Tanacetum parthenium

Tanacetum parthenium, known as feverfew,[1] is a flowering plant in the daisy family, Asteraceae. It is a traditional medicinal herb that is used commonly to prevent migraine headaches. Occasionally, it is grown for ornament. It usually is identified in the literature with its synonyms, Chrysanthemum parthenium and Pyrethrum parthenium.

This article is about the Eurasian Asteraceae species. For the North American Asteraceae genus, see Parthenium. For the band, see The Feverfew.

Feverfew
Scientific classification
Kingdom: Plantae
Clade: Tracheophytes
Clade: Angiosperms
Clade: Eudicots
Clade: Asterids
Order: Asterales
Family: Asteraceae
Genus: Tanacetum
Species:
T. parthenium
Binomial name
Tanacetum parthenium
(L.) Sch. Bip.
Synonyms
  • Chrysanthemum parthenium (L.) Bernh.
  • Matricaria parthenium L.
  • Pyrethrum parthenium (L.) Sm.

Description

The plant is a herbaceous perennial that grows into a small bush,[2] up to 70 cm (28 in) high, with pungently-scented leaves. The leaves are light yellowish green, variously pinnatifid. The conspicuous daisy-like flowers are up to 20 millimetres (3⁄4 in) across, borne in lax corymbs. The outer, ray florets have white ligules and the inner, disc florets are yellow and tubular. It spreads rapidly by seed, and will cover a wide area after a few years.[3][4]

Distribution and cultivation

Feverfew is native to Eurasia, specifically the Balkan Peninsula, Anatolia, and the Caucasus, but cultivation has spread it around the world and it now is found in the rest of Europe, North America, and Chile.[5]

A perennial herb, it should be planted in full sun, 38 to 46 cm (15–18 in) apart, and cut back to the ground in the autumn. It grows up to 70 cm (28 in) tall. It is hardy to USDA zone 5 (−30 °C (−22 °F)). Outside of its native range, it may become an invasive weed.[6]

Uses
Leaf of feverfew

In traditional herbal medicine, feverfew has been used for fever, headache, arthritis,[7] and digestive problems.[8][9][10]

Parthenolide

The active ingredients in feverfew include parthenolide.[11] There has been some scientific interest in parthenolide, which has been shown to induce apoptosis in some cancer cell lines in vitro and, potentially, to target cancer stem cells.[12][13][14] There are no published in vivo studies of parthenolide or feverfew for humans with cancer.

The role of parthenolide in inducing the antimigraine effects of feverfew has been investigated mostly in vitro. Antagonism of serotonin receptors and inhibition of neuronal released serotonin (5-HT) have been suggested for the mechanism of action.[15][16] Pathenolide also seems to play a role in the blockade of NO cascade and of the release of pro-inflammatory cytokines (TNF-α and IL-6) which might be involved in the pathogenesis of migraine.[17][18] Parthenolide has been shown to act as a TRPA1 partial agonist, causing selective channel desensitisation and a non-selective defunctionalisation of CGRP-containing sensory neurons. The release of the sensory neuropeptide CGRP within the trigeminovascular system has also been considered to be involved in the genesis of migraine headaches[19]

The parthenolide content of commercially available feverfew supplements varies substantially, by more than 40-fold, despite labeling claims of "standardization". A study found that the parthenolide content of these supplements bore little resemblance to the content claimed on the product labels.[20]

In August 2019, ScienceDaily reported that researchers at the University of Birmingham announced that they had developed a method to produce parthenolide directly from the plants and a way of modifying that parthenolide to produce a number of compounds, both of which techniques seem promising to enable clinical research into the potential of feverfew for medical applications.[21]

Six controlled clinical trials assessing the efficacy and safety of feverfew monotherapy in the prevention of migraine have been published. In total, 513 patients participated in these studies. Study sample sizes ranged from 17 to 170. In all studies, feverfew was self-administered orally one to three times daily in capsule form. Study duration ranged from two to eight months.[22][23][24][25][26][27] The majority of the clinical trials favoured feverfew over placebo. The data also suggest that feverfew is associated with only mild and transient adverse effects. The frequency of migraine was positively affected after treatment with feverfew. Reduction of migraine severity was also reported after intake of feverfew and incidence of nausea and vomiting decreased significantly.

