phytochemistry and pharmacology of genus ephedra · 2019. 8. 29. · pound 12, structurally similar...

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Chinese Journal of Natural Medicines 2018, 16(11): 08110828

doi: 10.3724/SP.J.1009.2018.00811

Chinese Journal of Natural Medicines

Phytochemistry and pharmacology of genus Ephedra

ZHANG Ben-Mei1∆, WANG Zhi-Bin1∆, XIN Ping1, WANG Qiu-Hong2, BU He1, KUANG Hai-Xue1*

1 Key Laboratory of Chinese Materia Medica (Ministry of Education), Heilongjiang University of Chinese Medicine, Harbin 150040, China; 2 Department of Natural Medicinal Chemistry, College of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510000,

China

Available online 20 Nov., 2018

[ABSTRACT] The genus Ephedra of the Ephedraceae family contains more than 60 species of nonflowering seed plants distributed throughout Asia, America, Europe, and North Africa. These Ephedra species have medicinal, ecological, and economic value. This review aims to summarize the chemical constituents and pharmacological activities of the Ephedra species to unveil opportunities for future research. Comprehensive information on the Ephedra species was collected by electronic search (e.g., GoogleScholar, Pubmed, SciFinder, and Web of Science) and phytochemical books. The chemical compounds isolated from the Ephedra species include alka-loids, flavonoids, tannins, polysaccharides, and others. The in vitro and in vivo pharmacological studies on the crude extracts, fractions and few isolated compounds of Ephedra species showed anti-inflammatory, anticancer, antibacterial, antioxidant, hepatoprotective, anti-obesity, antiviral, and diuretic activities. After chemical and pharmacological profiling, current research is focused on the antibac-terial and antifungal effects of the phenolic acid compounds, the immunosuppressive activity of the polysaccharides, and the antitumor activity of flavonoids.

[KEY WORDS] Ephedra; Phytochemistry; Pharmacology

[CLC Number] R284.1, R965 [Document code] A [Article ID] 2095-6975(2018)11-0811-18

Introduction

Ephedra is a genus of non-flowering seed plants belong-ing to the Ephedraceae family [1], which includes approxi-mately 67 species, mainly in the desert areas of Asia, America, Europe and North Africa. Among these species, 15 ones and four varieties can be found in China. Ephedra sinica is a member of genus Ephedra and is the primary species that has been used in China for more than 5000 years [2].

Ephedrae Herba is defined as the stem of Ephedra sinica

Stapf, Ephedra intermedia Schrenket C. A. Meyer, or Ephedra

equisetina Bunge (Ephedraceae) in the Chinese Pharma-

copoeia 15th edition. Dried E. sinica stems are traditionally

[Received on] 28-Dec.-2017 [Research funding] The study was supported by the Major State Basic Research Development Program (973 Program) of China ( No. 2013CB531800). [*Corresponding author] Tel: 86-451-87267188, Fax: 86-451-8726- 7188, E-mail: hxkuang@ yahoo.com △These authors contributed equally to this work.

These authors have no conflict of interest to declare.

used to treat cold, bronchial asthma, cough, fever, flu, head-

ache, edema and allergies. E. sinica has become a natural

product source of ephedrine, pseudoephedrine, and other com-

pounds [3]. In addition, in some western countries, Ephedra

sinica has been used as a dietary supplement [4]. It can also be

used to lose weight by increasing sweating and basal metabo-

lism and by stimulating the central nervous system [5]. More-

over, it has also been combined with cardiovascular drugs to

treat cardiovascular diseases [6]. Many reports about the side

effects of E. sinica have emerged, especially in western coun-

tries. A number of side effects of over-the-counter drugs con-

taining ephedrine have been reported, such as myocardial

infarction, arrhythmia, epilepsy, loss of consciousness, and

death [7]. In 2004, the FDA announced the prohibition of die-

tary supplements containing E. sinica [8]. With the restriction

on the use of E. sinica and its related preparations in the US,

other countries have also joined the ban, which has led to

difficulties in the use and development of ephedra drugs. To

resolve this problem, novel pharmacological effects of

ephedra should be investigated. In addition to ephedrine al-

kaloids, there are other substances in ephedra, such as poly-

ZHANG Ben-Mei, et al. / Chin J Nat Med, 2018, 16(11): 811828

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saccharides, flavonoids (30–71), tannins (72–118), and mis-

cellaneous compounds (119–145). These substances have

anti-inflammatory, anticancer, antibacterial, antioxidant, and

hepatoprotective activities. We conducted a systematic review

of the literature to summarize the currently reported chemical

constituents and pharmacological activities of Ephedra.

Historical and Botanical Characterization of Ephedra

E. sinica is one of the original species of the Ephedraceae family that was recorded in the Chinese Pharmacopoeia as “Ma Huang”. As a stimulant and an anti-asthmatic, E. sinica has a long medicinal history for the treatment of cold, fever, headache, rhinobyon and other symptoms [9]. In the ancient Han Dynasty, E. sinica was recorded as a stimulant and anti-tussive agent. During the time of the Roman Empire, E. sinica was well known until it was eventually dropped from medie-val European literature [10]. However, in the beginning of the 20th century, Ephedra sinica emerged as a weight loss and performance enhancement drug and gradually attracted inter-est. However, products containing Ephedra were banned in the US in 2004 after several years of high-profile reports of adverse events [11].

