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Clinical Trial to Investigate Potential of Sage for Alzheimer's Disease Treatment

  [ 58 votes ]   [ Discuss This Article ]
By Deborah Cooper • • February 13, 2001

Dr John A. Wilkinson is senior lecturer in phytochemistry and pharmacognosy and leads a research group in herbal medicines at Middlesex University, in the United Kingdom. The group specializes in the discovery of "new herbal medicines" and the development of new uses of traditionally-used herbal medicines. Dr. Wilkinson also teaches at Oxford University's Medical School. He also undertakes phytochemical and clinical studies for companies internationally, who are working on herbal medicines. Why are you testing sage? What type of sage are you testing and what are it's main components?

Wilkinson: Sage has a long history of use as a treatment for memory loss. In the medieval herbals it is often refrered to as "good for the brain". We have tested extracts of sage sourced from different parts of the world as possible acetylcholinesterase inhibitors, a clinically proven mechanism for treatment of memory loss in Alzheimer's (AD) patients. What we have found is a whole range of active constituents that are effective inhibitors of this enzyme.

However, what was extrordinary in our findings was that the whole extract was more active than the individual components and therefore this justifies the use of the herbal medicine rather than developing a synthetic drug from the plant. This is potentially very exciting as many herbal medicines have minimal or no side effects. We don't understand this at present but it is probably due to the fact that there are synergistic effects operating in a herbal medicine that helps lower the effective concentration of the active agents.

Also, many compounds found in herbal medicines as well as in fruits and vegetables are known to have balancing effects in the body. These probably all play a part in reducing the side effects of these medicines. Now that we have a possible mode of action, combined with some very strong herbal folklore, I am confident that sage is highly likely to impart some benefit to those people who have memory problems, particularly those in AD. Of course, what we now need is some good quality research data to show that this plant has a place in AD treatment. What is the goal of the trial?

Wilkinson: What we don't know is how much sage we need to see an effect. It is unlikely that the traditional dosage of sage will work in this particular indication as sage is used mainly for the relief of sore throats and menopausal problems. So we need to do some dosaging studies combined with some efficacy studies. What previous work led researchers to test sage?

We were inspired by previous work carried out at Kings College London and Newcastle Hospital where they showed that an extract of sage was an Acetylcholinesterase inhibitor. However, we have been focusing on the herbal medicine and finding potent synergy effects in the plant. On a wider level our goal is to develop herbal medicines that have the same level of testing as conventional synthetic drugs in terms of their quality control, safety and efficacy. This will increase patient and consumer confidence and make these medicines available to a much wider audience. This will ultimately mean that herbalists and naturopaths will be able to dispense higher quality herbal medicines and also that doctors will want to prescribe them. I believe that in the future, once research has been carried out in this way, that up to 50% of our medicines will be herbal medicines and this will help us to produce medicines based on sustainable sources of raw materials and that are environmentaly cleaner than those based on fossil fuels (synthetic drugs). How important is this research for Alzheimer's disease?

If sage works, then it is likely that it will have a multi-functional effect on AD, as the herb has many different compounds that are active in different ways. Some components for example, are also powerful antioxidants. It is also likely to provide a treatment that has minimum side effects. Some botanical forms of sage can be toxic when taken in large amounts. We have found a variety of sage that has most of the active constituents but none of the toxic ones. We have now formulated this into a capsule and we are providing this to a small limited number of patients in the UK and abroad, who can't or aren't prepared to wait for the results of the trial which we hope to conduct in the summer of 2001.

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