An Evidence-Based Systematic Review of Elderberry and Elderflower (Sambucus nigra) by the Natural Standard Research Collaboration

ABSTRACT An evidence-based systematic review of elderberry and elderflower (Sambucus nigra) by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.

[1]  C. Quave,et al.  Traditional food and herbal uses of wild plants in the ancient South-Slavic diaspora of Mundimitar/Montemitro (Southern Italy) , 2012, Journal of Ethnobiology and Ethnomedicine.

[2]  Ray Williams,et al.  Effect of an herbal mouth rinse in preventing periodontal inflammation in an experimental gingivitis model: a pilot study. , 2012, Compendium of continuing education in dentistry.

[3]  M. Oberbaum,et al.  Localized reduction of gingival inflammation using site-specific therapy with a topical gingival patch. , 2012, The Journal of clinical dentistry.

[4]  J. Grbic,et al.  A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. , 2011, Journal of the American Dental Association.

[5]  A. Henriques,et al.  Randomized clinical trial of a phytotherapic compound containing Pimpinella anisum, Foeniculum vulgare, Sambucus nigra, and Cassia augustifolia for chronic constipation , 2010, BMC complementary and alternative medicine.

[6]  S. Chrubasik,et al.  A systematic review on the sambuci fructus effect and efficacy profiles , 2010, Phytotherapy research : PTR.

[7]  P. Kroon,et al.  Cardiovascular disease risk biomarkers and liver and kidney function are not altered in postmenopausal women after ingesting an elderberry extract rich in anthocyanins for 12 weeks. , 2009, The Journal of nutrition.

[8]  B. Larijani,et al.  A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesity. , 2009, World journal of gastroenterology.

[9]  A. Schieber,et al.  An observational study and quantification of the actives in a supplement with Sambucus nigra and Asparagus officinalis used for weight reduction , 2008, Phytotherapy research : PTR.

[10]  R. Cavero,et al.  Journal of Ethnobiology and Ethnomedicine Open Access First Comprehensive Contribution to Medical Ethnobotany of Western Pyrenees , 2022 .

[11]  B. Karadžić,et al.  An ethnobotanical study on the usage of wild medicinal herbs from Kopaonik Mountain (Central Serbia). , 2007, Journal of ethnopharmacology.

[12]  W. Szymański,et al.  Journal of Ethnobiology and Ethnomedicine Open Access Wild Vascular Plants Gathered for Consumption in the Polish Countryside: a Review , 2022 .

[13]  Julie S. Jurenka,et al.  Colds and influenza: a review of diagnosis and conventional, botanical, and nutritional considerations. , 2007, Alternative medicine review : a journal of clinical therapeutic.

[14]  A. Hensel,et al.  Occurrence of N-phenylpropenoyl-L-amino acid amides in different herbal drugs and their influence on human keratinocytes, on human liver cells and on adhesion of Helicobacter pylori to the human stomach. , 2007, Planta medica.

[15]  R. Saller,et al.  Systematic Review of Clinical Data with BNO-101 (Sinupret?) in the Treatment of Sinusitis , 2006, Complementary Medicine Research.

[16]  G. Hajishengallis,et al.  Inhibition of proinflammatory activities of major periodontal pathogens by aqueous extracts from elder flower (Sambucus nigra). , 2006, Journal of periodontology.

[17]  P. Guarrera.  Traditional phytotherapy in Central Italy (Marche, Abruzzo, and Latium). , 2005, Fitoterapia.

[18]  M. Netzel,et al.  Bioavailability of anthocyanidin-3-glycosides following consumption of elderberry extract and blackcurrant juice. , 2004, International journal of clinical pharmacology and therapeutics.

[19]  E. Thom,et al.  Randomized Study of the Efficacy and Safety of Oral Elderberry Extract in the Treatment of Influenza A and B Virus Infections , 2004, The Journal of international medical research.

[20]  M. Murkovic,et al.  Effects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study , 2004, European Journal of Clinical Nutrition.

[21]  B. Warren,et al.  South Asians with ulcerative colitis exhibit altered lectin binding compared with matched European cases , 1997, The Histochemical Journal.

[22]  C. Sen,et al.  Anti-angiogenic, Antioxidant, and Anti-carcinogenic Properties of a Novel Anthocyanin-Rich Berry Extract Formula , 2004, Biochemistry (Moscow).

[23]  J. Roberts,et al.  Characterisation of an mRNA encoding a metallothionein-like protein that accumulates during ethylene-promoted abscission of Sambucus nigra L. leaflets , 2004, Planta.

[24]  C. Radauer,et al.  Type I allergy to elderberry (Sambucus nigra) is elicited by a 33.2 kDa allergen with significant homology to ribosomal inactivating proteins , 2003, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[25]  Awi Wiesel,et al.  Surveillance study of Sinupret in comparison with data of the Mainz birth registry , 2003, Archives of Gynecology and Obstetrics.