E. sinica plants are perennial herbs standing, more than one meter tall, with thin stems, no leaves, and a strong smell of pine and astringency [12]. Furthermore, E. sinica is a drought-tolerant shrub distributed in both temperate and sub-tropical arid environments in the northern hemisphere and South America [13].

Progress in Phytochemical Studies on the Genus Ephedra

Until now, phytochemical studies have revealed that

more than 145 compounds have been isolated and identified from the genus Ephedra, including alkaloids, flavonoids, tannins, and polysaccharides. The compounds isolated from each species are documented in Tables 1–6. Their chemical structures are shown in Figs. 1–5. Alkaloids

Alkaloids are the main components of this genus. Twenty-nine alkaloids, 1–29, were isolated from this genus. Structural characteristics of these compounds are listed as follows: (1) the amphetamine-type alkaloids (6–18) are the main active ingredients of E. sinica, including amphetamine alkaloids of three stereoisomers (6–11). In addition, com-pound 12, structurally similar to ephedrine, is an anti-in-flammatory compound isolated from Ephedra sinica and be-longs to the oxazolone derivatives. Compounds 13 and 14 may also belong to the oxazolidine alkaloid of the structure. Compounds 15 and 16, structurally similar to pseudoephed-rine and ephedrine, are trace alkaloids in E. sinica. Compound 18 is a new amphetamine-type alkaloid, which is isolated from the ethanol extract from the E. sinica stem. (2) Ephedri-nes isolated from the E. sinica root are mainly macrocyclic spermine alkaloids (1–4) and an imidazole alkaloid (5). (3) In recent years, five new quinoline alkaloids have been isolated from other species of Ephedra (19–23). These quinoline al-kaloids have a carboxyl group on the C-2 position and have oxygen-containing substitutions on the benzene ring (20, 22–23). Generally, these substitutions are methoxyl and hy-droxyl groups. (4) A pyrrolidine alkaloid (24) is isolated from the seeds of E. foeminea and E. foliata. (5) Other alkaloids (25–29) have been isolated from other species of Ephedra. The plant sources, names and structures of these alkaloid compounds are shown in Table 1 and Fig. 1.

Table 1 Alkaloids different species of the genus Ephedra (the structures of main compounds are illustrated in Fig. 1)

Classification Chemical name Plant source Ref.

Macrocyclic spermine alkaloids Ephedradine A (1) E. sinica (root) [26]

Ephedradine B (2) E. sinica (root) [27]

Ephedradine C (3) E. sinica (root) [27]

Ephedradine D (4) E. sinica (root) [28]

Imidazole alkaloid Feruloylhistamine (5) E. sinica (root) [29]

Amphetamine-type alkaloids D(–)-Ephedrine (6) E. Sinica, E. nebrodensis, E. major [30-32]

L(+)-Pseudoephedrine (7) E. sinica, E. nebrodensis [31, 33]

D(–)Norephedrine (8) E. sinica, E. nebrodensis [31, 33]

L(+)-Noreseudoephedrine (9) E. sinica [31, 33]

D(–)Methylephedrine (10) E. sinica, E. nebrodensis [31, 33]

L(+)-Methylpseudoephedrine (11) E. sinica, E. nebrodensis [31, 33]

Ephedroxane (12) E. sinica [34-35]

3, 4-Dimethyl-5-pheyloxazolidine (13) E. sinica [17, 35]

2, 3, 4-Trimethyl-5-phenyloxazolidine (14) E. sinica [17, 35]

O-benzoyl-L(+)-pseudoephedrine (15) E. sinica [35-36]

O-benzoyl-D(–)-ephedrine (16) E. sinica [35-36]

Hordenine (17) E. aphylla [35, 37]

(S)-N-((1R, 2S)-1-hydroxy-1-phenylpropan-2-yl)-5- oxopyrrolidine-2-carboxamide (18)

E. sinica [35, 38]


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Continued

Classification Chemicla name Plant source Ref.

Quinoline alkaloids Transtorine (19) E. transitoria [39]

6-Methoxykynurenic acid (20) E. pachyclada ssp. sinaica [40]

Kynurenic acid (21) E. pachyclada ssp. sinaica [40]

6-Hydroxykynurenic acids (22) E. foeminea ssp. foliata [40]

Ephedralone (23) E. Alata, E. aphylla [41-42]

Pyrrolidine alkaloid cis-3, 4-Methanoproline (24) E. foeminea ssp. foliate (seed) [43]

Other alkaloids Maokonine (25) E. sinica (root) [44]

(±)-1-Phenyl-2-imido-1-propanol (26) E. sinica [45]

Tetramethylpyrazine (27) E. sinica [46]

N-methybenzlamine (28) E. sinica [47]

