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''Petasites hybridus'', the butterbur, is a herbaceous perennial
flowering plant Flowering plants are plants that bear flowers and fruits, and form the clade Angiospermae (), commonly called angiosperms. The term "angiosperm" is derived from the Greek words ('container, vessel') and ('seed'), and refers to those plants t ...
in the family
Asteraceae The family Asteraceae, alternatively Compositae, consists of over 32,000 known species of flowering plants in over 1,900 genera within the order Asterales. Commonly referred to as the aster, daisy, composite, or sunflower family, Compositae ...
, native to
Europe Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a Continent#Subcontinents, subcontinent of Eurasia ...
and northern
Asia Asia (, ) is one of the world's most notable geographical regions, which is either considered a continent in its own right or a subcontinent of Eurasia, which shares the continental landmass of Afro-Eurasia with Africa. Asia covers an are ...
. Although used over centuries in
traditional medicine Traditional medicine (also known as indigenous medicine or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the ...
to treat various disorders, there are no approved medical uses, but it is sold as a
dietary supplement A dietary supplement is a manufactured product intended to supplement one's diet by taking a pill, capsule, tablet, powder, or liquid. A supplement can provide nutrients either extracted from food sources or that are synthetic in order ...
. Concerns about the potential toxic effects of
pyrrolizidine alkaloid Pyrrolizidine alkaloids (PAs), sometimes referred to as necine bases, are a group of naturally occurring alkaloids based on the structure of pyrrolizidine. Pyrrolizidine alkaloids are produced by plants as a defense mechanism against insect he ...
s in butterbur limit its use in human and animal studies.


Etymology and common names

The botanical name ''Petasites'' derived from the Greek word, ''petasos'', from the plant's broad leaves resembling a wide-brimmed hat. ''Butterbur'' may have derived from the use of leaves to wrap butter centuries ago. It is also called ''bog rhubarb'', ''Devil's hat'', and ''pestilence wort''.
Synonyms A synonym is a word, morpheme, or phrase that means exactly or nearly the same as another word, morpheme, or phrase in a given language. For example, in the English language, the words ''begin'', ''start'', ''commence'', and ''initiate'' are ...
include ''P. officinalis'', ''P. ovatus'', ''P. vulgaris'', and ''Tussilago petasites'' L.


Description

The species is
dioecious Dioecy (; ; adj. dioecious , ) is a characteristic of a species, meaning that it has distinct individual organisms (unisexual) that produce male or female gametes, either directly (in animals) or indirectly (in seed plants). Dioecious reproducti ...
, the male and female flowers being borne on separate plants. In Britain, the male flowers are widespread, but the female flowers have a restricted distribution in northern and central England. The
flower A flower, sometimes known as a bloom or blossom, is the reproductive structure found in flowering plants (plants of the division Angiospermae). The biological function of a flower is to facilitate reproduction, usually by providing a mechanis ...
s are produced in the early spring, before the
leaves A leaf ( : leaves) is any of the principal appendages of a vascular plant stem, usually borne laterally aboveground and specialized for photosynthesis. Leaves are collectively called foliage, as in "autumn foliage", while the leaves, st ...
appear. They are pale pink, with several
inflorescence An inflorescence is a group or cluster of flowers arranged on a stem that is composed of a main branch or a complicated arrangement of branches. Morphologically, it is the modified part of the shoot of seed plants where flowers are forme ...
s clustered on a stem. The leaves are large, on stout tall stems, round, with a diameter of with petioles up to .


Distribution

It is native to central Europe, extending from the British Isles to the Caucasus, and from southern Italy north to southern Scandinavia. It is present as an introduced species in North America. In the British Isles, female plants are rarely found outside central and northern England, and the species may be naturalized as clonal populations outside this area, propagating via rhizome fragments. The preferred habitats are moist, fertile soils, often by rivers, streams and in wet meadows.


Dietary supplement and research

As there are no approved clinical uses of butterbur or its
extract An extract is a substance made by extracting a part of a raw material, often by using a solvent such as ethanol, oil or water. Extracts may be sold as tinctures, absolutes or in powder form. The aromatic principles of many spices, nuts ...
s, preparations are sold in some countries as a dietary supplement. There is no evidence that butterbur is useful for treating skin allergies,
bronchitis Bronchitis is inflammation of the bronchi (large and medium-sized airways) in the lungs that causes coughing. Bronchitis usually begins as an infection in the nose, ears, throat, or sinuses. The infection then makes its way down to the bronchi. ...
,
urinary tract infection A urinary tract infection (UTI) is an infection that affects part of the urinary tract. When it affects the lower urinary tract it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as a kidne ...
s,
asthma Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, co ...
, or other disorders.