Feverfew is registered as a traditional herbal medicine in the Nordic countries under the brand name Glitinum. Only powdered feverfew is approved in the European Union herbal monograph issued by the European Medicines Agency.[28]

Long-term use of feverfew followed by abrupt discontinuation may induce a withdrawal syndrome featuring rebound headaches and muscle and joint pains.[29] Feverfew may cause allergic reactions, including contact dermatitis.[30] Other side effects have included gastrointestinal upset such as nausea, vomiting, abdominal pain, diarrhea, and flatulence. When the herb is chewed or taken orally it may cause mouth ulcers and swelling and numbness of the mouth.[29] Feverfew should not be taken by pregnant women.[31] It may interact with blood thinners and increase the risk of bleeding, and also may interact with a variety of medications metabolized by the liver.[29]

History

The word "feverfew" derives from the Latin word febrifugia, meaning "fever reducer",[29] although it no longer is considered useful for that purpose.

Although its earliest medicinal use is unknown, it was documented in the first century (AD) as an anti-inflammatory by the Greek herbalist physician, Dioscorides.[32]

References
  1. "Tanacetum parthenium". Natural Resources Conservation Service PLANTS Database. USDA. Retrieved 8 December 2015.
  2. National Center for Complementary and Integrative Health. "FeverFew". Retrieved 18 July 2012.
  3. Parnell, J. and Curtis. 2012. Webb's An Irish Flora. Cork University Press. ISBN 978-185918-4783
  4. Clapham, A.R, Tutin, T.G. and Warburg, E.F. 1968. Excursion Flora of the British Isles. Cambridge University Press. ISBN 0-521-04656-4
  5. Jeffrey C (2001). "Tanacetum parthenium". Mansfeld's World Database of Agricultural and Horticultural Crops.
  6. Hadjikyriakou, G.; Hadjisterkotis, E. (2002). "The adventive plants of Cyprus with new records of invasive species". Zeitschrift für Jagdwissenschaft. Springer Science and Business Media LLC. 48 (S1): 59–71. doi:10.1007/bf02192393. ISSN 0044-2887. S2CID 42896188.
  7. University of Maryland Medical Center. "Feverfew". Archived from the original on 13 July 2012. Retrieved 18 July 2012.
  8. Pittler MH, Ernst E (2004). Pittler MH (ed.). "Feverfew for preventing migraine". Cochrane Database of Systematic Reviews (1): CD002286. doi:10.1002/14651858.CD002286.pub2. PMID 14973986.
  9. "Feverfew". National Center for Complementary and Integrative Health. July 2010. Retrieved October 6, 2011.
  10. Pareek A, Suthar M, Rathore GS, Bansal V (January 2011). "Feverfew (Tanacetum parthenium L.): A systematic review". Pharmacogn Rev. 5 (9): 103–10. doi:10.4103/0973-7847.79105. PMC 3210009. PMID 22096324.
  11. Meschino Health. "Comprehensive Guide to Feverfew". Retrieved 18 July 2012.
  12. Guzman ML, Rossi RM, Karnischky L, et al. (June 2005). "The sesquiterpene lactone parthenolide induces apoptosis of human acute myelogenous leukemia stem and progenitor cells". Blood. 105 (11): 4163–9. doi:10.1182/blood-2004-10-4135. PMC 1895029. PMID 15687234.
  13. Guzman ML, Jordan CT (September 2005). "Feverfew: weeding out the root of leukaemia". Expert Opin Biol Ther. 5 (9): 1147–52. doi:10.1517/14712598.5.9.1147. PMID 16120045. S2CID 8626116.
  14. Lesiak K, Koprowska K, Zalesna I, Nejc D, Düchler M, Czyz M (February 2010). "Parthenolide, a sesquiterpene lactone from the medical herb feverfew, shows anticancer activity against human melanoma cells in vitro". Melanoma Res. 20 (1): 21–34. doi:10.1097/CMR.0b013e328333bbe4. PMID 19949351. S2CID 35650531.
  15. Mittra, S; Datta, A; Singh, SK; Singh, A (2000). "5-Hydroxytryptamine-inhibiting property of Feverfew: role of parthenolide content". Acta Pharmacol Sin. 1106–1114 (21): 1106–14. PMID 11603284.
  16. Bejar, E (1996). "Parthenolide inhibits the contractile responses of rat stomach fundus to fenfluramine and dextroamphetamine but not serotonin". J Ethnopharmacol. 50 (50): 1–12. doi:10.1016/0378-8741(95)01319-9. PMID 8778501.
