Disease relevance of Ephedra

• CONTEXT: Ephedra and ephedrine sometimes are used for weight loss or enhanced athletic performance, but the efficacy and safety of these compounds are uncertain [1].
• CONCLUSIONS: In this 6-month placebo-controlled trial, herbal ephedra/caffeine (90/192 mg/day) promoted body weight and body fat reduction and improved blood lipids without significant adverse events [2].
• A healthy 40-year-old man was admitted to our hospital for new-onset congestive heart failure and severe acute hepatitis that developed several months after he began using anabolic-androgenic steroids, ephedra, and gamma-hydroxybutyrate supplements [3].
• BACKGROUND: Ephedrine has previously been described as a causative factor of vasculitis but myocarditis has not yet been associated with either ephedrine or its plant derivative ephedra [4].
• Adverse cardiovascular events attributed to anabolic steroid and ephedra use, such as arrhythmias, myocardial infarction, cardiomyopathy, and sudden death, are rarely reported [3].

High impact information on Ephedra

• No trials of ephedra and athletic performance were found; 7 trials of ephedrine were too heterogeneous to synthesize [1].
• Use of ephedra or ephedrine and caffeine is associated with increased risk of psychiatric, autonomic, or gastrointestinal symptoms, and heart palpitations [1].
• Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis [1].
• JAMA patient page. Ephedra and ephedrine [5].
• Usage patterns of the nonprescription products phenylpropanolamine (PPA) and ephedra are of particular interest because of recent safety concerns [6].

Chemical compound and disease context of Ephedra

• To examine the safety and efficacy of citrus aurantium, an herb now commonly used as a substitute for ephedra in dietary supplements marketed to promote weight loss, we conducted a systematic review [7].
• Anti-arthritic effects of Ephedra sinica STAPF herb-acupuncture: inhibition of lipopolysaccharide-induced inflammation and adjuvant-induced polyarthritis [8].

Biological context of Ephedra

• Effect of a dietary herbal supplement containing caffeine and ephedra on weight, metabolic rate, and body composition [9].
• Ephedrine pharmacokinetics after the ingestion of nutritional supplements containing Ephedra sinica (ma huang) [10].
• TREATMENT: In the studies on PCA, MBST (hot water extract of the whole herbal formula), extracts of Ephedra herb (Mao), l-ephedrine and other reference drugs were orally administered immediately or at various times before or 5 min after the antigen challenge [11].
• Resting energy expenditure during the last 30 min was 4.5+/-2.5% higher in the placebo trial and 10.7+/-2.5% higher (P<0.05) in the caffeine/ephedra trial; REE was 8.5 +/- 2.0% higher (P<0.05) in the caffeine/ephedra trial compared with the placebo trial [12].
• Nitrosation of a tea made from Ephedra altissima yielded N-nitrosoephedrine (NEP), N-nitrosopseudoephedrine (NPEP), N-nitrosoproline (NPRO), N-nitrosomethylbenzylamine (NMBA), trace quantities of 2 unidentified non-volatile nitrosamines and the new nitroso compound 2-(N-nitroso-N-methylamino)propiophenone (NMAP) [13].

Anatomical context of Ephedra

• The agent contains ephedra alkaloids and caffeine, which are both central nervous system stimulants; the etiology of seizure was attributed to their consumption [14].

Associations of Ephedra with chemical compounds

• Amphetamine and substituted amphetamines, including methamphetamine, methylphenidate (Ritalin), methylenedioxymethamphetamine (ecstasy), and the herbs khat and ephedra, encompass the only widely administered class of drugs that predominantly release neurotransmitter, in this case principally catecholamines, by a non-exocytic mechanism [15].
• Data on the following dietary supplements were identified: chitosan, chromium picolinate, Ephedra sinica, Garcinia cambogia, glucomannan, guar gum, hydroxy-methylbutyrate, plantago psyllium, pyruvate, yerba maté, and yohimbe [16].
• Ascorbate may play a role in shock and asthma treatments and potentiate the cardiovascular health consequences of PPA and Eph (Ephedra) [17].
• Pharmacological actions of analogues of feruloylhistamine, an imidazole alkaloid of Ephedra roots [18].
• Hypotensive actions of ephedradines, macrocyclic spermine alkaloids of Ephedra roots [19].

Gene context of Ephedra

• We report here on 6 cases of dilated cardiomyopathy associated with ephedra use [20].
• Pharmacognostical studies of Ephedra plants Part I - The comparative histological studies on Ephedra rhizomes from Pakistan and Afghanistan and Chinese crude drugs "Ma-Hung-Gen" [21].
• Analysis with an objective causality assessment scale revealed a probable adverse drug reaction between the patient's use of anabolic steroids, ephedra, and gamma-hydroxybutyrate and the development of his cardiomyopathy and acute liver injury [3].
• 5.8 S rRNA from the gymnosperm Ephedra kokanica Regl [22].

Analytical, diagnostic and therapeutic context of Ephedra

• A validated HPLC method for the determination of ephedrine-type alkaloids, commonly found in Ephedra supplements, is presented [23].
• Ephedrine-type alkaloid content of nutritional supplements containing Ephedra sinica (Ma-huang) as determined by high performance liquid chromatography [23].

References