Echinacea and echinocandins: A breakthrough in the treatment of Candida or a historical fact?

by Monica Wilde, Research Herbalist

For over a century Western herbalists have prescribed the herb Echinacea angustifolia root extract to improve the treatment outcome of patients being treated for the yeast infection commonly known as thrush (Candida albicans). This was backed up by clinical evidence that patients taking Echinacea angustifolia internally, in combination with topical antifungal creams or pessaries, also had a much lower recurrence of the condition.

The development of echinocandins, the first class of antifungals to target the fungal cell wall, the first new antifungal drug class introduced for more than 15 years, was considered a milestone achievement in antifungal chemotherapy by the pharmaceutical industry. The drug caspofungin acetate (Cancidas®) from Merck was the first echinocandin marketed in 2001 (six years after Merck patented a semisynthetic copy of the respective echinacea phytocompound in 1995). Echinocandins inhibit the synthesis of β-D-glucan in fungal cell walls. Their advantages include low toxicity, rapid fungicidal activity against most isolates of Candida spp.

As a herbal medicine Echinacea angustifolia root is extremely effective and rarely has side-effects in otherwise healthy patients. On the other hand, caspofungin, given by injection has a whole host of side effects listed: http://www.drugs.com/sfx/cancidas-side-effects.html  

It begs the question that if Echinacea angustifolia root is so effective taken orally, why would anyone want to develop an injectable concentrate with side effects? Sadly the answer is in the economics.  With the cost of clinical trials needed to licence a drug with a claim being hundreds of thousands of pounds, who on earth would want to invest in a simple, low-tech, herbal extract that is easy for any manufacturer or herbalist to reproduce and cannot be patented. So clinical trials remain sadly lacking for simple, natural herbal extracts with high efficacy and low risk as practitioners of traditional herbal medicine just do not have access to this level of funding.

For more about the herbal approach to treating Candida (thrush) click here.

References

Cruz I, Cheetham JJ, Arnason JT, Yack JE, Smith ML. Alkamides from Echinacea disrupt the fungal cell wall-membrane complex. Phytomedicine. 2014 Mar 15;21(4):435-42. doi: 10.1016/j.phymed.2013.10.025. Epub 2013 Nov 16. PubMed PMID: 24252333.

Morazzoni P, Cristoni A, Di Pierro F, Avanzini C, Ravarino D, Stornello S, Zucca M, Musso T. In vitro and in vivo immune stimulating effects of a new standardized Echinacea angustifolia root extract (Polinacea). Fitoterapia. 2005 Jul;76(5):401-11. PubMed PMID: 15949903.

Roesler J, Steinmüller C, Kiderlen A, Emmendörffer A, Wagner H, Lohmann-Matthes ML. Application of purified polysaccharides from cell cultures of the plant Echinacea purpurea to mice mediates protection against systemic infections with Listeria monocytogenes and Candida albicans. Int J Immunopharmacol. 1991;13(1):27-37. PubMed PMID: 2026472.

Steinmüller C, Roesler J, Gröttrup E, Franke G, Wagner H, Lohmann-Matthes ML.  Polysaccharides isolated from plant cell cultures of Echinacea purpurea enhance the resistance of immunosuppressed mice against systemic infections with Candida  albicans and Listeria monocytogenes. Int J Immunopharmacol. 1993 Jul;15(5):605-14. PubMed PMID: 8375943.