  17. Reuter, U; Chiarugi, A; Bolay, A; Moskowitz, MA (2002). "Nuclear factor-kappaB as a molecular target for migraine therapy". Ann Neurol. 51 (4): 507–16. doi:10.1002/ana.10159. PMID 11921057. S2CID 57785704.
  18. Magni, P; Ruscica, M; Dozio, E; Rizzi, E; Beretta, G; Maffei Facino, R (2012). "Parthenolide Inhibits the LPS-induced Secretion of IL-6 and TNF-a and NF-κB Nuclear Translocation in BV-2 Microglia". Phytother. Res. 26 (9): 1405–9. doi:10.1002/ptr.3732. PMID 22359368. S2CID 503735.
  19. Materazzi, S; Benemei, S; Fusi, C; Gualdani, R; De Siena, G; Vastani, N; Andersson, DA (2013). "Parthenolide inhibits nociception and neurogenic vasodilatation in the trigeminovascular system by targeting TRPA1 channel". Pain. 154 (12): 2750–8. doi:10.1016/j.pain.2013.08.002. PMC 3843982. PMID 23933184.
  20. Draves AH, Walker SE (2004). "Parthenolide content of Canadian commercial feverfew preparations: Label claims are misleading in most cases" (PDF). Canadian Pharmacists Journal. 136 (10): 23–30. Archived from the original (PDF) on 2012-04-20.
  21. Hidden chemistry in flowers shown to kill cancer cells, ScienceDaily, August 1, 2019
  22. Johnson, ES; Kadam, NP; Hylands, DM; Hylands, PJ (1985). "Efficacy of feverfew as prophylactic treatment of migraine". Br Med J (Clin Res Ed). 291 (6495): 569–73. doi:10.1136/bmj.291.6495.569. PMC 1418227. PMID 3929876. S2CID 196382961.
  23. Murphy, JJ; Heptinstall, S; Mitchell, JR (1988). "Randomised double-blind placebo-controlled trial of feverfew in migraine prevention". Lancet. 189–192 (8604): 189–92. doi:10.1016/s0140-6736(88)92289-1. PMID 2899663. S2CID 21460233.
  24. Palevitch, D; Earon, G; Carasso, R (1997). "Feverfew (Tanacetum parthenium) as a prophylactic treatment for migraine: a double-blind placebo-controlled study". Phytotherapy Research. 11 (7): 508–511. doi:10.1002/(SICI)1099-1573(199711)11:7<508::AID-PTR153>3.0.CO;2-H.
  25. de Weerdt, CJ; Bootsma, HPR; Hendriks, H (1996). "Herbal medicines in migraine prevention: Randomized double-blind placebo-controlled crossover trial of feverfew preparation". Phytomedicine. 3 (3): 225–30. doi:10.1016/S0944-7113(96)80057-2. PMID 23195074.
  26. Diener, HC; Pfaffenrath, V; Schnitker, J; Friede, M; Henneicke-von Zepelin, HH (2005). "Efficacy and safety of 6.25 mg t.i.d. feverfew CO2-extract (MIG-99) in migraine prevention - a randomized, double-blind, multicentre, placebo-controlled study". Cephalalgia. 25 (11): 1031–41. doi:10.1111/j.1468-2982.2005.00950.x. PMID 16232154. S2CID 25754461.
  27. Pfaffenrath, V; Diener, HC; Fischer, M; Friede, M; Henneicke-von Zepelin, HH (2002). "The efficacy and safety of Tanacetum parthenium (feverfew) in migraine prophylaxis—a double‐blind, multicentre, randomized placebo‐controlled dose–response stud". Cephalalgia. 22 (7): 523–32. doi:10.1046/j.1468-2982.2002.00396.x. PMID 12230594. S2CID 46596473.
  28. (EMA)
  29. "Feverfew". University of Maryland. Retrieved 6 October 2011.
  30. Killoran, CE; Crawford, GH; Pedvis-Leftick, A (2007). "Two cases of compositae dermatitis exacerbated by moisturizer containing feverfew". Dermatitis : Contact, Atopic, Occupational, Drug. 18 (4): 225–9. doi:10.2310/6620.2007.06063. PMID 18021604.
  31. Yao M, Ritchie HE, Brown-Woodman PD (November 2006). "A reproductive screening test of feverfew: is a full reproductive study warranted?". Reprod. Toxicol. 22 (4): 688–93. doi:10.1016/j.reprotox.2006.04.014. PMID 16781113.
  32. "Agricultural (Herbs and Spices): Feverfew Information". Government of Saskatchewan. Archived from the original on 4 November 2012. Retrieved 6 January 2012.

Further reading

Johnson, E. S.; Kadam, N. P.; Hylands, D. M. (August 31, 1985). "Efficacy Of Feverfew As Prophylactic Treatment Of Migraine". British Medical Journal (Clinical Research Edition). 291 (6495): 569–573. doi:10.1136/bmj.291.6495.569. JSTOR 29520398. PMC 1418227. PMID 3929876.

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