Elderberry (Sambucus nigra)
Elderberry belongs to a family of flowering shrubs known as Sambucus or Elder. They are native to Europe but have become naturalized in many parts of the world including the United States. Cultivated for medicinal and food purposes, the fruit is used to produce jams, syrups, and wine. The berries are a rich source of anthocyanins and other phenolics and nutrients. Several species of Sambucus produce elderberries with similar chemical compositions including American Elder (Sambucus canadensis) and Blue Elder (Sambucus caerulea), but European Elder (Sambucus nigra) is the type most studied and used in supplements.
Uses
Elderberry has been used for centuries to both prevent and treat colds and flu symptoms, for inflammation and respiratory diseases, and to relieve constipation. The Commission E approved the internal use of elderflower for colds. The British Herbal Compendium lists its uses for the common cold, feverish conditions, and as a diuretic. The German Standard License for elderflower tea calls it a diaphoretic medicine for the treatment of feverish common colds or catarrhal complaints.
Chemistry/Pharmacology
The fruit of Sambucus nigra (elderberries) contains several constituents responsible for pharmacological activity. Among these are the flavonoids quercetin and rutin, anthocyanins identified as cyanidin-3-glucoside and cyanidin-3-sambubioside, the hemagglutinin protein Sambucus nigra agglutinin III (SNA-III), cyanogenic glycosides including sambunigrin, viburnic acid, and vitamins A and C.
Clinical Studies
In vitro studies demonstrate that elderberries possess antiviral, antibacterial, antidiabetic, immunomodulatory, antioxidant, anti-inflammatory, and chemopreventive properties, although inhibition of cancer cell growth was shown to be weak. Flavonoids and proanthocyanidins were shown to block HIV1 infection and may have additive effects with existing AIDS drugs such as enfuvirtide. Elderberry also conferred protective effects against oxidative stressors in endothelial cells. However, it did not demonstrate vasoprotective effects, and randomized trials found it ineffective in improving cardiovascular disease biomarkers or for improving cholesterol levels. Small studies found elderberry to be safe and effective in a preparation for chronic constipation and in reducing episodes of tonsillitis in children. It may also help reduce symptoms of influenza, but larger studies are needed to confirm these findings.
Biomechanical Mechanism
Elderberry inhibits H1N1 activities by binding to H1N1 virions as well as by blocking host cell recognition and entry. It may also prevent HIV1 infection by binding to viral glycoproteins such as gp120, but additional investigations are required to clarify those mechanisms. Elderberry’s anti-inflammatory effects may result from increased cytokine production or inhibition of nuclear transcription factor kappaB and phosphatidylinositol 3-kinase. An elderberry extract improved metabolic disturbances in a murine model of obesity by lowering serum triglycerides, inflammatory markers, and insulin resistance. Its antidiabetic properties occur via activation of peroxisome proliferator-activated receptor gamma and stimulation of insulin-dependent glucose uptake. Elderberry may also influence HDL dysfunction associated with chronic inflammation by affecting hepatic gene expression in hyperlipidemic mice. Another study indicates its chemopreventive potential is related to the induction of quinone reductase as well as cyclooxygenase-2 and ornithine decarboxylase inhibition.
Sources/Articles
Boroduske, Anete, Kaspars Jekabsons, Una Riekstina, Ruta Muceniece, Nils Rostoks, and Ilva Nakurte. "Wild Sambucus nigra L. from north-east edge of the species range: A valuable germplasm with inhibitory capacity against SARS-CoV2 S-protein RBD and hACE2 binding in vitro." Industrial Crops and Products 165 (2021): 113438. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969829/
Christensen KB, Petersen RK, Kristiansen K, et al. Identification of bioactive compounds from flowers of black elder (Sambucus nigra L.) that activate the human peroxisome proliferator-activated receptor (PPAR) gamma. Phytother Res. Jun 2010;24 Suppl 2:S129-132.
Farrell NJ, Norris GH, Ryan J, Porter CM, Jiang C, Blesso CN. Black elderberry extract attenuates inflammation and metabolic dysfunction in diet-induced obese mice. Br J Nutr. 2015 Oct 28;114(8):1123-31.
Farrell N, Norris G, Lee SG, Chun OK, Blesso CN. Anthocyanin-rich black elderberry extract improves markers of HDL function and reduces aortic cholesterol in hyperlipidemic mice. Food Funct. 2015 Apr;6(4):1278-87.