Migraines

Although some preliminary studies indicate that butterbur may reduce the frequency of
migraine headaches Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...
in adults and children, clinical
neurology Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal ...
associations do not recommend it because of concerns of possible
liver toxicity Hepatotoxicity (from ''hepatic toxicity'') implies chemical-driven liver damage. Drug-induced liver injury is a cause of acute and chronic liver disease caused specifically by medications and the most common reason for a drug to be withdrawn fr ...
.


Rhinitis

Although there have been studies of butterbur root or leaf extracts as possible therapies for symptoms of hay fever (
allergic rhinitis Allergic rhinitis, of which the seasonal type is called hay fever, is a type of inflammation in the nose that occurs when the immune system overreacts to allergens in the air. Signs and symptoms include a runny or stuffy nose, sneezing, red, ...
), the results were insufficient to determine effectiveness and safety.


Traditional medicine

''Petasites hybridus ''leaves were used in
Austrian Austrian may refer to: * Austrians, someone from Austria or of Austrian descent ** Someone who is considered an Austrian citizen, see Austrian nationality law * Austrian German dialect * Something associated with the country Austria, for example: ...
and
Czech Czech may refer to: * Anything from or related to the Czech Republic, a country in Europe ** Czech language ** Czechs, the people of the area ** Czech culture ** Czech cuisine * One of three mythical brothers, Lech, Czech, and Rus' Places * Czech, ...
traditional medicine internally (as tea or cold maceration in ethanol) and externally (as compresses or maceration in vinegar) for treatment of infections, fever, flu, colds, hay-fever, and allergies.


Phytochemicals

''Petasites hybridus'' contains
senecionine Senecionine is a toxic pyrrolizidine alkaloid isolated from various botanical sources. It takes its name from the ''Senecio'' genus and is produced by many different plants in that genus, including ''Jacobaea vulgaris'' (''Senecio jacobaea''). It ...
and other toxic
pyrrolizidine alkaloid Pyrrolizidine alkaloids (PAs), sometimes referred to as necine bases, are a group of naturally occurring alkaloids based on the structure of pyrrolizidine. Pyrrolizidine alkaloids are produced by plants as a defense mechanism against insect he ...
s in its leaves and roots. Also present are the
sesquiterpene Sesquiterpenes are a class of terpenes that consist of three isoprene units and often have the molecular formula C15H24. Like monoterpenes, sesquiterpenes may be cyclic or contain rings, including many unique combinations. Biochemical modific ...
ester In chemistry, an ester is a compound derived from an oxoacid (organic or inorganic) in which at least one hydroxyl group () is replaced by an alkoxy group (), as in the substitution reaction of a carboxylic acid and an alcohol. Glycerides ...
s petasin, isopetasin, and neopetasin.


Potential toxicity

Butterbur
extract An extract is a substance made by extracting a part of a raw material, often by using a solvent such as ethanol, oil or water. Extracts may be sold as tinctures, absolutes or in powder form. The aromatic principles of many spices, nuts ...
s have been found to contain hepatotoxic pyrrolizidine alkaloids at the retail level. These extracts are not recommended during pregnancy or breastfeeding. The adverse effects of butterbur reported in clinical trials include mainly gastrointestinal problems, such as nausea, flatulence, and belching. In 2015, the American Academy of Neurology withdrew its original endorsement of butterbur due to safety concerns. Long-term health effects and interaction of butterbur with other drugs have not been well documented. However, it can theoretically interact with certain blood pressure and heart medications, as well as with drugs that can induce a liver
enzyme Enzymes () are proteins that act as biological catalysts by accelerating chemical reactions. The molecules upon which enzymes may act are called substrates, and the enzyme converts the substrates into different molecules known as products ...
called
CYP3A4 Cytochrome P450 3A4 (abbreviated CYP3A4) () is an important enzyme in the body, mainly found in the liver and in the intestine. It oxidizes small foreign organic molecules ( xenobiotics), such as toxins or drugs, so that they can be removed from ...
. Prior cases of liver damage have been reported from people taking butterbur, with cases varying in
adverse effect An adverse effect is an undesired harmful effect resulting from a medication or other intervention, such as surgery. An adverse effect may be termed a " side effect", when judged to be secondary to a main or therapeutic effect. The term compl ...
s from
cholestasis Cholestasis is a condition where bile cannot flow from the liver to the duodenum. The two basic distinctions are an obstructive type of cholestasis where there is a mechanical blockage in the duct system that can occur from a gallstone or malig ...
and
inflammation Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molec ...
to liver failure.


References


External links

* {{Taxonbar, from=Q375620 hybridus Plants described in 1753 Taxa named by Carl Linnaeus