Human immune system
Immunology is the most difficult topic in physiology. Even though I once graduated from the advanced exam "Immunology" at prof. I do not feel the worse of Krč, an immunologist. From the entire course I still remember the feeling of astonishment that I got myself after studying the T cell maturation and antibody development chapters. In a magazine I have forgotten, I've long ago read that about a third of the total human genes are involved in the construction of the nervous system, one third in the immune system, and one third in all other tasks. I do not know how much this claim is still valid today, but we can really say that the immune system is about as complex as the brain, with the difference that the immune system does not give anatomical clues to its understanding.
How does it go in the immune system?
Experts of immunology may forgive me when I say that the immune system is most reminded of the totalitarian police apparatus:
All cells and molecules of the human body are registered and introduced as "own" before birth. For this purpose, the thymus, in which the lymphocyte cells of the police, are trained so as to be able to react against all possible and impossible molecules except their own.
If a foreign molecule is born later in life, there is always a certain number of immune cells that have the ability to recognize it. The foreign molecule is transported to the lymph node, which acts as a police station. The case is first assessed. If the immune system chooses to react against that foreign molecule, a rapid mutation and selection process will take place under the guidance of the dendritic cell, which will lead to amazing optimization of the receptor recognizing the foreign molecule and cloning the original cell that carried it within 3-4 days. Optimized receptor clones can then go on a body wand, searching for and destroying cells containing the foreign molecule (this is called type 1 response, cell or cytotoxic response). The other option is that clones begin to release the optimized receptor loosely into the extracellular space, and the diffusion itself will find target molecules, such as the surface of microbes (this is called type 2 response, or antibody, humoral response, humor = juice).
Intracellular parasites (e.g., viruses) and tumors are blocked by the fact that each cell (except red blood cells) carries MHC molecules functioning as a ID card on the surface. MHC molecules present as if they are a photograph of the inner environment of the wearer's cell - each individual MHC molecule is wearing a randomly selected fragment of intracellular proteins. Cells whose fragments correspond to foreign molecules are destroyed. Those cells that would try to avoid detection by reduced MHC expression are killed by a special group of surveillance cells - NK lymphocytes.
Basic concepts of immunology
Let me briefly mention the basic immunological terms I often mention in my texts - please keep in mind that the immune system is still a lot more complex:
- Passive Immunity - Mechanical protection of skin, mucous membranes, mucus, work of ciliary epithelium that carries out dirt from our bronchi, chemical protection of acidity of the skin, stomach, vagina, bacterial lysozyme in saliva and tears, peroxidase system (lactoperoxidase, DUOX) Or blood-brain barrier, etc.
- Active immunity - Response of the immune system caused by the presence of the pathogen in the body.
- Congenital Immunity - The innate ability of the immune system to recognize common pathogens. As with raiders it is typical that it is shaved wrongly and is standing with a club around the corner, and pathogens have some common molecular features that can be easily distinguished. E.g. Leukocytes have several types of so-called TLR receptors (TLR1-13) recognizing bacterial or fungal polysaccharides on their surface; inside the cells there is a DICER1 enzyme with the ability to recognize and chop double-stranded RNA viruses,
- Immunity obtained - Our immune system has the ability to develop and produce a large number of specific antibodies, tailored to specific antigens, in the course of a short period of time.
- Antigen - Any foreign molecule that causes an immune response. Typically, antigens are spoken in the style of "anti-something specifically recognizes something antigen".
- Antigen receptor - Some negative fingerprint. They are molecules that fit precisely with their foreign genes to foreign antigens. These include BCR (B cell antigen receptor), TCR (T cell antigen receptor) and immunoglobulins, or antibodies , which are essentially free-flowing antigenic receptors secreted in a large number of B lymphocytes. In the process of immune system maturation before birth, our organism creates a number of antigenic receptors that have the ability to recognize all possible and impossible foreign molecules. Receptors that react with their own molecules are destroyed during the ripening process.
- Antibodies (immunoglobulins) - The antibody, or immunoglobulin, is a free floating protein very similar to the B and T lymphocyte antigen receptors. The source of antibodies is B lymphocytes. The immunoglobulin shape resembles a clothes peg with a specially shaped head, passionate as a negative imprint on foreign molecules. Immunoglobulin consists of two parts: larger (so-called heavy chain) and smaller (so-called light chain). Both parts undergo intensive gene manipulations for the first time in the maturation of the immune system before birth, and the second for an infection where they are still deliberately mutated and selected so as to bind as tightly as possible to the antigen. Immunoglobulins are further subdivided into subtypes (IgA, IgD, IgE, IgG, IgM), differing in detail.
