August 2008 • w w w. s k i n a n d a l l e rg y n ew s. c o m Aesthetic Dermatology 33

C O S M E C E U T I C A L C R I T I Q U E : Part I

ngelica sinensis, better known as pendently displayed antioxidant activities. dong quai, is a fragrant perennial L. barbarum extract was the strongest, but Aplant that has been used for med- all the extracts inhibited ferric chloride- icinal purposes for more than a thousand ascorbic acid–induced lipid peroxidation in years in , Japan, and Korea. A. sinen- rat liver homogenate in vitro, and demon- sis is best known as a traditional treat- strated significant superoxide anion-scav- ment for dysmenorrhea, amenorrhea, enging activity as well as antisuperoxide menopause, and related conditions in formation activity (Phytother. Res. women. 2004;18:1008-12). The herb is used throughout the world, Another study revealed that the total including the United States, polysaccharide from A. as an unregulated oral sup- sinensis confers antitumor plement and in some topical effects on in vivo murine multibotanical formulations. models and, in vitro, inhibits . C

The dried root of A. sinen- invasion and metastasis of N I , sis is included in several herbal hepatocellular cancer cells O T O formulations, typically for (World J. Gastroenterol. H P K amenorrhea, endometriosis 2003;9:1963-7). C O T S I

and premenstrual syndrome, In a study of the effects of / A S and as a hormone replace- 14 commonly used herbs on I D A ment therapy alternative, cellular proliferation and © even though Western medi- apoptosis of a hepatic stel- Although little dermatologic research has been done, the , B Y L E S L I E S . cine has not established B A U M A N N , M . D. late cell line in rats, A. sinen- also known as dong quai, appears to have antioxidant and antitumorigenic activity. whether such indications are sis was among five herbs that appropriate or justified (Inte- exhibited both antiprolifera- trointestinal damage (Planta Med. monary fibrosis (Zhonghua Jie He He Hu grative Cancer Therapies 2003;2:120-38; tive and proapoptotic properties in asso- 2000;66:348-51). Xi Za Zhi 1996;19:26-8). Nurse Pract. 1997;22:55-6, 61-6). ciation with upregulation of Fas and Bax Some of the same researchers fol- Similarly, a traditional Chinese medic- Despite numerous anecdotal reports of and downregulation of Bcl-xL. Investiga- lowed up by demonstrating that A. sinen- inal decoction containing A. sinensis and its effectiveness in exerting estrogenic ef- tors suggested that further research is sis extract has a direct wound-healing ef- Astragalus membranaceus, which is used for fects, a study of 71 postmenopausal warranted into the antifibrotic potential of fect on gastric epithelial cells. The herb stimulating production of red blood cells women showed that A. sinensis alone failed these herbs to promote apoptosis in he- significantly promoted epithelial cell mi- and bolstering cardiovascular function, to produce estrogenic effects on endome- patic stellate cells, which are integral in he- gration over an artificial wound, and was shown in a rat model to confer my- trial thickness or vaginal maturation. In patic fibrosis and are known to possess an- dose-dependently stimulated DNA syn- ocardial protection against ischemia- addition, the herb eased menopause symp- tifibrotic activity (J. Ethnopharmacol. thesis as well as concurrent epithelial reperfusion injury (Phytother. Res. toms no better than placebo (Fertil. Ster- 2005;100:180-6). growth factor mRNA expression (Life 2000;14:195-9). il. 1997;68:981-6). Sci. 2001;68:961-8). Injection of Qi-Xue, another Chinese Although the reported effects of this re- Action in the Skin Subsequent research confirmed that A. herb combination containing A. sinensis, puted “women’s herb” remain dubious in Perhaps the evidence providing the most sinensis crude extract does dose-dependently Panax , and Astragalus monogholicus, the West, evidence is increasing that A. direct link to dermatologic application confer a direct healing effect on gastric mu- is thought to prevent severe hypoxic pul- sinensis possesses anticarcinogenic prop- comes from a study of the effects of A. cosal lesions in rats, and it also promotes monary hypertension by enhancing heart erties, which are often associated with an- sinensis on melanocytes and tyrosinase ac- wound repair in culture (Biochem. Phar- function (Zhongguo Yi Xue Ke Xue Yuan tioxidant potential and implications for tivity. The potent herb was noted for sig- macol. 