Visnaga
Botanical Description & Habitat
Ammi visnaga
Family
Apiaceae
Common Names
cromolyn sodium
khellin
Habitat
Mediterranean region
Medicinal Parts
The fruit, and extracts of the fruit
Historical Properties & Uses
From the rather humble beginnings of a folk remedy in the back lands of the Middle East, visnaga has emerged as one of the most important asthmatic preventatives of modern times.
Several centuries ago in the Middle East someone discovered Khella (Ammi visnaga) relieved pain associated with kidney stones. This use spread throughout most of the eastern Mediterranean countries, including the Nile delta and Arabia.
About 1879 the active principle of visnaga was isolated and called khellin. Khellin quickly became a part of the doctor's standard pharmacy in Egypt and Arabia.
In the 1930's an Egyptian research team began a serious clinical and pharmacology investigation of khellin that substantiated the folklore claims. Further research showed khellin was a substantial smooth muscle relaxant and a strong dilator of coronary arteries. Quickly, visnaga became a standard treatment for angina, even though the use of the substance had certain side effects, such as nausea. Then, several years later, in a attempt to detoxify khellin, investigators chanced upon its profound anti-asthmatic properties, for which khellin and its derivatives (cromolyn sodium) have become some of the best treatments.
The West never really got involved in the excitement the rest of world was experiencing over visnaga. Even today, all khellin-derived drugs are available by prescription only. In Europe and in most Eastern countries over-the-counter cromolyn sodium preparations can be obtained.
Method of Action
Visnaga Reduces Kidney Stone Pains
Khellin is effective in reducing pain associated with kidney stones because it relaxes the spasm in the muscle fibers induced by kidney stones. For this purpose, visnaga was listed in the Egyptian Pharmacopoeia as early as 1934.
Visnaga Relieves the Pain of Angina
In 1944 and 1946, scientists at Cairo University published now classic papers revealing the coronary dilating properties of khellin, and reporting the successful treatment of over 30 cases of angina pectoris.
The French and Polish medical establishments immediately picked up on these results and included khellin in their pharmacopoeias. Other studies replicated the Cairo research and correlated the coronary dilation effect to a smooth muscle relaxant action. Side effects (mainly nausea and vomiting) in many subjects continued to plague clinical studies.
Visnaga, because of its action on the smooth musculature, is also effective against bronchial asthma, but does not have the preventive property of cromolyn.
Khellin Derivatives (e.g., cromolyn sodium) Have Excellent Antiasthmatic Action
In 1956, a group of researchers from Fisons Labs in England, while attempting to produce a form of khellin devoid of side effects, chanced upon a significant effect against antigen-induced bronchospasm in an asthmatic volunteer. This particular khellin derivative did not have significant smooth muscle relaxing properties, however. Intriguingly, the new substance had fewer side effects.
Subsequent animal tests were negative, and the project formally abandoned. As fate would have it, however, one of the researchers was himself asthmatic, and offered himself as a continual subject. As a result, they were eventually able to work out a series of substances which effectively blocked asthma attacks and which possessed a very low degree of toxicity. The most active and least toxic of these compounds was disodium cromoglycate or cromolyn sodium, which was nothing more than two chromone molecules hooked together across a sodium bridge.
Since chromone was the basic molecule of khellin itself, the new substance was simply two khellin molecules hooked together, by which action unpleasant side effects were eliminated.
Cromolyn works solely as a preventive. If taken regularly, cromolyn blocks asthma attacks, especially in childhood asthma. It doesn't work once the attack begins.
Traditional treatments are not preventive, accompanied by serious side effects, and are habituating in that more and more of a drug has to be taken over time.
Research clearly demonstrates the effectiveness of cromolyn sodium in preventing asthma attacks and allergic reactions in people subject to:
1. Inhalation provocation with a number of common allergens.
2. Direct application of allergen to nasal mucosa.
3. Bronchial asthma.
4. Seasonal allergic rhinitis.
5. Perennial allergic rhinitis.
6. Hayfever.
7. Exercise-induced asthma.
8. Gastrointestinal disturbances involving immune or allergic reactions such as ulcerative colitis, canker sores, proctitis, and gastrointestinal protein intolerance in infancy.