(2S, 3S, 4S)-2-(carboxycyclopropyl)glycine (29) E. altissima [43]

Fig. 1 Alkaloids isolated from the genus Ephedra


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Flavonoids Flavonoids are the most common class of secondary me-

tabolites within this genus. More than forty flavonoids (30–71) have been identified from the genus Ephedra, which are clas-sified as flavonols (30–46), dihydroflavonols (47–48), fla-vonones (49–51), flavanols (52–57), flavones (58–69), and anthocyans (70–71). Flavones and their glycosides, as well as flavonols and their 3-O-glycosides constituents, are the most common flavonoids in Ephedra. The sugar moieties of these

flavonoid glycosides are commonly made up of glucose and rhamnose. Formerly, it was believed that most flavonoids in the genus were derivatives of the flavonol aglycones kaemp-ferol, herbacetin or quercetin. Recently, some other aglycones such as apigenin, catechin, luteolin, and hesperetin have been characterized. Most flavonoid glycosides are mono-gly-cosides or di-glycosides. In addition, three glycosides (35) and four glycosides (69) are also present. Information about flavonoids is shown in Table 2 and Fig. 2.

Table 2 Flavonoids of different species of the genus Ephedra (the structures of main compounds are illustrated in Fig. 2)


Flavonols Herbacetin (30) E. sinica [48]

Kaempferol (31) E. sinica (root) [49]

Quercetin (32) E. sinica (root) [49]

33.Herbacetin 7-methyl ether (33) E. sinica [48]

34.Rutin (34) E. campylopoda [17]

Herbacetin 8-methyl ether3-O-glucoside-7-O-rutinoside (35) E. alata [50]

Herbacetin 7-O-(6″-quinylglucoside) (36) E. alata [50]

Herbacetin 3-O-rhamnoside 8-O-glucoside (37) E. aphylla [42]

Pollenitin B (38) E. sinica [51]

Herbacetin-8-methyl ether 3-O-glucoside (39) E. sinica [48]

Herbacetin 7-O-glucoside (40) E. sinica [51]

Kaempferol 3-O-rhamnoside 7-O-glucoside (41) E. sinica [51]

Herbacetin 7-O-neohesperidoside (42) E. sinica [51]

Kaempferol-3-O-glucoside-7-O-rhamnoside (43) E. sinica [51]

Kaempferol 3-O-rhamnoside (44) E. alata [50]

Quercetin 3-O-rhamnoside (45) E. alata [50]

Quercetin-3-O-glucoside (46) E. campylopoda [17]

Dihydroflavonol Dihydroquercetin (47) E. sinica (root) [49]

3-Hydroxynaringenin (48) E. sinica (root) [52]

Flavonone 3′, 4′, 5, 7-Tetrahydroxy flavanone (49) E. sinica (root) [49]

Naringenin (50) E. sinica (root) [52]

Hesperidin (51) E. sinica [53]

Flavanols (–)-epicatechin (52) E. sinica , E. nebrodensis [51, 54]

(–)-epiafzelechin (53) E. sinica (root) [49]

Catechin (54) E. sinica [51]

Afzelechin (55) E. sinica (root) [49]

Leucocyanidin (56) E. sinica [55]

Symplocoside (57) E. sinica [51]

Flavones Tricin (58) E. sinica [48]

Luteolin (59) E. sinica [56]

Apigeni (60) E. sinica (root) [49]

3-Methoxyherbacetin (61) E. sinica [48]

Apigenin-5-rhamnoside (62) E. sinica [48]

6-C-glycosyl-chrysoeriol (63) E. sinica [57]

Swertisin (64) E. sinica [58]

Isovitexin-2″-O-rhamnoside (65) E. sinica [51]

Apigenin-7-O-glucoside (66) E. campylopoda [17]

Vitexin (67) E. sinica [51]

Lucenin III (68) E. alata [50]

2″, 2′″-Di-O-β-glucopyranosyl-vicenin II (69) E. aphylla [42, 59]

Anthocyan Leucodelphinidin (70) E. sinica [55]

Leucopelargonin (71) E. sinica [55]


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Fig. 2 Flavonoids isolated from the genus Ephedra


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Tannins Tannins are also important compounds in Ephedra, which

mainly exist in the form of condensation. Tannins, mainly proan-thocyanidins, have been proven to be present in many Ephedra plants (e.g., Eurasian Ephedra: E. przewalskii, E. alata, E. distachya, E. fragilis and E. intermedia; North American Ephedra: E. californica, E. nevadensis, E. fasciculata, E. trifurca, E. torreyana, and E. viridis) [14]. At present, the con-densed tannins of procyanidin A-type (Fig. 4) are the most common in Ephedra [15], containing dimers (72–98), trimers (99–110, 112, 113), and tetramers (114–118). These com-pounds are made of flavan-3-ol monomer units, which are linked together through C4-C6 (107, 108), C4-C8, or C2-O-C7 bonds. Compound 111 belongs to the B-type proanthocyanid-ins, which do not contain C-O-C bonds. In addition, all the flavan-3-ol monomer units are afzelechin/epiafzelechin, cate-chin/epicatechin, and gallocatechin/ epigallocatechin. The plant species, chemical names, and structures of tannins are shown in Table 3 and Fig. 3.