[26]  M. Murkovic,et al.  Urinary excretion of cyanidin glycosides. , 2002, Journal of biochemical and biophysical methods.

[27]  R. Prior,et al.  Absorption and metabolism of anthocyanins in elderly women after consumption of elderberry or blueberry. , 2002, The Journal of nutrition.

[28]  J. Blumberg,et al.  Bioavailablility of elderberry anthocyanins , 2002, Mechanisms of Ageing and Development.

[29]  C. Sen,et al.  Anti-angiogenic Property of Edible Berries , 2002, Free radical research.

[30]  C. Tsourounis,et al.  A survey of dietary supplement use during pregnancy at an academic medical center. , 2001, American journal of obstetrics and gynecology.

[31]  V. Barak,et al.  The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. , 2001, European cytokine network.

[32]  J. Joseph,et al.  Incorporation of the elderberry anthocyanins by endothelial cells increases protection against oxidative stress. , 2000, Free radical biology & medicine.

[33]  M. Murkovic,et al.  Analysis of anthocyane glycosides in human serum , 2000, Fresenius' journal of analytical chemistry.

[34]  P. Flatt,et al.  The traditional plant treatment, Sambucus nigra (elder), exhibits insulin-like and insulin-releasing actions in vitro. , 2000, The Journal of nutrition.

[35]  J. Dudenhausen,et al.  Fetal fibronectin as a marker for an imminent (preterm) delivery. A new technique using the glycoprotein lectin immunosorbent assay. , 1999, Journal of immunological methods.

[36]  R. Prior,et al.  Anthocyanins are detected in human plasma after oral administration of an elderberry extract. , 1999, Clinical chemistry.

[37]  M. Schlaak,et al.  Dietary lectins can induce in vitro release of IL‐4 and IL‐13 from human basophils , 1999, European journal of immunology.

[38]  J. Fleurentin,et al.  Effect of extracts of Orthosiphon stamineus benth, Hieracium pilosella L., Sambucus nigra L. and Arctostaphylos uva‐ursi (L.) spreng. in rats , 1998, Phytotherapy research : PTR.

[39]  M. Popp,et al.  [Profile and effectiveness of a phytogenic combination preparation for treatment of sinusitis]. , 1999, Wiener medizinische Wochenschrift.

[40]  M. Murkovic,et al.  Antioxidant and Prooxidant Activities of Elderberry (Sambucus nigra) Extract in Low-Density Lipoprotein Oxidation , 1998 .

[41]  P. Zambenedetti,et al.  Histochemical Localization of Glycoconjugates on Microglial Cells in Alzheimer's Disease Brain Samples by UsingAbrus precatorius, Maackia amurensis, Momordica charantia,andSambucus nigraLectins , 1998, Experimental Neurology.

[42]  E. Méndez,et al.  Constitutive and inducible type 1 ribosome‐inactivating proteins (RIPs) in elderberry (Sambucus nigra L.) , 1998, FEBS letters.

[43]  P. Rougé,et al.  Elderberry (Sambucus nigra) contains truncated Neu5Ac(α‐2,6)Gal/GalNAc‐binding type 2 ribosome‐inactivating proteins , 1998, FEBS letters.

[44]  M. Konlee.  A new triple combination therapy. , 1998, Positive health news.

[45]  K. Kaack,et al.  Interaction of vitamin C and flavonoids in elderberry (Sambucus nigra L.) during juice processing , 1998, Plant foods for human nutrition.

[46]  G. Steiner,et al.  N -Acetylneuraminic acids (nana): a potential key in renal calculogenesis , 1998, Urological Research.

[47]  P. Rougé,et al.  The major elderberry (Sambucus nigra) fruit protein is a lectin derived from a truncated type 2 ribosome-inactivating protein. , 1997, The Plant journal : for cell and molecular biology.

[48]  L. Lukash,et al.  [The effect of the lectin from Sambucus nigra inflorescences on spontaneous and alkylating agent-induced mutagenesis in mammalian somatic cells]. , 1997, TSitologiia i genetika.

[49]  E. Yeşilada,et al.  Inhibitory effects of Turkish folk remedies on inflammatory cytokines: interleukin-1α, interleukin-1β and tumor necrosis factor α. , 1997 .

[50]  M. Ohyama,et al.  Reduced sialylation of glycoproteins in nasal glands of patients with chronic sinusitis. , 1997, Acta oto-laryngologica.

[51]  J. Goldman,et al.  Increased ventricular sialylation in patients with heart failure secondary to ischemic heart disease , 1997, Clinical cardiology.

[52]  I. Goldstein,et al.  Elderberry (Sambucus nigra) bark contains two structurally different Neu5Ac(alpha2,6)Gal/GalNAc-binding type 2 ribosome-inactivating proteins. , 1997, European journal of biochemistry.