2001;61:1439-48). Xue Bao 1990;12:51-5). dermatologic use. nificantly promoting In high doses, A. sinensis may increase In this vein, the potent antioxidant fer- melanocytic prolifer- The herb promoted Other Actions susceptibility to photosensitivity reactions, ulic acid, which was featured in this col- ation, which substan- An evaluation of the so sun exposure should be curtailed. It also umn in October 2005, has been identified tially increased cell melanocytic proliferation, therapeutic activity is contraindicated for patients taking war- as a major active component of A. sinen- counts, and fostering which upped cell counts, of A. sinensis on fo- farin (Lancet 2000; 355:134-8; J. Am. Med. sis, along with ligustilide (J. Pharm. Bio- melanin synthesis cal ischemic injury Womens Assoc. 1999;54:191-2, 195). med. Anal. 2005;38:664-9). and melanocytic ty- and fostered melanin in rats showed re- rosinase activity. Such synthesis and melanocytic duced volume of Conclusions Antitumor Action actions, the investiga- cerebral infarction, A. sinensis is one of the oldest and most Investigators assessing the antitumor ef- tors concluded, sug- tyrosinase activity. reduced Bax protein popular herbs used in traditional Chi- fects, in vitro and in vivo, of a chloroform gest a mechanism expression, and sig- nese medicine. While there is an ex- extract of A. sinensis on glioblastoma mul- that may justify the use of this fragrant nificant decreases in the number of neu- panding body of research on the broad tiforme brain tumors reported that the botanical in the treatment of skin dyschro- ronal apoptosis cells (Clin. Hemorheol. medical applications of this botanical herb strongly inhibits the growth of ma- mias (Di Yi Jun Yi Da Xue Xue Bao Microcirc. 2005;32:209-15). Improvement product, and it is being used in multi- lignant brain tumor cells, via cell cycle ar- 2003;23:239-41). in microcirculation, with obvious impli- botanical formulations, there is minimal rest and apoptosis induction, without In addition, A. sinensis is an ingredient cations for various organs, was achieved evidence as yet to warrant its use for der- damaging fibroblasts. in Si-Wu-Tang, a traditional Chinese for- by the intravenous injection of A. sinen- matologic purposes. In vitro, angelica spurred p53-depen- mula used to treat pruritus, chronic skin sis in a study examining the mechanism Recent studies, however, do seem to in- dent and -independent pathways, result- inflammation, and other conditions (Biol. of microcirculation disorder in the dicate that A. sinensis has antioxidant and ing in apoptosis. In human DBTRG- Pharm. Bull. 2002;25:1175-8). tongue in the common oral disease glos- antitumorigenic activity and that it war- 05MG and rat RG2 glioblastoma sodynia (Hua Xi Kou Qiang Yi Xue Za rants further investigation, including for multiforme tumor cells, angelica sup- Gastrointestinal Protection Zhi 2000;18:101-2, 108). its potential benefit to the skin. Research pressed malignant growth and reduced Polysaccharides isolated from the root of Aqueous extract of A. sinensis has been associating angelica with melanocytic, tumor volume. Researchers concluded A. sinensis have been found to impart an ul- shown in a rabbit model to impart my- anti-inflammatory, and antipruritic prop- that A. sinensis merits more research and cer-protective effect. ocardial protective effects caused by is- erties also deserves attention and further consideration as a potential brain tumor Specifically, angelica extract dose-de- chemia reperfusion (Zhongguo Zhong Xi study. I therapeutic agent (Clin. Cancer Res. pendently inhibited various neutrophil-de- Yi Jie He Za Zhi 1995;15:486-8). 2005;11:3475-84). pendent gastrointestinal lesions induced A study of the effects of two herbs used DR. BAUMANN is director of cosmetic In a study that assessed the antioxidant in rats by orally administered ethanol or in traditional Chinese medicine to treat dermatology at the University of Miami. To activities of three herbs used frequently in indomethacin. The investigators con- bleomycin-induced pulmonary fibrosis in respond to this column, or to suggest topics traditional Chinese medicine—A. sinensis, cluded that angelica exhibits anti-inflam- rats revealed that ligustrazini and, to a for future columns, write to Dr. Baumann at Lycium barbarum, and Poria cocos—aqueous matory action, and might be effective in lesser extent, A. sinensis, lessened the sever- our editorial offices via e-mail at extracts of these herbs concentration-de- preventing neutrophil-dependent gas- ity of alveolitis symptomatic of pul- [email protected].