- MHC (main histocompatibility complex) - All body cells are required to demonstrate on their surface a sufficiently high number of MHC I molecules with linked randomized chains of their internal proteins. It can be likened to a citizen's ID card with photos of the owner's internal peptides. If the cell presents foreign peptides, T C lymphocytes control apoptosis, and the affected cell still aids the perforation of its wall with a special perforin poison. The same fate meets the cell if it does not show a sufficient amount of MHC I, overseen by NK lymphocytes. The MHC II molecule, on the other hand, is not a citizen's card, but a police file with criminal photographs. MHC II molecules carry professional immune cells on their surface. If a foreign peptide is captured in MHC II, it means that the appropriate immune cell just handles its case.
- White blood cells (leukocytes) - Cellular police. It is divided into line guards (granulocytes) and specialists (lymphocytes). A particular type of leukocyte is monocytes, cellular garbage, who always have a lot of work to do in the immune reaction.
- Granulocytes - Watchmen serving with samurai determination. They have the shortest lifetime of all cells. Even if the immune reaction does not participate or survive, they will commit program dismantling (apoptosis) after a few days. The lifetime of the tank is about 15 minutes, so its durability can be sacrificed for other benefits (such as the turbine engine at Abrams or wankel on British tanks, bud2002cwh ). Similarly, there are granulocytes, which, unlike normal cells, do not need to take care of their health when choosing destructive methods against microbes. Granulocytes have a number of molecular means of combat that can be seen in their cytoplasm as grains - granules. The equipment is divided into three types:
- Neutrophilic granulocytes - The most abusive type.
- Eosinophilic granulocytes - Medium abundant.
- Basophilic granulocytes - Rare, except that they very resemble so-called mast cells (mast cells) , living in dormant lives as stationary defense in tissues.
Granulocyte methods include microbial feeding, acid burning, superoxide, peroxide, hypochlorite (in a drug known as Savo) and other caustics, digestive enzymes destruction and, among other things, large amounts of nitric oxide, which is otherwise necessary and beneficial to cellular communication at appropriate concentrations . The immune system really uses all possible methods, including nowadays loudly shattered DNA nanotechnology - Granulocytes seem to use DNA as a building material to construct miniature cages for microbes ( wartha2007net ).
- Lymphocytes - Police specialists. When the rookie arrives in the MHC II peripheral lymph node with a stuck foreign peptide, the immune response will not be answered immediately. The case is first solved, judged, mitigating and aggravating circumstances and the overall situation in the body are considered. Research shows that lymphocytes in the lymphoid tissue are still hurrying and still arguing with other lymphocytes. When a decision on the immune response occurs, the B and T lymphocytes are grouped around the dendritic cell and the mutation process and clonal selection (controlled evolution) that optimizes the antigenic receptor over the course of 3-4 days first resolves the foreign molecule. Lymphocytes are divided into:
- B lymphocytes - They are responsible for the production of antibodies (immunoglobulins). Both B cells and T lymphocytes have antigenic receptors - molecules capable of recognizing foreign struc- tures. While T cells retain their antigenic receptors (TCRs) on their surface, B lymphocytes are famous for their release into the environment as antibodies. B lymphocytes also have their surface antigenic receptors (BCRs), which are basically antibodies bound to the surface of the cell. After the immune response has subsided, part B lymphocytes are transformed into memory cells that provide long-term immunity.
- T lymphocytes - Cell lysing. Divided into:
- T C (cytotoxic) lymphocytes - Control of civilians. They have the ability to kill suspect cells, so they are called "cytotoxic". They carry a "Civilian Controller Card" on the surface, a CD8 molecule that binds to the "ID card" of MHC I. Using the TCR receptor, which is the equivalent of B lymphocyte antibodies, the T C lymphocytes look at a photograph of the cell's internal environment stuck in the MHC I card and decide if the cell needs to be destroyed. The method by which MHC B and T lymphocytes are controlled by BCR and TCR receptors also relates to prof. Hotter .
- T H (helper, "helper") lymphocytes - Investigation. They carry the "CD4 investigator's license" on the surface, which is linked to the "police file" of MHC II and, unfortunately, also to the HIV virus. It is divided into a number of other subtypes, of which the most important are T H 1, issuing T-cells and T H 2, which in turn authorize the activity of B lymphocytes.