[53]  E. Ernst,et al.  [Acute bronchitis: effectiveness of Sinupret. Comparative study with common expectorants in 3,187 patients]. , 1997, Fortschritte der Medizin.

[54]  P. Rougé,et al.  Isolation and Molecular Cloning of a Novel Type 2 Ribosome-inactivating Protein with an Inactive B Chain from Elderberry (Sambucus nigra) Bark* , 1997, The Journal of Biological Chemistry.

[55]  W. Kemmner,et al.  Colon carcinoma glycoproteins carrying α 2,6‐linked sialic acid reactive with Sambucus Nigra agglutinin are not constitutively expressed in normal human colon mucosa and are distinct from sialyl‐tn antigen , 1997, International journal of cancer.

[56]  Y. Takaishi,et al.  Inhibitory effects of Turkish folk remedies on inflammatory cytokines: interleukin-1alpha, interleukin-1beta and tumor necrosis factor alpha. , 1997, Journal of ethnopharmacology.

[57]  F. Stirpe,et al.  Toxicity and cytotoxicity of nigrin b, a two-chain ribosome-inactivating protein from Sambucus nigra : comparison with ricin , 1997, Archives of Toxicology.

[58]  Cherenkevich Sn,et al.  H2O2 generation and human neutrophil aggregation as affected by lectins , 1995 .

[59]  M. Shakibaei,et al.  The Nuclear Pore Complex Protein p62 Is One of Several Sialic Acid-containing Proteins of the Nuclear Envelope (*) , 1995, The Journal of Biological Chemistry.

[60]  M. Goodarzi,et al.  Decreased branching, increased fucosylation and changed sialylation of alpha-1-proteinase inhibitor in breast and ovarian cancer. , 1995, Clinica chimica acta; international journal of clinical chemistry.

[61]  O. Manor,et al.  Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. , 1995, Journal of alternative and complementary medicine.

[62]  S. Cherenkevich,et al.  [H2O2 generation and human neutrophil aggregation as affected by lectins]. , 1995, Gematologiia i transfuziologiia.

[63]  R. März,et al.  Placebo-controlled, randomized double-blind clinical trial with Sinupret® sugar coated tablets on the basis of a therapy with antibiotics and decongestant nasal drops in acute sinusitis. , 1994, Phytomedicine : international journal of phytotherapy and phytopharmacology.

[64]  W. Chang,et al.  Inhibitory effects of flavonoids on xanthine oxidase. , 1993, Anticancer research.

[65]  D. Treré,et al.  Expression of alpha 2,6-sialylated sugar chains in normal and neoplastic colon tissues. Detection by digoxigenin-conjugated Sambucus nigra agglutinin. , 1993, European journal of histochemistry : EJH.

[66]  E. Middleton,et al.  Effects of flavonoids on immune and inflammatory cell functions. , 1992, Biochemical pharmacology.

[67]  J. Grzybek,et al.  Antiviral activity of the infusion (SHS‐174) from flowers of Sambucus nigra L., aerial parts of Hypericum perforatum L., and roots of Saponaria officinalis L. against influenza and herpes simplex viruses , 1990 .

[68]  C. Bailey,et al.  Glycaemic effects of traditional European plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. , 1989, Diabetes research.

[69]  A. Menghini,et al.  Biological screening of Italian medicinal plants for anti‐inflammatory activity , 1987 .

[70]  I. Goldstein,et al.  The elderberry (Sambucus nigra L.) bark lectin recognizes the Neu5Ac(alpha 2-6)Gal/GalNAc sequence. , 1987, The Journal of biological chemistry.

[71]  S. Slavin,et al.  Enrichment for GM-CFU from human bone marrow using Sambucus nigra agglutinin: potential application to bone marrow transplantation. , 1986, Experimental hematology.

[72]  W. Broekaert,et al.  A lectin from elder (Sambucus nigra L.) bark. , 1984, The Biochemical journal.

[73]  Leads from the MMWR. Poisoning from elderberry juice. , 1984, JAMA.

[74]  H. Richard,et al.  Volatile constituents of dry elder (Sambucus nigra L.) flowers , 1983 .

[75]  A. Richstein,et al.  [Treatment of chronic sinusitis with Sinupret]. , 1980, Therapie der Gegenwart.

[76]  J. Ramshaw,et al.  The amino-acid sequence of plastocyanin from Sambucus nigra L. (Elder). , 1974, European journal of biochemistry.

[77]  J. Mclean,et al.  Triterpenoids in the bark of elder (Sambucus nigra) , 1964 .

[78]  J. Davídek.  Isolation of Chromatographically Pure Rutin from Flowers of Elder , 1961, Nature.

[79]  Pilot Clinical Study on a Proprietary Elderberry Extract : Efficacy in Addressing Influenza Symptoms , 2022 .