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Cette fiche a été compilée à partir de résumés PubMed (NIH) avec l'assistance d'une IA. Chaque affirmation factuelle est citée par un article PubMed réel (voir la liste des sources). Elle n'a pas encore été révisée par un humain — confirmez auprès d'un professionnel de santé avant utilisation.
Compilé à partir de 26 articles PubMed · modèle : gemma4:31b
Résumé
Blue cohosh (Caulophyllum thalictroides) is a medicinal herb used traditionally to promote labor and treat menstrual or inflammatory conditions [PMID:30000839, PMID:22988475].
Contexte
Blue cohosh is a botanical native to eastern North America, with roots and rhizomes used in traditional and Native American medicine [PMID:22988475, PMID:18376582, PMID:23420136].
Usages traditionnels
Traditionally used for the treatment of menopausal symptoms, rheumatic pain, menstrual disturbances, and as an anti-inflammatory remedy and aid in childbirth [PMID:22988475, PMID:18048069, PMID:12597249].
Composés actifs
Primary constituents include alkaloids (such as N-methylcytisine, magnoflorine, baptifoline, anagyrine, and lupanine) and triterpene saponins (including caulosaponins and various caulosides) [PMID:30000839, PMID:23420136, PMID:21872415, PMID:10543898].
Mécanisme d'action
Saponins are considered responsible for uterine-stimulating effects [PMID:18376582, PMID:12597249]. N-methylcytisine exhibits nicotine-like effects [PMID:30000839]. In vitro studies show it can suppress the expression of iNOS and proinflammatory cytokines (TNF-α, IL-1β, and IL-6) in microglia cells [PMID:22988475].
Preuves cliniques
Preuve DLabor Induction
Used by approximately 64% of surveyed US midwives as a labor-inducing aid, though evidence for safety and efficacy is largely anecdotal [PMID:18204101, PMID:17467597].
Preuve DInflammation
Suppressed LPS-induced iNOS and proinflammatory cytokines in microglia cells and suppressed COX-2 and iNOS in adrenal glands in an in vitro model [PMID:22988475].
Sécurité et effets indésirables
Toxicity includes severe gastrointestinal and cardiovascular effects [PMID:30000839]. Nicotinic toxicity (tachycardia, diaphoresis, abdominal pain, vomiting, and muscle weakness) has been reported following use as an abortifacient [PMID:12136970]. Methanol extracts have demonstrated mitochondriotoxic activity, disrupting cellular respiration and mitochondrial membrane potential [PMID:24328138].
Grossesse et allaitement
Strongly recommended against during breastfeeding due to potential toxicity to neonates [PMID:30000839]. Maternal use to stimulate labor is associated with severe neonatal outcomes, including perinatal stroke, acute myocardial infarction, profound congestive heart failure, shock, and multi-organ hypoxic injury [PMID:18204101, PMID:9544922, PMID:24328138]. N-methylcytisine has shown teratogenic activity in rat embryo cultures [PMID:10543898].
Interactions médicamenteuses
The alkaloidal fraction of blue cohosh showed strong in vitro inhibition of cytochrome P450 enzymes CYP 2C19, 3A4, 2D6, and 1A2 [PMID:19137500].
Synthèse des preuves
Evidence is primarily based on in vitro studies, case reports, and systematic reviews of literature; there is a lack of clinical trial data, and significant safety concerns exist regarding neonatal and cardiovascular toxicity.
Sources PubMed
1.PMID: 30000839 (2006) — Adverse effects of herbal medicines: an overview of systematic reviews. · Clinical medicine (London, England)
2.PMID: 18204101 (2008) — Safety and efficacy of blue cohosh (Caulophyllum thalictroides) during pregnancy and lactation. · The Canadian journal of clinical pharmacology = Journal canadien de pharmacologie clinique
3.PMID: 22988475 (2012) — Anti-Inflammatory Effect of Triterpene Saponins Isolated from Blue Cohosh (Caulophyllum thalictroides). · Evidence-based complementary and alternative medicine : eCAM
4.PMID: 18376582 (2008) — Alkaloids and saponins in dietary supplements of blue cohosh (Caulophyllum thalictroides). · Journal of AOAC International
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— Primary constituents of blue cohosh: quantification in dietary supplements and potential for toxicity.
· Analytical and bioanalytical chemistry
6.PMID: 12136970 (2002) — Nicotinic toxicity from tincture of blue cohosh (Caulophyllum thalictroides) used as an abortifacient. · Veterinary and human toxicology
7.PMID: 19137500 (2009) — Alkaloids and saponins as cytochrome P450 inhibitors from blue cohosh (Caulophyllum thalictroides) in an in vitro assay. · Planta medica
8.PMID: 21872415 (2011) — Analytical methods for determination of magnoflorine and saponins from roots of Caulophyllum thalictroides (L.) Michx. using UPLC, HPLC and HPTLC. · Journal of pharmaceutical and biomedical analysis
9.PMID: 18048069 (2008) — Alkaloids and saponins from blue cohosh. · Phytochemistry
10.PMID: 24328138 (2014) — Toxins in botanical dietary supplements: blue cohosh components disrupt cellular respiration and mitochondrial membrane potential. · Journal of natural products
11.PMID: 17467597 (2007) — Induction of labor with homeopathy: a case report. · Journal of midwifery & women's health
12.PMID: 12597249 (2003) — Determination of saponins and alkaloids in Caulophyllum thalictroides (blue cohosh) by high-performance liquid chromatography and evaporative light scattering detection. · Phytochemical analysis : PCA
13.PMID: 10543898 (1999) — Detecting potential teratogenic alkaloids from blue cohosh rhizomes using an in vitro rat embryo culture. · Journal of natural products
14.PMID: 9544922 (1998) — Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. · The Journal of pediatrics