- T S (suppressor, "suppressive") lymphocytes - (more recently, they say T reg , regulatory) - State advocates. They have access to various files and block the immune response.
- T M (memory, "memory") lymphocytes - Police archive. After a successful immune response, part of the veterans from the different T and B classes of lymphocytes will be converted to memory cells that retain the ability to re-create the antibody in the long term. Creating appropriate memory cells is the principle of vaccination.
- Other special classes of lymphocytes - They have different special abilities, eg they can clear bacteria according to specific bacterial metabolites otherwise in the body of absent,
- NK Cells - Disciplinary Supervision to Carry Citizens' Passes. Sick cells would, in theory, have avoided the destruction of T C lymphocytes by not carrying MHC I at all. For this case, there are NK lymphocytes that destroy cells with too little MHC I expression. The abbreviation NK is derived from a "natural killer," which is a phrase I do not like. NK cells also have many other functions.
- Monocytes - Cellular garbage collectors who also have police and combat functions. This division into guardians, specialists and garbage can only be illustrated - the division of labor between cells has no logic from the point of view of human occupations. In theory, all cells can do everything (they have a complete set of genes). When monocytes operate in tissues, they are called macrophages (literally big stomachs). When they settle down, they spread a network of numerous protrusions around them and say dendritic (tree) cells. Some of the monocytes penetrate into the brain where they must behave quietly and disrespectfully as a hotel maid so as not to disturb the neurons in thought - such monocytes are called microglia . However, the microglie must have the ability to change in a critical situation in a snap, in a hotel blast, and to deal with intruders even without the help of lymphocytes, which usually do not go to the brain.
- Immune system absorption - With T and B lymphocytes, our immune system has the ability to respond to pathogens that we and our ancestors have never encountered before. This is because shortly before birth, our immune system carries out the registration of any body of its own molecules. They are trained by billions of T and B lymphocytes capable of recognizing all possible and impossible molecules, except those that are our own.
High school for T lymphocytes is the thymus (thymus, from there T), in which it is first amplified, the development of individuality by targeted gene manipulations at the antigenic TCR receptor and subsequent selection. When selecting, those T cells that do not have sufficient recognition talent are first destroyed. In the second round, those that respond to their own structures are destroyed (therefore, for example, there is no immune response in congenital syphilis). B lymphocytes in mammals undergo the same training in bone marrow or lymph nodes, but birds have a special organ for the B lymphocyte training, a bloom of the cloaca ( bursa fabricii , hence B). The training will survive about 2% of the participating cells, 98% undergo apoptosis and macrophages are cleared.
Taught lymphocytes then enter the waiting phase. During their lifetime, they encounter a foreign peptide that, as well as their antigenic receptor, activates and, in agreement with other lymphocytes, they can become the main actors of the affinity maturation process in which ultra-fast controlled evolution (somatic hypermutation and clonal selection ). Ultra fast because it is not expected until the division is complete - the eukaryotic cell cycle would last for at least 24 hours, and only 4 iterations would be achieved in 4 days. Instead, mutated genes are selected by instant testing of their protein product. The result is a highly optimized antigen receptor. If Golem XIV Stanislaw Lema complains that Evolution moves from the original molecular genius to the worse technical solution ( work here , unfortunately in the net in English only), it can be said that in the immune system this genius remained under pressure Parasites are partly preserved.
- Communication molecules - All components of the immune system work together. For example, only B lymphocytes have the ability to produce specific immunoglobulins, but these are ultimately used by all the immune cells and the complement. Immunoglobulin can be considered an information molecule - it is a negative or rather a negative fingerprint. In addition, the immune system uses a variety of other communication molecules:
- Cytokines, chemokines - Common name for communication molecules of a herbicidal nature. These include interleukins, interferons, and dozens of other peptides with ugly names.
- Interleukins - Protein-based communication molecules in general managing strategy and tactics of immune responses: They trigger fever, control the proliferation of leukocytes, control inflammation, proclaim martial law,
- Interferons - Three types of antiviral alarm peptides.
- TNF (tumor necrosis factors) - Polyfunctional immune communication peptides that have gained glory in human scientists as anticancer alarm molecules.
- Eicosanoids (prostaglandins, leukotrienes, thromboxanes and others, so-called non-classical eicosanoids) - Communication molecules derived from twenty-carbon (twenty-20) fatty acids, arachidonic acid. It belongs to the world of essential fatty acids, well-known omega-3 and omega-6 unsaturated fatty acids, formerly called vitamin F. Our organism first affords ω-3 and ω-6 unsaturated bonds still ω-9 and ω-12, To form arachidonic acid. In addition, specialized enzymes produce communication eicosanoids. The key enzyme in their production is cycloxygenase , which is the target of the most common analgesics . Acetylsalicylic acid (aspirin) , paracetamol (paralen) and ibuprofen (brufen) share the same main effect - they block cycloxygenase.