Table 3 Tannins compounds of different species of the genus Ephedra


Ephedrannin A (72) E. sinica (root) [60-61]Dimer proanthocyanidins Ephedrannin B (73) E. sinica (root) [60-61]

Muhuannin A (74) E. sinica (root) [62]

Muhuannin D (75) E. sinica (root) [60, 63]

Muhuannin B (76) E. sinica (root) [60]

Muhuannin E (77) E. sinica (root) [60]

Muhuannin C (78) E. sinica (root) [17]

Muhuannin F (79) E. sinica (root) [64]

Muhuannin G (80) E. sinica (root) [64]

Muhuannin H (81) E. sinica (root) [64]

Muhuannin I (82) E. sinica (root) [64]

Muhuannin J (83) E. sinica (root) [64]

Muhuannin K (84) E. sinica (root) [64]

Ephedrannin D1 (85) E. sinica [65]













Ephedrannin D14 (98) E. herb [65]

Continued


Ephedrannin Tr1 (99) E. sinica [65] Trimer proanthocyanidins Ephedrannin Tr2 (100) E. sinica [65]

Ephedrannin Tr3 (101) E. sinica [65]













Ephedrannin Te1 (114) E. sinica [51] Tetramer proanthocya-nidins Ephedrannin Te2 (115) E. sinica [51]

Ephedrannin Te3 (116) E. sinica [51]



Polysaccharides

Large-molecule components in Ephedra species have also been studied. Ephedra sinica contains a high amount of polysaccharides, which range from 3% to 5% of the total dry weight [16]. Additionally, it has been reported that the con-centration of uronic acid measured by the phenol sulfuric acid method is 45.9% [17]. A water-soluble arabinan (Mw 6.15 kDa) has been isolated from the E. sinica stems and investigation of its structure has indicated that the polysaccharide consists

of (1→5)-Araf, (1→3, 5)-Araf, T-Araf, (1→3)-Araf, and (1→

2, 5)-Araf residues at proportions of 10 : 2 : 3 : 2 : 1. The

structure includes a branched (1→5)-α-Araf backbone where

branching exists at the O-2 and O-3 positions of the residues with 7.7% and 15.4% of the 1, 5-linked α-Araf substituted at the O-2 and O-3 positions. The presence of a branched

structure contains a much longer linear (1→5)-α-Araf back-

bone as a repeating unit. Generally, the tentative structure of the arabinan (ESP-B1H) is shown in Fig. 4 [18]. Another acidic hetero-polysaccharide (ESP-B4) has been isolated from E. sinica and shows an immunosuppressive effect [19]. It contains

a repeating unit of [→4]-GalpA-(1→2)-Rhap-(1→) as a hairy

region, substituted by arabinose, xylose, galactose, glucose, mannose, and glucuronic acid [20]. Three acidic hetero- poly-saccharides (ESP-A3, ESP-A4, and ESP-B4) have also been isolated and purified from the stem of E. sinica. Their mono-saccharide compositions and corresponding molar ratios are shown in Table 4 [21]. Furthermore, a pure polysaccharide


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Fig. 3 Tannins isolated from the genus Ephedra

(ESP-B1) was isolated from E. sinica. It consisted of mannose, glucose, galactose, and arabinose. The ratios of the substances are shown in Table 4 [22]. Additionally, two polysaccharides

(ESP-A1 and ESP-A2) have been isolated from the cold water extract of E. sinica [23]. Their monosaccharide compositions and ratios are also shown in Table 4. Moreover, monosaccharide


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composition and proportion of polysaccharides from Ephedra root have been analyzed. The results are shown in Table 4 [24]. In addition, five hypoglycemic glycans (ephedrans A, B, C, D,

and E) are isolated from Ephedra distachya [25]. Their mono-saccharide compositions and proportions have been determined. The results are shown in Table 5.

Fig. 4 The tentative structures of the arabinan (ESP-B1H)

Table 4 Monosaccharide composition and proportion of polysaccharides from Ephedra sinica

polysaccharides arabinose rhamnose galacturonic acid mannose glucose galactose xylose glucuronc acid

Ephedra root polysaccharide 7.59 5.93 9.94

ESP-B1 93.3 3.5 2.2 1.0

ESP-A3 7.5 14 3.8 13.7 1.0 22.3 6.8 10.2

ESP-A4 4.1 5.1 2.2 1.6 1.0 17.3 1.2 3.1

ESP-B4 4.5 2.0 50.0 1.0 1.0 5.5 1.0 1.5

ESP-A1 61.1 12.9 11.1 11.6 3.2

ESP-A2 67.7 5.0 6.7 20.6

Table 5 Monosaccharide composition and proportion of polysaccharides from Ephdra distachya

polysaccharides molecular mass rhamnose trehalose arabinose xylose mannose galactose glucose

