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Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review

BACKGROUND: Elderberry has traditionally been used to prevent and treat respiratory problems. During the COVID-19 pandemic, there has been interest in elderberry supplements to treat or prevent illness, but also concern that elderberry might overstimulate the immune system and increase the risk of ‘...

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Autores principales: Wieland, L. Susan, Piechotta, Vanessa, Feinberg, Termeh, Ludeman, Emilie, Hutton, Brian, Kanji, Salmaan, Seely, Dugald, Garritty, Chantelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026097/
https://www.ncbi.nlm.nih.gov/pubmed/33827515
http://dx.doi.org/10.1186/s12906-021-03283-5
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author Wieland, L. Susan
Piechotta, Vanessa
Feinberg, Termeh
Ludeman, Emilie
Hutton, Brian
Kanji, Salmaan
Seely, Dugald
Garritty, Chantelle
author_facet Wieland, L. Susan
Piechotta, Vanessa
Feinberg, Termeh
Ludeman, Emilie
Hutton, Brian
Kanji, Salmaan
Seely, Dugald
Garritty, Chantelle
author_sort Wieland, L. Susan
collection PubMed
description BACKGROUND: Elderberry has traditionally been used to prevent and treat respiratory problems. During the COVID-19 pandemic, there has been interest in elderberry supplements to treat or prevent illness, but also concern that elderberry might overstimulate the immune system and increase the risk of ‘cytokine storm’. We aimed to determine benefits and harms of elderberry for the prevention and treatment of viral respiratory infections, and to assess the relationship between elderberry supplements and negative health impacts associated with overproduction of pro-inflammatory cytokines. METHODS: We conducted a systematic review and searched six databases, four research registers, and two preprint sites for studies. Two reviewers independently assessed studies for inclusion, extracted data from studies, assessed risk of bias using Cochrane tools, and evaluated certainty of estimates using GRADE. Outcomes included new illnesses and the severity and duration of illness. RESULTS: We screened 1187 records and included five randomized trials on elderberry for the treatment or prevention of viral respiratory illness. We did not find any studies linking elderberry to clinical inflammatory outcomes. However, we found three studies measuring production of cytokines ex vivo after ingestion of elderberry. Elderberry may not reduce the risk of developing the common cold; it may reduce the duration and severity of colds, but the evidence is uncertain. Elderberry may reduce the duration of influenza but the evidence is uncertain. Compared to oseltamivir, an elderberry-containing product may be associated with a lower risk of influenza complications and adverse events. We did not find evidence on elderberry and clinical outcomes related to inflammation. However, we found evidence that elderberry has some effect on inflammatory markers, although this effect may decline with ongoing supplementation. One small study compared elderberry to diclofenac (a nonsteroidal anti-inflammatory drug) and provided some evidence that elderberry is as effective or less effective than diclofenac in cytokine reduction over time. CONCLUSIONS: Elderberry may be a safe option for treating viral respiratory illness, and there is no evidence that it overstimulates the immune system. However, the evidence on both benefits and harms is uncertain and information from recent and ongoing studies is necessary to make firm conclusions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12906-021-03283-5.
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spelling pubmed-80260972021-04-08 Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review Wieland, L. Susan Piechotta, Vanessa Feinberg, Termeh Ludeman, Emilie Hutton, Brian Kanji, Salmaan Seely, Dugald Garritty, Chantelle BMC Complement Med Ther Research Article BACKGROUND: Elderberry has traditionally been used to prevent and treat respiratory problems. During the COVID-19 pandemic, there has been interest in elderberry supplements to treat or prevent illness, but also concern that elderberry might overstimulate the immune system and increase the risk of ‘cytokine storm’. We aimed to determine benefits and harms of elderberry for the prevention and treatment of viral respiratory infections, and to assess the relationship between elderberry supplements and negative health impacts associated with overproduction of pro-inflammatory cytokines. METHODS: We conducted a systematic review and searched six databases, four research registers, and two preprint sites for studies. Two reviewers independently assessed studies for inclusion, extracted data from studies, assessed risk of bias using Cochrane tools, and evaluated certainty of estimates using GRADE. Outcomes included new illnesses and the severity and duration of illness. RESULTS: We screened 1187 records and included five randomized trials on elderberry for the treatment or prevention of viral respiratory illness. We did not find any studies linking elderberry to clinical inflammatory outcomes. However, we found three studies measuring production of cytokines ex vivo after ingestion of elderberry. Elderberry may not reduce the risk of developing the common cold; it may reduce the duration and severity of colds, but the evidence is uncertain. Elderberry may reduce the duration of influenza but the evidence is uncertain. Compared to oseltamivir, an elderberry-containing product may be associated with a lower risk of influenza complications and adverse events. We did not find evidence on elderberry and clinical outcomes related to inflammation. However, we found evidence that elderberry has some effect on inflammatory markers, although this effect may decline with ongoing supplementation. One small study compared elderberry to diclofenac (a nonsteroidal anti-inflammatory drug) and provided some evidence that elderberry is as effective or less effective than diclofenac in cytokine reduction over time. CONCLUSIONS: Elderberry may be a safe option for treating viral respiratory illness, and there is no evidence that it overstimulates the immune system. However, the evidence on both benefits and harms is uncertain and information from recent and ongoing studies is necessary to make firm conclusions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12906-021-03283-5. BioMed Central 2021-04-07 /pmc/articles/PMC8026097/ /pubmed/33827515 http://dx.doi.org/10.1186/s12906-021-03283-5 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Wieland, L. Susan
Piechotta, Vanessa
Feinberg, Termeh
Ludeman, Emilie
Hutton, Brian
Kanji, Salmaan
Seely, Dugald
Garritty, Chantelle
Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review
title Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review
title_full Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review
title_fullStr Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review
title_full_unstemmed Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review
title_short Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review
title_sort elderberry for prevention and treatment of viral respiratory illnesses: a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026097/
https://www.ncbi.nlm.nih.gov/pubmed/33827515
http://dx.doi.org/10.1186/s12906-021-03283-5
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