- Complement - A set of mutually interacting protein molecules (labeled C1 to C9, possibly even more than nine), capable of self-identifying and destroying or at least labeling pathogens. The C1 molecule recognizes the pathogen either directly or with immunoglobulins, and the C2-C8 molecules then assess the situation to prevent the destruction of a good cell by mistake, and C9 then creates an attacking complex that perforates the target membrane. Additionally, the cells in addition to the complement protect the protectin antidote, which inhibits the action of the C9 molecule. Just like the slow-witted conclusion of the 45th Sturmkwurm , or the mechanical ladybird that our cyber theorist and Slovakian immigrant Jozef Kelemen are so happy about, the complement is an example of genius in simplicity. Magazines are slowly starting to bombard us with reports of "smart" antibiotics in America so we do not feel inferior, it's good to know that up to 5% of our blood serum proteins are the molecules of the smartest antibiotic-complement.
- Defensins - Effective antibiotics created by our body. It can be said that from the point of view of common microbes, we are among poisonous animals.
- A-defensiny - A weapon of granulocytes and other immune cells.
- Β-defensins - Antibacterial poisons that we excrete on the surface of our skin, mucous membranes and body cavities.
- Apoptosis - Controlled cellular disassembly. Subjects are over-harvested if they have damaged DNA if they are parasitic, or if they have a suspicion of tumor growth itself. I consider the term "cell suicide" to be misleading. (I also think of "death" as a completely unscientific expression, but at other times.)
- Autoimmunity - As with any system, even in the immune system, errors occur. There are quite a few cases where certain proteins in our cells appear in the course of their lives, and lymphocytes have to understand that these proteins are not hostile. Lymphocytes themselves can without a false judgment and accidentally trigger an autoimmune response. Immune errors are very dangerous because they can accidentally easily destroy the population of their own cells, as is the case with type 1 diabetes mellitus . The immune system should also not over react to dozens of useful bacteria, fungi and (possibly) useful viruses occurring on the skin and the digestive tract.
Immune system problems
It turns out that most civilization diseases, or diseases of longevity, are somehow related to poor functioning of the immune system. We already know several mechanisms of aging . We have the theory of oxidative aging and antioxidants, the theory of DNA aging, the theory of telomere reduction, the theory of mitochondrial aging ... I believe that the theory of immune system degradation should be added to this list. It is not just allergy and asthma, but also arthritis, arthrosis , diabetes , or seemingly unrelated atherosclerosis . Immunomodulatory drugs should be considered for all these diseases.
Immunomodulatory effects of natural drugs with emphasis on ginseng
Many of the natural adaptogen (and nonadaptogenes) affect the immune system. Sensu stricto adaptogens can be expected to interact with the glucocorticoid axis, whose immunomodulatory significance is well known ( Sapolsky2000hdg ). A great deal of scientific effort has been devoted to modeling ginseng adaptogen and healing fungi of the Polyporales group , for which the immunomodulatory effect is considered to be the most important. Another known immunomodulatory adaptogen is purpura ( Echinacea purpurea ) , Astragalus membranaceus . The active substances are triterpenoids ( Christensen2009gcb , Paterson2006gtf ) and other secondary metabolites ( Percival2000uem , Block2003ise ), but also specific proteoglycans / polysaccharides are also important for all of the plants / fungi.
Essence of immunomodulatory effects
The immune response can roughly be divided into two types that compete with each other:
- Cytotoxic (against viruses, tumors): -> maturation T H 1 -> activation of T C lymphocytes
- Antibody (against most bacteria): -> maturation T H 2 -> activation of B lymphocytes
When the disease occurs, the immune system must correctly evaluate the type of threat and consider what kind of pathogens it concentrates on. Antigens from the affected tissue are transported to the lymph node, where interleukin IL-2 is produced and an immune response is triggered. The type of response is the result of a discussion of T lymphocytes and dendritic cells (DB) on the antigen. They express their opinion using cell cytokines:
- DB type 1, T H 1 - production of IFN-γ (gamma interferon), TNF (tumor necrosis factor alpha), IL-12
- DB type 2, T H 2 - production of interleukins IL-4, IL-10
The final decision is in the hands of DB - at its discretion, governs adolescence of T lymphocytes either to the T H 1 type (cytotoxic response) or to the T H 2 type (antibody response).