A 1.2 × 106 2.4 1.0 0.8 0.7 0.2 1.0 0.2

B 1.5 × 106 1.0 0.3 0.7 0.9 0.9 1.0 0.1

C 1.9 × 104 0.2 0.4 0.3 1.0 0.2

D 6.6 × 103 0.5 1.0 0.1 1.0 0.2

E 3.4 × 104 0.4 0.4 0.3 1.0 0.7

Miscellaneous compounds

Three phenolic glycoside compounds (129–131) are isolated from E. nebrodensis and four phenolic acids (134–136, 140) are isolated from E. equisetina. Some other phenolic com-pounds which have been isolated from the stems of E. sinica are trans-cinnamic acid (132), syringing (133), quinaldic acid

(137), caffeic acid (141), chlorogenic acid (142), and a new glycoside of phenylpropionic acid (143), while 2-hydroxyl- 5-methoxybenzoic acid (138) and iso-ferulic acid (139) are also isolated from the E. sinica roots. Additionally, six terpenoid compounds (123–128), a lignin compound (120), and an ester compound (122) are isolated from the E. sinica roots. Further-


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more, a new naphthalene derivative, 1-methyl-2, 3-methyle-nedioxy-6-naphthalenecarboxylic acid methyl ester (121), and two quinones (144–145) are isolated from the E. sinica stems.

In addition, a lignin compound (119) is isolated from E. alata. These compounds are shown in Table 6, and their structures are presented in Fig. 5.

Table 6 Miscellaneous compounds of different species of the genus Ephedra


Lignans (±)-Syringaresinol (119) E. alata [41]

Sesquipinsapol B (120) E. sinica (root) [64]

Naphthalenes Methyl-2,3-methylenedioxy-6-naphthalenecarboxylic acid methyl ester (121) E. sinica [45]

Esters Ethyl caprylate (122) E. sinica (root) [66]

Terpenoid (–)-α-Terpineol-8-O-β-D-glucopyranoside (123) E. sinica (root) [64]

(+)-α-Terpineol-8-O-β-D-glucopyranoside (124) E. sinica (root) [64]

Geranyl-β-D-glucopyranoside (125) E. sinica (root) [64]

Daucosterol (126) E. Sinica (root) [64]

Sitosterol (127) E. sinica (root), E. campylopoda [64, 67]

Stigmasterol-3-O-β-D-glucopyranoside (128) E. sinica (root) [66]

Phenolic acids Nebrodenside A (129) E. nebrodensis [31, 54]

Nebrodenside B (130) E. nebrodensis [31, 54]

O-coumaric acid glucoside (131) E. nebrodensis [31, 54]

Trans-cinnamic acid (132) E. sinica [51]

Syringin (133) E. sinica [51]

ρ-Coumaric acid (134) E. alata, E. aphylla, E. equisetina [41-42, 68]

ρ-Hydroxybenzoic acid (135) E. aphylla, E. equisetina [42, 68]

Protocatechuic acid (136) E. aphylla, E. equisetina [42, 68]

Quinaldic acid (137) E. pachyclada [69]

2-Hydroxyl-5-methoxybenzoic acid (138) E. sinica (root) [64]

Iso-ferulic acid (139) E. sinica (root) [64]

Vanillic acid (140) E. equisetina [68]

Caffeic acid (141) E. sinica [45]

Chlorogenic acid (142) E. sinica [45]

(3R)-3-O-β-D-glucopyranosyl-3-phenylpropanoic acid (143) E. sinica [38]

Quinones Physcion (144) E. sinica [45]

Rhein (145) E. sinica [45]

Pharmacological Properties of Ephedra

Ephedra sinicahas been used for thousands of years in the treatment of allergies, bronchial asthma, cold, fever, etc. Since Professor Nagayoshi Nagai reported ephedrine analogs as the active constituents in E. sinica, most of the pharmacol-ogical effects of E. sinica have been attributed to ephedrine analogs, although E. sinica also contains other chemical com-ponents, such as flavonoids, tannins, and other compounds. However, these ephedrine analogs have some side effects, including insomnia, palpitations, arrhythmia, and hypertension, because these compounds can stimulate the sympathetic and parasympathetic nerves. Additionally, the synthetic form of ephedrine, amphetamine, is more addictive and toxic. The US Food and Drug Administration banned the use of dietary sup-plements containing ephedrine analogs in 2004. To solve this

problem, the pharmacological effects of other components of E. sinica need to be further studied, such as flavonoids, poly-saccharides, tannins, organic acids and others. The following sections mainly describe the pharmacological effects of crude extracts and isolated compounds from the genus Ephedra. Anti-inflammatory activity

As early as 1985, it was reported that ephedrine analogs, mainly including ephedrine (6), pseudoephedrine (7), and ephe-droxane (12), had potent anti-inflammatory activity in vivo. This anti-inflammatory effect was likely due to the inhibition of prostaglandin E2 biosynthesis [70].