Ferreira, Sandrine S., Amélia M. Silva, and Fernando M. Nunes. "Sambucus nigra L. Fruits and flowers: chemical composition and related bioactivities." Food Reviews International (2020): 1-29. https://d1wqtxts1xzle7.cloudfront.net/64244881/2020_Sambucus%20nigra%20L%20Fruits%20and%20Flowers%20Chemical%20Composition%20and%20Related%20Bioactivities-with-cover-page-v2.pdf?Expires=1642456598&Signature=UbqRKEjbniwUhkSxQd2XJ3zpKtC9yBNxj4FF41wfL0e6C~ERNrbXVp1ryOlxW3ezE1e-W0Vx2Ki0LTVF7fAGcOFQltGkmKI1S5g68sIsBdswMucxGYiOFc98BYqCuVh5dtk~PaiRjaj~TD8m4FZ7lT2dRshTGSIa~y9NJZejjv2AdCpwfkWHFhYAz~NtxISGLmt2ASHGHLEAkNVUmUZWpUbFYjRay72O1hvRfo3V-piZrDTJr7bcO8HFqoto5Y2c614XBKf-KuuPxWh-BvcG5orfdrH9fHvbrQdJR~SOUEr12GQuRQ0mV2r9A7GqOUxix9ChyvOHYH66iqv3MMksNw__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA
Frank T, Janssen M, Netzet G, et al. Absorption and excretion of elderberry (Sambucus nigra L.) anthocyanins in healthy humans. Methods Find Exp Clin Pharmacol. Oct 2007;29(8):525-533.
Harnett J, Oakes K, Carè J, et al. The effects of Sambucus nigra berry on acute respiratory viral infections: A rapid review of clinical studies. Adv Integr Med. 2020 Dec;7(4):240-246.
Harokopakis E, Albzreh MH, Haase EM, et al. Inhibition of proinflammatory activities of major periodontal pathogens by aqueous extracts from elder flower (Sambucus nigra). J Periodontol. Feb 2006;77(2):271-279.
Hawkins J, Baker C, Cherry L, Dunne E. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Complement Ther Med. 2019 Feb;42:361-365.
Krawitz, Christian, Mobarak Abu Mraheil, Michael Stein, Can Imirzalioglu, Eugen Domann, Stephan Pleschka, and Torsten Hain. "Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses." BMC complementary and alternative medicine 11, no. 1 (2011): 1-6. https://link.springer.com/article/10.1186/1472-6882-11-16
Lin, Pei, Eunson Hwang, Hien TT Ngo, Seul A. Seo, and Tae-Hoo Yi. "Sambucus nigra L. ameliorates UVB-induced photoaging and inflammatory response in human skin keratinocytes." Cytotechnology 71, no. 5 (2019): 1003-1017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6787119/
Porter, Randall S., and Robert F. Bode. "A review of the antiviral properties of black elder (Sambucus nigra L.) products." Phytotherapy Research 31, no. 4 (2017): 533-554. https://sambucol.co.il/_Uploads/dbsAttachedFiles/SMB-2017-Black-elderberry-Meta-analysis-Porter_et_al-2017-Phytotherapy_Research-1.pdf
Radojković, Marija, Milena Vujanović, Tatjana Majkić, Gokhan Zengin, Ivana Beara, Michelina Catauro, and Domenico Montesano. "Evaluation of Sambucus nigra L. Biopotential as an Unused Natural Resource." Applied Sciences 11, no. 23 (2021): 11207. https://www.mdpi.com/2076-3417/11/23/11207
Roschek B, Jr., Fink RC, McMichael MD, et al. Elderberry flavonoids bind to and prevent H1N1 infection in vitro. Phytochemistry. Jul 2009;70(10):1255-1261.
Scopel M, Mentz LA, Henriques AT. Comparative analysis of Sambucus nigra and Sambucus australis flowers: development and validation of an HPLC method for raw material quantification and preliminary stability study. Planta Med. Jul 2010;76(10):1026-1031.
Shahsavandi, Shahla, Mohammad Majid Ebrahimi, and Ameneh Hasaninejad Farahani. "Interfering with lipid raft association: A mechanism to control influenza virus infection by Sambucus nigra." Iranian journal of pharmaceutical research: IJPR 16, no. 3 (2017): 1147. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5610768/
Thole JM, Kraft TF, Sueiro LA, et al. A comparative evaluation of the anticancer properties of European and American elderberry fruits. J Med Food. Winter 2006;9(4):498-504.
Torabian, Golnoosh, Peter Valtchev, Qayyum Adil, and Fariba Dehghani. "Anti-influenza activity of elderberry (Sambucus nigra)." Journal of functional foods 54 (2019): 353-360. https://carmelberry.com/wp-content/uploads/2020/02/ElderberryStudyFlu2019.pdf
Waknine-Grinberg JH, El-On J, Barak V, et al. The immunomodulatory effect of Sambucol on leishmanial and malarial infections. Planta Med. May 2009;75(6):581-586.
Youdim KA, Martin A, Joseph JA. Incorporation of the elderberry anthocyanins by endothelial cells increases protection against oxidative stress. Free Radic Biol Med. Jul 1 2000;29(1):51-60.
Zakay-Rones Z, Thom E, Wollan T, et al. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res. Mar-Apr 2004;32(2):132-140.
Zakay-Rones Z, Varsano N, Zlotnik M, 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. J Altern Complement Med. Winter 1995;1(4):361-369.