diseases of locomotors apparatus (rheumatism, arthrosis, arthritis and gout; 2) adjuvant therapy in flu like symptoms; France (about 10 combination products as herbal teas; indications 1) Traditionally used to promote urinary and digestive elimination functions; 2) Traditionally used as analgesic (headache, toothache); 3) Traditionally used in the symptomatic treatment of minor painful joint conditions, and Spain (in combination products as herbal teas)2.

Filipendulae ulmariae flos is an ingredient of 6 herbal teas in Germany, each one consisting of Filipendulae ulmariae flos, Tiliae flos and Sambuci flos. According to Wichtl (1994), the flowers are a component of some mixed herbal teas as remedies for influenza, rheumatism and kidney-bladder. Inthe UK, some multi-ingredient products containing the flowers or extracts are on the market. 

Historical data on medicinal use
The medicinal use of Filipendula ulmaria has been described from the late 16th and 17th century(Halkes, 1998). In general, preparations from herb and/or flowers have been used traditionally ininflammatory diseases (Madaus, 1938; Gessner and Orzechowski, 1974; Van Hellemont, 1988; Wichtl,1994; Zeylstra, 1998; Halkes, 1998) and as a diuretic (Madaus, 1938; Gessner and Orzechowski,1974; Van Hellemont, 1988; Wichtl, 1994; Zeylstra, 1998; Halkes, 1998). Zeylstra (1998) concludes,that the uses of Filipendula shifted over the years from a diuretic towards an antirheumatic. 

In most the literature sources, mainly herbal tea preparations are described, however, Van Hellemont(1988) also mentions a tincture. A tincture (1:5 in 45% V/V alcohol) of the herb is used againstrheumatic muscle and joint pains (British Herbal Pharmacopoeia, 1974). A product containing 250 mg of dried, powdered flowering tops in hard capsules was authorised in France in 1988 as a traditionally used medicine in the symptomatic treatment of minor painful articular conditions and to facilitate renal and digestive elimination functions. This product has been on the market since 1980 and was already mentioned in a price list dated January 1981 of the French firm Laboratoires Arkochim. Dry aqueous extracts of the herb in capsules containing 200 mg (indications: “traditionally used as an analgesic (headache, toothache)” and “traditionally used in the symptomatic treatment of minor painful articular conditions”) have been marketed since 1986. Sachets containing 1.5 g of a fragmented herb have been marketed since 1990 as a traditionally used medicine in the symptomatic treatment of minor painful joint conditions. In some countries of the EU, tinctures or possible tincture-based products containing alcoholic extracts of Filipendula herba are on the market as food supplements used for complaints such as rheumatic and arthritic pain.

Overview of available pharmacological data regarding the herbalsubstance(s), herbal preparation(s) and relevant constituents thereof
Anti-inflammatory and antipyretic activity and related effects; effects on gastric ulcers
An aqueous leaf extract was reported to inhibit both prostaglandin biosynthesis and platelet activationfactor (PAF)-induced exocytosis/release of elastase (Tunón et al., 1995). The elastase inhibitingproperties of 50% (V/V) ethanolic flower and leaf extracts were attributed to the presence of tannins (Lamaison et al., 1990).
Methanolic flower extracts (with flavonoids as main constituents) demonstrated to strongly inhibit xanthine oxidase activity in vitro (Kazazi et al., 2009).
Preparations of Filipendulae ulmariae flos have been reported to cause lowering of motor activity andrectal temperature, myorelaxation and potentiation of narcotic action (Barnaulov et al., 1977), to prolong life expectancy of mice, lower vascular permeability and prevent the development of stomach ulcers in rats and mice (Barnaulov et al., 1977; Halkes, 1998).
Antiulcerative effects were also documented for other parts of the plant (Halkes, 1998; Barnes et al., 2007). On the other hand, a flower decoction appeared to potentiate the ulcerogenic properties of histamine in guinea-pigs. The greatest anti-ulcer activity is associated with aqueous flower extracts (Halkes, 1998; Barnes et al., 2007). Orally administered flavonoids, as well as flower extracts from Filipendula ulmaria, appeared to have a protective effect against reserpine-induced lesions of the rat
stomach (Halkes, 1998).

Immunomodulatory activity
Different extracts of both herb and flowers were shown to strongly inhibit luminol-dependent chemiluminescence, T-cell proliferation and the classical pathway of the complement system; the latter activity appearing not to be attributable to tannins (Halkes et al., 1997a). From a range of flower extracts, prepared with different solvents, the ethyl acetate extract was found to exert the strongest inhibition towards the classical pathway of complement activation. The active compounds, however,  were not identified (Halkes et al., 1997b). A flower decoction has been documented to enhance the growth-stimulating activity of mice peritoneal macrophages, both in vitro and in vivo (Bespalov et al., 1992).

Antibacterial activity In vitro bacteriostatic activity of several 70% ethanolic and aqueous flower extracts against a range of urinary tract pathogens have been described (Halkes, 1998; ESCOP, 2003; Barnes et al., 2007). Growth-inhibitory effects (in vitro) against a variety of bacteria were also demonstrated for a combination of 70% ethanolic and aqueous extracts (Csedõ et al., 1993). 

Anticarcinogenic activity Flower decoctions have been reported to show anticarcinogenic activity against chemically induced tumours in rats and mice (Bespalov et al., 1992; Halkes, 1998) and against transplanted tumours in mice (Bespalov et al., 1992). Isolated rugosin D displayed antitumour activity against transplanted tumours in mice (Miyamoto et al., 1987). 

Other effects An increase of bronchial tone in cats and a potentiation of bronchospastic properties of histamine in guinea-pigs by ethanolic and aqueous preparations of Filipendulae ulmariae flos have been observed (ESCOP, 2003; Barnes et al., 2007). Furthermore, in vitro enhancement of intestinal tone in guineapigs and of uterine tone in rabbits has been described (Barnes et al., 2007). A heparin-like complex from the flowers showed in vivo anticoagulant and fibrinolytic properties in animals after intramuscular and intravenous injection (Kudriashov et al., 1990; Kudriashov et al., 1991). Isolated rugosin D demonstrated to possess a high capacity for binding to bovine serum albumine (BSA) in vitro (Beart et al., 1985; ESCOP, 2003). 

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