Another study on the possible effects of ephedra- monk-shood-asarum-soup (“Mahuang-Fuzi-Xixin-Tang” in Chinese) on the IgE-mediated anaphylaxic response was measured in 2004. Interestingly, only E. sinica and ephedra-monkshood- asarum-soup inhibit IgE-mediated histamine release and


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Fig. 5 Structures of miscellaneous compounds from different species of the genus Ephedra


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increase cAMP levels from rat basophilic leukemia (RBL-2H3) cells. However, the components responsible for the inhibitory effect of E. sinica are not ephedrines [71]. It may be another component distinct from the ephedrine derivatives, which should be studied further. Another study showed that E. sinica could suppress the expression of cyclooxygenase (COX-2) in C6 rat glioma cells [72]. Prostaglandins (PGs) are major me-diators in the regulation of inflammation and immune func-tion. COX is the rate-limiting enzyme in PG production. Ac-tivation of nuclear factor-κB (NF-κB) participates in the tran-scriptional activation of the COX-2 gene. The E. sinica plays an anti-inflammatory role by inhibiting the expression of COX-2 protein and NF-κB-dependent transcription.

In 2005, the water distillates of E. sinica were injected into the ST36 acupoint on each knee joint in adjuvant-induced arthritic rats. The E. sinica herb-acupuncture showed an anti- arthritic effect [73]. The experiment was performed using an in vitro phorbol 12-myristate 13-acetate (PMA)/lipopolysaccharide (LPS)-induced human macrophage model and an in vivo ad-juvant-induced arthritic (AIA) rat model. After treatment with E. sinica, the mRNA expression of tumor necrosis factor-α (TNF-α) and interleukin (IL)-6 genes were down- regulated. Interestingly, Ephedra did not work in the non-acupoint. It exerted a medicinal effect when injected only into the appro-priate acu-point. The E. sinica herb-acupuncture therapy could reduce adverse effects associated with the disease. It could be an alternative to traditional therapy.

Wang et al. found that the acidic polysaccharides from E. sinica had immunosuppressive activity and confirmed that the main acidic polysaccharide ESP-B4 had potential therapeutic effects on rheumatoid arthritis. ESP-B4 reduces the release of inflammatory factors and cytokines by inhibiting the TLR4 signaling pathway [19].

Iksoo et al found that in the Ephedra root extracts, ephe-drannin A (72) and ephedrannin B (73) had anti-inflammatory effects. They could suppress the transcription of TNF-α and IL-1β and inhibit LPS-induced inflammation. They suppressed the translocation of NF-κB and the phosphorylation of p38 mitogen-activated protein (MAP) kinase [61].

The complement-inhibiting components of E. sinica could treat the second injury after spinal cord injury (SCI). E. sinica reduced inflammation and improved motor function after SCI by inhibiting the activity of complement. These results showed that E. sinica could inhibit the activity of complement hemo-lysis and myeloperoxidase, decrease the complement deposi-tion and improve motor function [74]. Furthermore, Ling et al. extracted and purified the complement-inhibiting component of E. sinica. C3 complement is harmful to the neurological function of patients with subarachnoid hemorrhage (SAH), which can cause brain damage, including brain cell death, blood-brain barrier damage, and brain edema. The extracts of E. sinica could not only improve the neurological function of rats after brain injury, but could also improve the early blood-brain barrier and brain edema after SAH [75].

Antibacterial and antifungal activities The phenolic compounds isolated from the Ephedra

herbs exhibit substantial antimicrobial activity against Gram- positive bacteria and Gram-negative bacteria [76]. Among E. strobilacea, E. pachyclada and E. Procera, the E. strobilacea showed the highest antimicrobial activity against three mi-croorganisms, including Pseudomonas aeruginosa, a Gram negative bacterium, Staphylococcus aureus, a Gram positive bacterium, and Aspergillus nigra a fungus. The plant metha-nolic extracts of E. pachyclada show significant antimicrobial activity against Klebsiella pnemoniae, a Gram negative bacte-rium, Bacillus subtilis, a Gram positive bacterium and highest antifungal activity against the Candida albicans microorgan-ism. There is a strong relationship among total phenol content and antioxidant, antimicrobial activity, as phenols are very important plant constituents because their hydroxyl groups can scavenge free radicals [77].

From the n-BuOH-soluble fraction of the EtOH extracts from E. sinica, 12 A-type proanthocyanidins are isolated and identified. These compounds are tested by measuring the minimum inhibitory concentrations (MIC) against bacteria (both Gram-positive and Gram-negative) and fungi, with a concentration range of 0.00 515–1.38 mmol·L–1 [65].

Additionally, other secondary metabolites from E. tran-sitoria have been assessed for their antibacterial activity. One of the isolated quinolone alkaloid (4-quinolone-2-carboxylic acid) (19) exhibits significant inhibitory activity against common bacteria, including Enterobacter cloacae, Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa [39].

