Artichoke
Cynara scolymus L., C. cardunculus L., Family: Asteraceae (daisies)
Globe artichoke , garden artichoke , alcachofra (Brazil)
 
Clinical Overview
Uses
Artichoke has been used for its antioxidant and GI soothing effects. It also may have cytoprotective actions in the liver and hypocholesterolemic effects.

Dosing
Artichoke leaf extract at 1.5 g/day was found to lower serum cholesterol and triglycerides in a postmarketing survey study.

Contraindications
Contraindications to the use of artichoke include allergy to Asteraceae family plants and any bile duct obstruction.

Pregnancy/Lactation
Generally recognized as safe or used as food. Avoid dosages above those found in food because safety and efficacy are unproven.

Interactions
None well documented.

Adverse Reactions
Artichoke can cause allergic reactions in sensitive individuals, most commonly dermatitis.

Toxicology
Lack of toxicity data suggests limiting use during pregnancy and lactation.

 
Botany
The artichoke is a member of the daisy family. It is a perennial herb, widely cultivated in the Mediterranean regions and adjoining parts of central Europe. This well-known plant grows to a height of approximately 2 meters. It has a strong, erect stem and its large leaves are lobed and gray-green. The edible flower bud is purple-green in color, and has scales or bracts that enclose it. It blooms from July to August. 1 , 2 , 3 , 4
 
History
The artichoke has been cultivated for thousands of years. 1 In the first century AD, Dioscorides recommended applying mashed roots on the body to sweeten offensive odors. 2
The artichoke was used as food and medicine by ancient Egyptians, Greeks, and Romans. The artichoke appeared in Europe in the 15th century. 4 The botanical name is derived in part from the tradition of fertilizing the plant with ashes, and partly from the Greek skolymos , meaning “thistle” from the spines found on the bracts (they are not leaves) that enclose the flower heads forming the edible portion of the plant. 5 The French have used artichoke juice as a liver tonic. The herb's abilities to break down fat and improve bile flow have been recognized. 6 Artichoke has been used traditionally to treat a variety of conditions including hepatic diseases, jaundice, dyspepsia, and chronic albuminuria. It has also been used as a diuretic and to manage postoperative anemia. 2 The flower head is cooked and eaten as a delicacy. The flower contains a sweetener that enhances flavor perception, while the leaves contain bitter principles that are used in the preparation of aperitif liqueurs. 7
 
Chemistry
Nutritionally, one large (100 g) artichoke contains 38 calories, 1 g fat, 5.8 g carbohydrates, and 3.4 g protein. 1 This protein was rich in phenylalanine, tyrosine, histidine, alanine, and glycine in one report. 8 In another report, aspartic and glutamic acids were abundant amino acids present, along with sugars. 9 Galactose is present at less than 0.1 mg/100 g of artichoke in a report discussing diet in galactosemic patients. 10 Artichoke also contains fiber, 1 , 11 calcium, phosphorus, potassium, folic acid, vitamin C, niacin, thiamine, trace minerals, 1 , 4 and carotenoids. 12
Acids present in artichoke consist primarily of acid alcohols, including glyceric, malic, citric, glycolic, lactic, and succinic acids. 13 Much of the pharmacologic activity of the leaves has been attributed to the presence of caffeoylquinic acid derivatives, mono- and di-caffeoylquinic acids, including chlorogenic, neochlorogenic, and cryptochlorogenic acids, luteolin, and cynarin. 14 , 15 , 16 HPLC determination of these derivatives has been performed. 17 The relative proportion of these compounds varies with the strain, age, and generation of the plant. 18 , 19 For example, germinating seeds of the artichoke have higher cynarin content than the leaves. 20 Caffeic acid specifically and these derivatives have been widely studied and percentages can vary depending on certain factors. 3 , 14 , 21 , 22 Hydroxymethylacrylic acid also has been isolated from artichoke. 23
Bitter sesquiterpene principles such as geosheimin, cynaratriol, and cynaropicrin have been found from Cynara species. 24 Cynaropicrin content exists in highest content in young leaves, but not in root mature fruits and flowers. 14 Dehydrocynaropicrin, grossheimin, 3 grosulfeimin and related guaianolides, 25 , 26 and cynarolide 27 have been isolated from the plant. Flavonoids (0.1% to 1%), including flavone glycosides and rutin, are present in artichoke. 3 , 14 , 28 Flavonoid glycosides apigenin, luteolin, cynaroside, scolimoside, cosmoside, quercetin, isorhamnetin, maritimein, and others also have been reported. 29 , 30 Analysis of phenolic compounds in fresh vs cooked/canned artichoke has been performed. 31
Volatile oils have been found in artichoke, including beta-selinene and caryophyllene as major sesquiterpenes, eugenol, phenylacetaldehyde, and decanal. 14 Analysis of volatile oil in artichoke from another report finds 32 compounds. 32 Fatty acid composition of oil has been investigated. 33 Artichoke is an ideal source for essential polyunsaturated fatty acids, containing stearic, palmitic, oleic, and linoleic (50%) acids. 34 Color and anthocyanic pigments in artichoke have been evaluated. 35
Numerous enzymes, including oxidases, peroxidases, cynarase, and ascorbinase are present in artichoke. 7 , 14 Ribulose-1,5-diphosphate carboxylase has been investigated. 36 , 37 Artichoke polyphenol oxidase has also been found in the plant. 38 , 39 Milk-clotting proteinases, possibly aspartic proteinases, exist in artichoke as well. 40
Other constituents in artichoke include phytosterols (taraxasterol), tannins, sugars, starch, and inulin. 14 At low temperatures, artichoke contains more inulin and less starch; at high temperatures, the opposite is observed. 41 L-asparagine was found in artichoke fluid. 42
Overviews of artichoke constituents/preparations are available; however, they are written in German or Russian. They discuss chemical composition in review of major materials 43 and evaluate artichoke preparations, including freshly squeezed juice and dried preparations. 44 , 45 , 46 A report in English evaluated by HPLC, the active ingredients in artichoke and variations in compounds according to different parameters. 47
 
