Althaea rosea / Stokroos

Common names : English name : garden Hollyhock , Arabic name : Khatma wardi , Khatmi wardi.

Distribution : It is native to China , southern Europe , the Middle and Near east , Mediterranean and central
Asian regions. The plant grows best in medium-fertile, moist, but well-drained soil. The plant can not grown in
the shades. It can be found in woodlands, cultivated beds and sunny edges.

Traditional use: It is used as expectorant, cooling and diuretic, cough mixtures, and emmenagogue. Decoction
of flowers is used as anti-inflammatory, febrifuge, demulcent and astringent agent. As a demulcent and
astringent, the roots are useful in the treatment of ulcers. Flowers as well as roots are used in the treatment of
inflammation of the kidneys and the uterus. Seeds are thought to be diuretic and febrifuge(41-43). 

Physicochemical properties(11)
Total ash 7.3 ± 0.32 %, acid insoluble ash 1.48 ± 0.16 %, water soluble ash 3.33 ± 0.24 %, and loss on drying
in crude drug (%) 8.2 ± 0.38 % .
Successive extraction (% Extractable matter) : petroleum ether extract 8.18 ± 0.85 %, chloroform extract 2.76
± 0.12 % , methanol extract 3.63 ± 0.32 % , and aqueous extract 11.24 ± 0.14 % .

Chemical constituents:
Althaea rosea contained high molecular weight acidic polysaccharides (1.3 to 1.6 million Dalton) known as
mucilages which found in flowers and leaves. These mucilages were composed of glucoronic acid, galacturonic
acid, rhamnose and galactose(12). Fahamiya found that aqueous extract of the seeds of Althaea rosea Linn contain alkaloids, carbohydrates, phenolic compounds and flavonoids, while methanolic extracts contained all the above compounds as well as
glycosides . However, chloroform extract contained only carbohydrate(11). 

Dudek et al investigated the distribution of phenolic acids in the flowers of Althaea rosea var. nigra . They studied the methanolic and methanolic-aqueous extracts of whole flowers, petals and calyxes of Althaea rosea (L.) Cav. var. nigra. They found that the plant contained, cinnamic (ferulic, p-coumaric, caffeic), benzoic (p- hydroxybenzoic, vanillic, syringic) acids and p-hydroxyphenylacetic acid. p-Coumaric, syringic and p- hydroxybenzoic acids were detected almost in all fractions. In the petals almost all of detected phenolic acids were found (except caffeic acid in methanolic extract, syringic and p- ydroxyphenylacetic acids in methanolic- aqueous extract). In the calyxes the vanilic and p-hydroxyphenylacetic acids were not found. The total content of phenolic acids in whole flowers was 60 mg%, in petals , 120 mg% and 30 mg% in calyxes(13). Raknimov and Mezthlumyan found that the amount of pectins in the stems was greater than in the roots. 
Sugars isolated from the plant stems and roots included arabinose, rhamnose , galactose, xylose and galacturonic acid.
The percentage of hemicelluloses was 26.6 % in the stems and 14.1% in the roots. The amount of proteins in the
stems was 11.3% and in the roots 12.1%. 17 amino acids were found in Althaea rosa stems and roots. The amino acid composition included valine, threaonine, methionine, isoleucine, leucine, lysine, phenylalanine, histidine and arginine. The predominant amino acid were asparagine, glutamine and leucine. The amount of
hemicellulose was 26.6% in the stems and 14.1 % in the roots. trace elements in Althaea rosa were determined.

The amount of microelements : Pb , Cd , Cu, Zn, Sn, Cr, and Fe in the stems were 30.1 , 0.67 , 30.0, 93.6,
23.1, 196.0 mg/kg and 106.0, while, their amounts in the roots were 26.1, 0.83, 24.2, 37.5 , 18.5 , 200.5 , and
790 mg/kg respectively(14).

Pharmacological activities 

Antimicrobial effects :
The antimicrobial activities of n-hexane, methanol, ethanol, ethyl acetate and water extracts of Althaea rosea L.
flowers were reported against Escherichia coli ATCC 29998, Escherichia coli ATCC 25922, Escherichia coli
ATCC 11230, Staphylococcus aureus ATCC 6538, Staphylococcus aureus ATCC 29213, Staphylococcus
epidermidis ATCC 12228, Salmonella thyphimurium CCM 5445, Enterobacter cloacae ATCC 13047, Enterococcus faecalis ATCC 29212, Pseudomonas aeroginosa ATCC 27853 as bacteria and Candida albicans ATCC 10239 by disc diffusion method(44). 