Another study evaluated the effects of E. major on fungal growth and aflatoxin (AF) production by Aspergillus para-siticus NRRL 2999. It was found that the methanolic extracts of plant aerial parts and roots inhibited fungal growth and aflatoxin B1 (AFB1) production dose-dependently with IC50 values of 559.74 and 3.98 μg·mL–1 for AFB1, respectively. Meanwhile, essential oil extracts of plant aerial parts signifi-cantly inhibited fungal growth at the highest concentration of 1000 μg·mL–1 without any obvious effect on AFB1 produc-tion at all concentrations used (0–1000 μg·mL–1) [78]. Anti-cancer activity

An investigation has shown that the water fraction (EW), the remaining water phase from the methanol extract of E. sinica after fractionation with ethyl acetate and butanol, pos-sesses significant antitumor activity in BDF1 mice containing B16-F10 melanoma cells. Administration at 30 mg·kg–1·d–1 showed comparable inhibitory activity on the growth of the tumor in vivo. The in vitro antitumor activity is due to its anti- angiogenic and anti-invasion effects. At doses up to 30 μg·mL–1, a non-cytotoxic concentration, EW inhibits tube formation induced by human umbilical vein endothelial cells and the invasion of B16F10 melanoma cells through a matrix mem-brane by more than 90% [79].

A study has reported that herbacetin (30), the aglycon of herbacetin 7-O-neohesperidoside (42) isolated from Ephedra


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plants, has antiproliferative and analgesic effects [80]. Another study has shown that it could also suppress the HGF-induced motility of human breast cancer MDAMB-231 cells [81]. The mechanism of this inhibitory action is through inhibiting ty-rosine phosphorylation of c-Met and the PI3K/Akt pathway. Additionally, the herbacetin (30) can directly inhibit the tyro-sine kinase activity of c-Met [51, 82]. To further investigate the mechanism of ephedra inhibiting the phosphorylation of Met, another study has found that Ephedra could promote HGF- stimulated MET and p-MET endocytosis followed by its downregulation in an NSCLC cell line. The degradation of MET likely occurrs in the late endosome pathway [83].

The preparation method of ephedrine alkaloids-free Ephedra Herb (EFE) extracts has been established. The EFE extracts have anti-proliferative effects against the H1975 non-small cell lung cancer (NSCLC) cell line [84]. Moreover, the antiproliferative effects arecomparable to that of the E. herb ex-tract. Therefore, the EFE, a new herbal medicine with reduced side effects and retained anticancer effects, may have great potential for development.

Additionally, a study has reported that the methanol ex-tracts from E. herb has inhibitory effects on the X-linked in-hibitor of apoptosis protein (XIAP). An in vitro fluorescence polarization assay and a protein fragment complementation analysis have confirmed that the extracts of Ephedra contain an inhibitory component for XIAP. Moreover, silica gel col-umn chromatography and precipitation from methanol and chloroform mixtures have confirmed that the active ingredi-ents are oligomeric proanthocyanidins. The inhibitory activity of oligomeric proanthocyanidins has been evaluated, with an IC50 value of 27.3 μg·mL–1 through in vitro FP assay and pro-tein fragment complementation analysis [85]. Antioxidant and hepatoprotective activity

As early as 1985, feruloylhistamine (5), an imidazole al-kaloid, was isolated from underground part of Ephedra plants (Ephedraceae). A series of feruloylhistamine analogs were also prepared. The study found that the feruloylhistamine analogs exhibited antihepatotoxic actions [29].

The phenolic and flavonoid constituents from the E. alata plant show an antioxidant effect [86]. As a natural source of potent antioxidants, the constituents could prevent many diseases when used in food, cosmetics, and pharmaceutical products [87].

An in vitro and in vivo study has revealed that the E. pachyclada extracts possess significant protective effects on primary hepatocytes against carbon tetrachloride damage. Inflammation and oxidative stress are the major causes of liver disease. E. pachyclada has anti-inflammatory and anti-oxidant activities. The antioxidant activity of the E. pachy-clada extracts was measured in vitro by 2, 2'- di-phenyl-1-picrylhydrazyl (DPPH) and β-carotene bleaching assays. The DPPH scavenging activity of E. pachyclada ex-tracts showed an IC50 value of 55.53 ± 0.5 μg·mL–1. The hepatoprotective effects of E. pachyclada extracts were also examined in vivo on mouse models of carbon tetrachloride

(CCL4)-induced chronic and acute liver failure. These results have demonstrated that the pathological indexes of hepatic injury, including aspartae aminotransferase (AST) and alanine aminotransferase (ALT), are significantly reduced in CCL4+ low/high E. pachyclada groups. In addition, the pathological examination showed that hepatic injuries, including inflam-mation, necrosis and hepatitis, are partially healed with the treatment of E. pachyclada extracts [88]. Therefore, the hepa-toprotective mechanism of E. pachyclada is to inhibit oxida-tive stress and inflammation.

In another D-galactosamine and lipopolysaccharide (LPS)- induced hepatitis model, the hepatoprotective effects of Ephedra extracts have been evaluated [89-90]. The Ephedra extracts markedly alleviates hepatocyte apoptosis and in-flammatory factor infiltration by reducing of serum alanine aminotransferase (ALT) and total bilirubin (T. Bil) activity, levels of TNF-α, and the activities of caspase- 8, 9, and 3.