9. Food allergy such as sensitivity to cow's milk, canker sores, systemic mastocytosis, eggs, potatoes, corn, pork, red wine, milk, fish, oranges, and colic in infants.
10. Conjunctivitis.
11. Aspirin intolerance.
Cromolyn appears to act by inhibiting the release of substances like histamine from mast cells. Calcium probably plays a role in this process, since this mineral must combine with cell membranes in just the right way to release histamine from the cells. Cromolyn probably interferes in this mechanism. But cromolyn has no direct effect on histamines and other allergic response mediators. Once released from the cell, cromolyn cannot prevent their further operation. Cromolyn has no anti-inflammatory, anti-cholinergic, anti-serotinergic, anti-bradykinic or anti-SRS-A activity. It is truly a novel therapeutic approach to the treatment of asthma. It is simply preventive.
Drug Interactions & Precautions
Possible Interactions
The antacid nature of this herb may decrease or delay the absorption of nalidixic acid and the sulfonamides.
Safety Factors & Toxicity
The use of Visnaga and Khellin, and various other extracts will produce a certain amount of nausea and vomiting in some people. In homeopathic doses, no side effects are observed.
Cromolyn sodium has very little toxicity: research shows it is not metabolized by man, has no carcinogenic action, does not affect normal immunologic defense mechanisms, does not cause birth defects or embryonic malfunctions.
Preparation & Administration
Whole Ammi visnaga is not generally available to the public.
Use proprietary preparations. Follow manufacturers' directions.
Note: This Herbal Preparation information is a summary of data from books and articles by various authors. It is not intended to replace the advice or attention of health care professionals.
References
Akacic, B. Ammi visnaga (l.) Lam. - sirovina za kelin. Farmaceutski Glasnik, 18, 227-236, 1962.
Anrep, G.V., et. al. British Heart Journal, 8, 171, 1946.
Altounyan, R.E.C. Developments in the treatment of asthma with disodium cromoglycate. Acta Allergol., 30(suppl 12), 65-86, 1975.
Bernstein, I.L., et.al. A controlled study of cromolyn sodium sponsored by the drug committee of the American Academy of Allergy. Journal Allergy Clin. Immunol. 50, 235-245, 1972.
Bruderman, I. Cromolyn therapy. M. Stein. ed. New Directions in Asthma. Park Ridge, Ill., American College of Chest Physicians, 1975, pp. 447-456.
Cox, J.S.G. Disodium cromoglycate: mode of action and its possible relevance to the clinical use of the drug. British Journal of Disease of the Chest, 65, 1890204, 1971.
Masica, A.V., E.A. Freidman & M.A. Kornfield. Clinical experience with long-term cromolyn sodium administration in 53 asthmatic children. Annals of Allergy, 37, 1-7, 1976.
Mowrey, Daniel B., Ph.D. Exper. Psych., Brigham Young University. Director of Nebo Institute of Herbal Sciences. Director of Behavior Change Agent Training Institute. Director of Research, Nova Corp.
Plummer, A.L. Choosing a drug regimen for obstructive pulmonary disease. Postgraduate Medicine, 63(5), 113-119, 1978.
Sellars, W.A. & J. Pflanzer. Cromolyn sodium in the treatment of asthma: its effectiveness and use. South Med. J., 68, 970-975, 1975.
Toogood, J.H., et. al. A double-blind study of disodium cromoglycate for prophylaxis of bronchial asthma. Am. Rev. Respir. Dis. 104, 323-330, 1971.
Uhlenbroock, K. & K. Mulli. Khellin, ein beitrag zur pharmakologie der inhaltstoffe der ammin visnaga, 4. Arzneimittel Forschung, 3(8), 407-411, 1953.
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