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DOI: 10.1055/s-2006-949982
Polyphenols are of special relevance for the multiple mechanisms of action of the willow bark extract STW 33-I (Proaktiv®)
The pharmacological profile of the willow bark extract STW 33-I (water extract, 16–23:1) and the contribution of its fractions to it were studied in a number of pharmacological models in vitro and in vivo for elucidating its clinical effects.
In Interferon-γ/LPS treated monocytes, STW 33-I reduced expression of iNOS, COX-2, the antiapoptotic protein Bcl2, Il-1β, Il-6 and TNF-α, measured by real time PCR, with IC50 between 10 and 200µg/mL. It inhibited PGE2, Il-6 and MMP-3 in chondrocytes. Activities of 5-LOX, hyaluronidase, elastase (HLE), COX-1 and -2 and oxidation in AAPH and XOD reactions were inhibited. Five fractions of the extract, obtained by sequential extraction with solvents of increasing polarity and analytically characterized by HPLC, were tested as well, showing that the fractions containing the different groups of polyphenols were responsible for the main part of the effect, while the fraction containing the main part of the salicylates showed only a minor contribution.
In vivo, STW 33-I (50 to 150mg/kg b.w.) was effective in writhing test in mice, Randall-Sellito model, brewers yeast model, paw edema, adjuvant arthritis and air pouch model in rats. In the latter, PGE2 and LTB4, Il-1β, Il-6, TNF- α, TxB4, COX-2 and the antioxidative parameters MDH were decreased, GSH increased.
These studies show multiple mechanisms of the willow bark extract, including anti-inflammatory, -oxidative, -pyretic, joint protecting, and analgesic actions. These were mainly not due to salicylates, but to polyphenols, which therefore seem to be the group most relevant for the therapeutic efficacy of STW 33-I (Proaktiv®) in back pain.