St. John’s Wort

Rachael Krob, Melissa Morrison & Katie Wooten

St. John’s Wort

• Hypericum perforatum from the family Hypericaceae– genus Hypericum– 400 species worldwide

• Common Name: Goatweed

Klamath Weed

Amber Touch-and-Heal

Blood of Christ

Hardhay

Guttiferae

Tipton weed

Botanical Description• SJW is an aromatic perennial herb, usually growing between 1-3

feet-small oblong leaves dotted with glandular trichomes

containing essential oils-flowers are yellow with an abundance of bushy stamens- 5 petals with black dots on the periphery

• Native to Europe, Asia and parts of Africa

• Widespread in the U.S. and can be found in sunny places such as fields, meadows, and roadsides

Ethnobotany -What’s in a name?

• “wort”- English word for plant• “perforatum”- Latin word for hole

• Legend of SJW

• Origin of name dates back to the Middle Ages

-believed the red resin was blood from the beheaded St. John the Baptist

-flowers have brightest appearance on June 24th, John the Baptist’s birthday

Ethnobotany

• Gaelic tradition

• Food flavoring

• Crop blessings– Soaked plant in olive oil until “blood” was released– Red oil used to bless crops

• Pre-Christian Religious practices– Protect from evil spirits and banish witches– Sleeping with plant provided blessings– “herba demonis fuga”: herb that chases away the devil

Historical Usage

• Used by various countries to treat:– Depression– Kidney disorders– Wound treatment– Antibacterial– Anti-viral (AIDS)– GI disorders– Diuretic– Night terrors– Cancer

Historical Uses

• Many early herbalist/physicians recommended SJW– Hippocrates, Gerard, Pliny the Elder, Dioscorides

• Medicinal usage well document with 1st written record dating back to 1st century A.D.– Pliny the Elder

• Dioscorides recommended SJW in his medical text for the treatment of sciatica and burns

• First suggested by Paracelsus to treat mental illnesses– Work led to centuries of research in this area– 1630: Agelo Sala mentioned SJW’s excellent reputation for

treating “illnesses of the imagination, melancholia, and anxiety”

Historical Usage

• SJW continued to spread and was eventually introduced to the American Indians– Used to treat tuberculosis and other breathing

conditions

• Today, SJW is best known for anti-depressive activities, but research continues in many areas, especially cancer and AIDS

• Currently, SJW is listed in national pharmacopoeias of France, Poland, Czechoslovakia, Russia, Germany and Romania

Current Medical Uses

• Depression

• Cancer

• HIV/AIDS***(Further research and trials is needed to confirm effectiveness)

• Burns, cuts, and herpes (painful blisters of genital herpes).

Methods of Use

•Depremin and Depesin : contains 0.5 mg Hypericin

•Natrol

•Kira or Jarsin 300

•Capsules•Tinctures•Teas (powder)

Depression• In any given 1-year period, 9.5 percent of the population,

or about 18.8 million American adults, suffer from a depressive illness (Robins)

• “In Germany, it is prescribed twenty times more often than popular pharmaceutical drugs Zoloft and Prozac”

• Effectiveness of St John's Wort. in Major Depression (Shelton et al. 1978-1986)

• St.John’s wort for depression-an overview and meta-analysis of randomised clinical trials (Linde et al. 253-258)

Cancer

• Compounds from St.John’s Wort have anticancer properties

• St.John’s Wort More Implications for Cancer Patients (Mansky et al. 1187-1188)

• Anti-cancer Activities of Hypericin in the Dark (Blank et al. 120-125)

• Antivascular Tumor Eradication by Hypericin-mediated Photodynamic Therapy (Chen et al. 509-513)

HIV/AIDS• Hypericin seems to interfere with the reproduction of retroviruses• Further research is needed

• P27SJ, a novel protein in St John's Wort, that suppresses expression of HIV-1 genome (Sarkissian et al. 288-295)

Side Effects

• Anxiety, dry mouth dizziness, gastrointestinal symptoms, fatigue, headache, or sexual dysfunction.

• Research shows that St. John’s Wort interacts with some drugs.

• Indinavir, Irinotecan, Cyclosporine, Digoxin, Warfarin, Birth control pills, and Antidepressants.

Compounds

• SJW contains naphtodiantrons, flavonoids, phloroglucinols, phenolic acids, and essential oils

• The active compounds are:– Hypericin, pseudohypericin (naphtodiantrons)

• Cancer

– Hyperforin (phloroglucinol)• Used for depression

Compound Structures

Mode of Action - Depression• Hyperforin – major component• Inhibits the 3H-GABA transporter GAT1 and the

3H-L-glutamate transporter EAAC1• Monensin, a Na+ ionophore, inhibits reuptake of

these, serotonin, and dopamine • Hyperforin does not act on this channel, but it

appears to act on a sodium conductive pathway

• 2003 study – upregulates serotonin 5-HT(2) receptors in mice

(Wonnemann, 2000)

(Butterweck, 2003)

Mode of Action - Cancer

• Study by F. Pajonk, 2005– Hypericin inhibits NF-κB, a major transcription

factor influencing apoptosis– Leads to premature apoptosis

• Study by B. Chen, 2002– Photodynamic therapy and hypericin– Destroys vascular cells in tumors– Has potential for use in solid tumors

Mode of Action – HIV/AIDS

• Protein from SJW - p27SJ

• Binds to C/EBPβ – inhibits its interaction with DNA

• p27SJ decreases level of viral replication in HIV infected cells

(Darbinian-Sarkissian , 2006)

Contraindications

• Hyperforin– May activate pregnane X receptor– PXR induces CYP3A4 transcription– Results in quicker metabolism of certain

xenobiotics

(Moore, 2000)

Work Cited

Blank, Michael, Mathilda Mandel, Sadick Hazan, and Yona Keisari. "ANTI-cancer Activities of Hypercin in the Dark." Photochemistry and Photobiology May 2001: 120-125.

Chen, Bin, Tania Roskams, and Peter A.M. de Witte. "Antivascular Tumor eradication by Hypericin-mediated Photodynamic Therapy." Photochemistry and Photobiology 76.5 (2002): 509-513.

Linde, Klaus, Gilbert Ramirez, Cynthia Mulrow, and Dieter Melchart. "St. John's wort for depression- an overview and meta-analysis of randomised clinical trials." BMJ 313 (1996): 253-258.

Mansky, Patrick, and Stephen Straus. "St.John's Wort: More Implications for Cancer Patients." Journal of the National Cancer Institute Aug 2002: 1187-1188.

Shelton, Richard, Martin Keller, Alan Gelenberg, and David Dunner. "Effectiveness of St John's Wort in Major Depression." JAMA 285.15 (2001): 1978-1986.

"St. John's Wort." July 2005. National Center for Complementary and Alternative Medicine. 10 Apr. 2006

Robins LN, Regier DA (Eds). Psychiatric Disorders in America, The Epidemiologic Catchment Area Study, 1990; New York: The Free Press.

Rosenthal, Norman. St.John's Wort: the herbal way to feeling good. New York: HarperCollins, 1998.

Sarkissian, N Darbinian, A Darbinyan, J Otte, and S Radhakrishnan. "P27SJ, a novel protein in St John's Wort, that suppresses expression of HIV-1 genome." Gene Therapy 13 (2005): 288-295.