| Candidate ID: | R1507 |
| Source ID: | DB13975 |
| Source Type: | experimental |
| Compound Type: |
biotech
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| Compound Name: |
Black cohosh
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| Synonyms: |
Black cohosh; Black snakeroot; Cimicifuga racemosa; Cimicifuga racemosa rhizome; Cimicifuga racemosa root; Cimicifuga racemosa root with rhizome; Cimicifugae rhizoma; Fairy candle root; Rattleroot
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| Molecular Formula: |
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| SMILES: |
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| DrugBank Description: |
Black cohosh (_Actaea racemosa_ or _Cimicifuga racemosa_), a member of the buttercup family, is a perennial plant which native to North America. Historical names for this plant include snakeroot, black bugbane, rattleweed, macrotys, and rheumatism weed. Black cohosh has a long history of use. Native Americans used it for its purported benefits in treating musculoskeletal pain, fever, cough, pneumonia, sluggish labor, and menstrual irregularities. European settlers were said to use black cohosh as a tonic to support female reproductive health.
Hormone replacement therapy (HRT) is the standard treatment for early symptoms in post-menopausal women, however, increases the risk of stroke, heart diseases, as well as breast cancer in older women. Various studies have shown that the number of post-menopausal women using hormone replacement therapy is currently low and that the effects of hormone replacement therapy in reducing menopausal symptoms are not as positive as expected. For these reasons, there has been a trend toward using alternative therapies to relieve menopausal symptoms.
Black cohosh has been associated with serious safety concerns. Results from studies suggest that C. racemosa possesses a central activity instead of a hormonal effect.
The American College of Obstetrics and Gynecology guidelines on the use of botanicals, such as black cohosh, for the management of menopausal symptoms the use of for up to six months, especially in treating the symptoms of sleep and mood disturbance, and hot flushes.
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| CAS Number: |
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| Molecular Weight: |
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| DrugBank Indication: |
Treatment of menopausal symptoms and menstrual dysfunction .
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| DrugBank Pharmacology: |
This agent is purported to relieve some of the vasomotor symptoms of menopause, including hot flashes and night sweats.
A 2012 Cochrane review analyzed 16 randomized clinical trials on the effectiveness of black cohosh in reducing menopausal symptoms, including hot flushes, night sweats, vaginal dryness, and numerous combinations of symptoms which were measured by validated rating scales. There is currently insufficient evidence to support the use of black cohosh for menopausal symptoms. The studies were quite heterogeneous in design, duration, type and amount of black cohosh used, and main findings.
A 2016 systematic review and meta-analysis of randomized clinical trials analyzed four studies of herbal and plant-based therapies that included black cohosh to treat menopausal symptoms. It was suggested that composite and specific phytoestrogen supplementations were associated with small reductions in the incidence of hot flashes and vaginal dryness, however, no significant reduction in night sweats.
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| DrugBank MoA: |
Although the mechanism by which black cohosh relieves menopausal symptoms is unknown, several hypotheses have been made. It is believed to act through the following mechanisms/effects:
1) as a selective estrogen receptor modulator
2) through serotonergic pathways
3) as an antioxidant
4) on inflammatory pathways
The primary active component of the black cohosh root is believed to be the _terpene glycoside_ fraction, including _actein_ and _cimifugoside_. The triterpenes are one of the most ubiquitous and diverse groups of plant natural products. They are classified as complex molecules that are beyond the reach of chemical synthesis in the laboratory. Simple triterpenes are constituents of surface waxes and specialized plant membranes and may possibly serve as signaling molecules. More complex glycosylated triterpenes (also known as saponins) provide protection against pathogens and pests. The rhizome (stem portion of the plant) also contains other potentially biologically active substances, including alkaloids, flavonoids, and tannins. The therapeutic activity of black cohosh was initially believed to be the activation of estrogen receptors; however, more recent studies show that although some components of the extract bind to at least one subtype of estrogen receptor, the receptor binding produces very little (if any) estrogenic effect, and may selectively block some of the effects.
An early study reported that treatment with black cohosh leads to a decrease in luteinizing hormone (LH) levels consistent with its purported estrogenic effect. Despite this, more recent studies have shown no effect on levels of LH, follicle-stimulating hormone (FSH), or prolactin. To this day it is unclear whether black cohosh exerts its effect via estrogen receptors or through another mechanism.
One study observed that while the most prominent _triterpene_ in black cohosh, known as _23-epi-26-deoxyactein_, inhibits cytokine-induced nitric oxide production in brain microglial cells, the complete black cohosh extract demonstrated to enhance this pathway. A variety of activities have been reported for black cohosh and its compounds, however, the absorption and tissue distribution of these compounds is not known.
_Cimicifuga racemosa_ (black cohosh) is used most often to treat symptoms occurring during menopause. However, in recent years, several concerns regarding its safety have been voiced.
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| Targets: |
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| Inclusion Criteria: |
Therapeutic strategy associated
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