Immunomodulatory effects of ginseng right
The fact that ginseng affects the immune system is now overwhelmed by doubt ( Christensen2009gcb , Choi2008bcp , Xiang2008cau ). Ginseng enhances immunity especially against viruses and tumors. Cancer can also be seen as immune failure . In tumor diseases, ginseng is a welcome supportive agent, also with some direct antitumor effects .
The ginseng content influences the choice of immune response. Christensen2009gcb (chapter "Immunomodulation") refers to the thesis that ginseng supports cytotoxic response (against tumors and viruses). In contrast, Lee2004gre demonstrates that the majority panaxoside Rg 1 of ginseng has the opposite effect. To third, ginseng has a proven anti-inflammatory and anti-allergic effect. A comprehensive scientific view of the immunomodulatory effect of ginseng is not available, but the current data confirm that its constituents have immune-tolerant effects on the immune system, which is typical of the adaptogenic effects .
Stimulating effect of ginseng on the immune system
Adaptogens in general and ginseng, in particular, have several adverse effects on the active substances . Specifically, ginseng limits inflammation , works against autoimmune diseases, and often applies where doctors usually prescribe immunosuppressive corticosteroids. Is ginseng immunosuppressive?
The answer to this question is not clear. Acute fever (ie infection ) is one of the few traditional contraindications of ginseng. Therefore, I believe that at least some infections reassuring the effect of ginseng on white blood cells are not welcome. However, ginseng is by no means merely an immunosuppressant (which, moreover, is not even mentioned corticoids, Sapolsky2000hdg ). In many bacterial and most viral infections, ginseng helps - immune improves.
Ginseng-specific polysaccharides have been shown to suppress Staphylococcus aureus septicemia at an optimal dose of 25μg / kg ( Lim2002aep , Lim2004iap ). The effect has been associated with multiple increases in NO production and cytokines (TNF-α, IL-1, IL-6 and IFN-γ) macrophages.
The effect of ginseng on the ability of macrophages to respond to long-term stress infection ( Pannacci2006pgm ) was investigated. It is generally known that long-term stress decreases immunity ( Viswanathan2005saa ), but short-term macrophage stress activates ( Berczi1998scn ). Ginseng ginsan ginseng polysaccharide (25 mg / kg / day per os) in mice increased the expression of TLR receptors in macrophages (these receptors non-specifically recognize pathogens) and thus the ability of macrophages to respond to infection ( Ahn2006igi ). Ginseng also positively affects anti-cancer immunity .
Specific immunomodulatory effects:
- On monocytes / macrophages : Panaxosides Rb 1 and Rb 2 suppressed TNF-α production in both mouse and human macrophages stimulated lipopolysaccharides with IC 50 ~ 50 and ~ 25 μM ( Cho2001 ). According to Lee2002fma , red ginseng increased the production of TNF-α macrophages. In contrast, according to Cho2001vie , ginsenosides Rb1 , Rb2 , Rg1 are potent inhibitors of TNF-α production in macrophages stimulated by bacterial lipopolysaccharides. The aforementioned panaxosides suppress the production of other inflammatory cytokines such as IL-6 and IL-1β ( Rhule2006pna ).
- Spleen mice lymphocytes found that pxsd. Rb 1 and Re at a concentration of about 100 μM significantly increased the proliferation of mitogens stimulated by T H (CD4 +) and B lymphocytes, Rg1 had no effect on it, whereas Rb 2 reduced it with IC 50 about 25 μM. Rb2 also suppressed the production of IL-2 lymphocytes following concavalin stimulation with IC50 ~ 13.3 μM. UT C (CD8 +) lymphocytes were different results - Rb 2 and Rb 1 did not replicate their proliferation after IL-2 stimulation, whereas Re and Rg 1 of their proliferation were limited by IC 50 57.5 and 64.7 μM ( Cho2002gfp ). According to Lee2004gre , gssd. Rg 1 promotes the maturation of T H 2 lymphocytes and the production of IL-4. By contrast, Lee2006grh claims that gssd. Rg1 promotes the maturation of T H 1 lymphocytes.