A recent study has found that ephedra non-alkaloids have therapeutic potential for the treatment of hyperlipidemia in diet-induced mice [91-92]. These non-alkaloids can improve lipid metabolism. They may prevent free radical generation and support recuperation of liver function. What is more, they are relatively safe for use under the maximum tolerated dose. Antiviral activity

E. herb extracts can induce the replication of latent hu-man immunodeficiency virus type 1 (HIV-1) in latently in-fected U1 cells in vitro, through NF-κB activation. The ulti-mate goal is to eliminate the persistent viral reservoirs in in-dividuals infected with HIV-1. NF-κB is an inducible cellular transcription factor that regulates a wide variety of cellular and viral gene expression. The E. herb extracts can efficiently induce NF-κB nuclear translocation and activate the NF-κB promoter [93].

A study has confirmed that ephedrine alkaloids-free Ephedra Herb (EFE) extracts have anti-influenza virus activ-ity by showing inhibition of MDCK cell infected with influ-enza virus A/WSN/33 (H1N1) [81]. The IC50 values of Ephedra Herb extract and EFE are 8.6 and 8.3 μg·mL–1, respectively. The safety assessment of EFE extracts suggests that it is safer than Ephedra Herb extract itself. EFE could be a safer alter-native to Ephedra Herb, but further study is necessary. Miscellaneous biological activities

Zhai et al have examined the effects of E. sinica on the treatment of bleomycin-induced rat idiopathic pulmonary fibrosis. Pulmonary fibrosis is characterized by early lung injury followed by fibrosis. E. sinica can significantly reduce alveolitis and pulmonary fibrosis grades [94-95]. E. sinica has been used to treat pulmonary fibrosis in the clinic, suggesting that traditional Chinese medicine had a major impact on idio-pathic pulmonary fibrosis.

The hydro-alcoholic extract from the stems of E. pachy-clada has been shown to be effective in experimentally healing rat ulcers [96]. E. pachyclada, is frequently cited by Kerman people as an active agent against gastrointestinal disorders.


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As activators of transient receptor potential vanilloid 1 (TRPV1), a pain receptor, the E. Herb extract has analgesic effects [97-98]. However, ephedrine does not show such effects.

2, 3, 5, 6-Tetramethylpyrazine (TMP) (27) isolated from E. sinica has been evaluated for its depigmenting effect in a UVA-induced melanoma/keratinocytes co-culture system. TMP at a 100 μmol·L–1 concentration significantly decreased the expression of tyrosinase-related protein 1 (TRP1) and microphthalmia-associated transcription factor (MITF) levels. Cytokines, such as TNF-α, IL-1β, IL-8 and granulocyte-ma-crophage colony-stimulating factor (GM-CSF), were signifi-cantly decreased with TMP treatment [99]. TMP could be used as a possible drug candidate to improve pigmentation of the skin.

Additionally, the ephedrannins A (72) and B (73) isolated from E. sinica roots exhibit significant inhibitory activity on melanogenesis in B16F10 melanoma cells. These compounds inhibit the expression of the tyrosinase gene in a dose-de-pendent manner. In addition, the inhibition by ephedrannin B (72) is more effective than that of ephedrannin A (73) [100]. Ephedrannin B can be a better candidate for whitening the skin.

Conclusions and Future Perspectives

In this review, we summarize the chemical components isolated from the genus Ephedra and their pharmacological activities. One hundred and forty-five chemicals belonging to the groups of alkaloids, flavonoids, polysaccharides, tannins and others have been isolated from the genus Ephedra. Addi-tionally, Ephedra species have anti-inflammatory, anti-tumor, antioxidant, hepatoprotective, antibacterial, and antifungal activities.

We need to do more research on the pharmacology and phytochemistry of Ephedra species in the future. First, ephe-dra non-alkaloids, as a new herbal medicine with reduced side effects and retained anticancer and analgesia effects, have great potential for development. However, the mechanism of ephedra polysaccharide in the treatment of hyperlipidemia needs further study. Second, the pharmacological activities of more than twenty medicinal plants of genus Ephedra have been reported, but many other species of the genus Ephedra have not been studied for their chemical compositions and pharmacological activities. Therefore, further study on these species is needed. Third, although the ephedra polysaccharide has anti-inflammatory, anti-complement and immunosuppres-sion effects, the relationship between the ephedra polysaccha-ride structure and its pharmacological activity needs to be further studied.

The active components of E. sinica have been identified, which play a guiding role in the quality control of E. sinica. The aforementioned pharmacological experiments on the mechanisms of action of E. sinica, can provide guidance for the clinical application of E. sinica.

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Cite this article as: ZHANG Ben-Mei, WANG Zhi-Bin, XIN Ping, WANG Qiu-Hong, BU He, KUANG Hai-Xue. Phytochem-

istry and pharmacology of genus Ephedra [J]. Chin J Nat Med, 2018, 16(11): 811-828.

phytochemistry and pharmacology of genus ephedra · 2019. 8. 29. · pound 12, structurally similar...

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