Cardiovascular effects
Alcoholic extract of the flower of Althaea rosea (L.) increased the outflow of coronary artery of isolated guinea
pig's heart and markedly dilated the blood vessels in the hind-limbs of rats. The extract showed a transient
hypotensive effect on anesthetic cats. It inhibited platelet aggregation induced by ADP and showed a inhibitory
effect on experimental thrombosis formation(45). 

Prevention of urolithiasis
In both preventive and curative protocols, treatment of rats with hydroalcoholic extract of Althaea rosea roots
significantly reduced the kidney calcium oxalate deposits compared to ethylene glycol group. Administration
of Althaea rosea extract also reduced the elevated urinary oxalate due to ethylene glycol(46). 

Antiestrogenic effects :
In traditional folk medicine the Althaea rosea flowers were regarded as an emmenagogue. Literature data have
proved that the infusion and methanolic extract of Althea rosea influence hormonal activity and affected the
morphology of the sexual organs of the rats. It exerted estrogenic activity, but exact component of this plant
responsible for this activity was not determined. The in vivo test proved that p-hydroxybenzoic acid was
estrogenic. Dudek et al proved that this compound present in different parts of Althea rosea and could be
responsible for its estrogenic activity (13). 

Effect on Immune system :
 Water extract of Althaea rosea produce the following effects on immune system(47) :
1- Induced a transient non-specific polyclonal response indicated by the production of IL-4 in treated, nonimmunized
mice.
2- Initially boosted the production of anti-EA antibodies and IL-4, a T- helper 2 cytokine.
3- Suppress production of gamma-interferon, a T- helper 1 cytokine.

Cytotoxic effects:
The cytotoxic activity of n-hexane, methanol, ethanol, ethyl acetate and water extracts of Althaea rosea L. was
investigated by brine shrimp assay. Ethyl acetate extract showed cytotoxic activity against brine shrimp(44).

References
11. 11- Fahamiya, N. Pharmacological, physicochemical and phytochemical investigation of Althaea rosa. IJPRD 2011; 4(03):129 - 140. 12. 12- Classen B and Blasheck W. High molecular weight acidic polysaccharides from Malva sylvestris and Alcea rosea. Planta Medica 1998; 64(7): 640-644. 13. 13- Dudek M , Awska IM and Szudlarek M. Phenolic acids in the flowers of Althaea rosea var. nigra. Acta Poloniae Pharmaceutica - Drug Research 2006 ; 63 (3):207-211. 14. 14- Raknimov DA and Mezthlumyan LG. Chemical composition of dry extract from Alcea rosa . Chemistry of Natural Compounds 2007 ; 43(5):508-510. 15. 15-Blaschek W, Franz G. A convenient method for the quantitative determination of mucilage polysaccharides in Althaeae radix. Planta Medica 1986; 52:537. 16. 16-Samuelsson G. (ed.) Drugs of natural origin, a textbook of pharmacognosy. Stockholm, Swedish Pharmaceutical Press 1992. 17. 17-Tomoda M. The structural features of Althaea-mucilage representative mucous polysaccharide from the roots of Althaea officinalis. Chemical and Pharmaceutical Bulletin 1980; 28:824–830. 18. 18-European Medicines Agency Evaluation of Medicines for Human Use. Assessment report on Althaea officinalis L. Radix.Doc. Ref.: MEA/HMPC/98718/2008. London, 14 May 2009. 19. 19-Buchwald W and Szczyglewska D . Marshmallow – a source of mucilaginous substances. Wiad. Ziel 1999; 2: 8-9. 20. 20-Deters A, Zippel J, Hellenbrand N, Pappai D, Possemeyer C, and Hensel A . Aqueous extracts and polysaccharides from Marshmallow roots (Althea officinalis L.): Cellular internalization and stimulation of cell physiology of human epithelial cells in vitro. J Ethnopharma 2010; 127(1): 62-69. 21. Gudej J. Determination of flavonoids in leaves, flowers and roots of Althaea officinalis. Farm Pol 1990; 5(6): 153-155. 22. Valiei M, Shafaghat A and Salimi F. Chemical composition and antimicrobial activity of the flower and root hexane extracts of Althaea officinalis in Northwest Iran . Journal of Medicinal Plants Research 2011; 5(32): 6972-6976 23. Rashidi A , Mousavi B, Reza Rahmani M, Ali Rezaee M , Hosaini W, Motaharinia Y, Davari B and Zamini G. Evaluation of antifungal effect of Lavandula officinalis, Salvia officinalis L., Sumac, Glycyrrhiza glabra, and Althaea officinalis extracts on Aspergillus niger, Aspergillus fumigatus, and Aspergillus flavus species. Journal of Medicinal Plants Research 2011; 6(2): 309-313. 24. Naovi SA, Khan MS and Vohora SB. Antibacterial, anti-fungal and anthelmintic investigations on Indian medicinal plants. Fitoterapia 1991; 62(3): 221-228.
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