- Pxsd. F1 and Rg1 in mouse splenocyte culture selectively increase the production of type 2 cytokines (IL-4 in splenocytes, IL-12 in macrophages) and their transcription factor GATA-3, while pxsd. Rh 1 and 20 (R) -Rh 1 selectively enhance the production of cytokines type 1 (IFN-γ in splenocytes) and their transcription factor T-bet. All of the mentioned pxsd. (F1, Rg1, Rh1 and 20 (R) -Rh1) increase the binding of the transcription factor NF-κB to DNA. Interestingly, maximal increases in cytokines occur at concentrations of 5μM and 10μM, higher concentrations increase cytokines again less, at 50μM more than twice less than 10μM ( Yu2005pgd ).
- On dendritic cells : According to Takei2004dcm and Takei2008dcp , compound K and gssd. 20 (S) -PPT affect monocytic dendritic cells towards type 1 immune responses. These studies discuss the possibility of anticancer effect of ginseng and the opportunity for immunotherapy of tumors affected by dendritic cells.
- On NK cells : Choi2008bcp discusses the ability of ginseng extract and specifically panaxoside Rh 2 to restore NK cell activity and immune cells after their mitomycin challenge.
- Granulocytes : Gssd. Re activates neutrophilic granulocytes against tumor cells ( Plohmann1997iae ).
- Against Influenza : The effect of ginseng on influenza is revealed in the article Flu and Viral Disease .
- HIV: Choi2008bcp ginseng suppresses HIV proliferation and alleviates AIDS.
- On the adhesion of lymphocytes to endothelium and diapedesis : Some panaxosides, such as notoginsenoside R1 ( Chen2008enr ) or ginsenoside Rb1 ( He2007peg ), restrict the adhesion of lymphocytes to the endothelium, explaining the observed effect against atherosclerosis and inflammation .
Immunomodulatory proteoglycans and polysaccharides
Proteoglycans and polysaccharides play an important role in the immunomodulatory effects of natural drugs. It is also true ginseng ( Sun2011sba , Yun1993iat ), American ginseng ( Assinewe2002epp , Wilson2013uai Azike2015ssi ) and other herbs. Again, when we take P. ginseng , for example, acidic polysaccharides ginsenan PA and ginsenan PB increase serum immunoglobulin IgG and activate phagocytosis ( Tomoda1993cta , Tomoda1994csg ). Information in this field is constantly developing; relevant publications on the immunomodulatory effect of ginseng polysaccharides include Lim2004iap , Choi2008rga , Yoo2012peg , Wang2013mmb and others.
Other classical adaptogens with immunomodulatory effects
- Japanese marshmallow ( Panax japonicus ) in the mouse model improves the recovery of the damaged immune system. ( Zhang2011epi )
Immunomodulating effects of glossy gloss
The proteoglycan fraction of the gloss has activated immunity in human monocytes (22364151) and improves immunity to the mouse immunosuppression model (22403542). Otherwise, the work on the influence of glossary on the immune system is large, and most of them comment on their antitumor effects .
Other immunomodulatory adaptogens
Immunomodulatory effect is essential for a large number of adaptogens, so it is difficult to navigate according to scientific publications. I recommend using the tradition of TCM as an orientation for specific diseases. But to make the local list of immunomodulatory adaptogens empty, then relevant references point to
- Vitania ( Rasool2006irw , Minhas2012tew , Ku2014wii , Ichikawa2006wpa )
- Ginger ( Lakhan2015zep )
- Kurkumu ( Lakhan2015zep )
- Opuncii ( Zhao2012ieo )
- Chinese caterpillar ( Lee2014aec ).
An overview of the most widely known immunomodulatory herbs Ilyas2016rhi (except the above) states:
- Umbilical cord (Centella asiatica)
- Licorice (Glycyrrhiza spp.)
- Asparagus spp.
- Aralia (Aralia mandshurica)
- Picrorrhiza kurroa
- Lawsonia alba
- Cabbage (Brassica oleracea)
- Mistletoe (Viscum album)
- Canavalia ensiformis
- Len (Linum usitatissimum)
- Wormwood (Artemisia princeps)
- Purple Thuja (Echinacea purpurea)
- wheat bran
- Rice bran
- Aloe vera (Aloe vera)
- Sorrel (Rumex acetosella)
- Membrane dioscorea
- Tinospora cordifolia
- Litchi (Litchi chinensis)
- Lead (Plumbago zeylanica)
- Aniseer (Pimpinella anisum)
- Poisonous Catharantus roseus (vinkristin)
- Poisonous Claviceps purpurea (ergot alkaloids)
- Uncaria tomentosa
- Amur Cork (Phellodendron amurense)
- Berberin from Cissampelos pareira