Uses and Pharmacology
Artichoke possesses many properties, including antioxidant effects, hepatoprotective ability, GI soothing qualities, and cholesterol-lowering effects.
Antioxidant activity   The flavonoid constituents in artichoke (eg, luteolin) demonstrate antioxidant activity. 48
Animal data   Flavonoids/polyphenol fractions possess chemopreventive effects as well, as seen with mouse skin cancers. 49 , 50 Similarly, triterpene taraxasterol from artichoke was found to also markedly inhibit induced skin tumors in mice. 51 Flavonoid silymarin from the plant had similar actions. 52
Antioxidant effects of artichoke in the liver have been numerously reported. Certain extracts have been demonstrated to be effective in regeneration of rat liver. 53 , 54 Later reports confirm artichoke extracts as having antioxidative and protective potential in rat hepatocytes. Constituents cynarin and caffeic acid specifically have been shown to be responsible for these effects. 55 , 56 , 57
Clinical data   Research reveals no clinical data regarding the use of artichoke as an antioxidant.
Cholesterol-lowering effects   Artichoke has been found to possess cholesterol-lowering effects. Leaf extracts were found to inhibit cholesterol biosynthesis.
Animal data   Constituents cynaroside and its aglycone luteolin were mainly responsible for this effect, while chlorogenic, caffeic dicaffeoylquinic acids, and cynarin demonstrated little or no inhibitory effects. 58 , 59
Clinical data   Another report also concluded the ineffectiveness of cynarin, demonstrating no hypolipidemic actions in 17 patients with familial type II hyperlipoproteinemia. 60 A prospective study investigating 143 patients with total cholesterol greater than 280 mg/dL reported that patients given 1800 mg dry extract/day vs placebo over a 6-week period experienced statistically significant changes in total and LDL cholesterol. Total cholesterol was decreased 18.5% vs 8.6% and LDL cholesterol was reduced 22.9% vs 6.3% in patients using the dry artichoke extract vs placebo, respectively. Thus, dry artichoke extract was recommended to treat hyperlipoproteinemia, preventing atherosclerosis and coronary heart disease. 61
Other uses   A review on artichoke leaf extract is available, discussing digestive, antioxidative, hepatoprotective, lipid-lowering, and other effects. 62
GI effects of artichoke include beneficial actions in digestive and dyspeptic ailments, loss of appetite, and gallbladder problems. 2 , 3 , 15 Artichoke flavonoids and caffeoylquinic acids are responsible for these actions, including hepatobiliary dysfunction and digestive complaints. 63 Naturally occurring fructose-containing oligosaccharides in artichoke act as prebiotics in the gut. 64
Other reported effects of artichoke include analgesic/anti-inflammatory 65 and hypoglycemic. 25 The artichoke is a good source of nutrition, including protein and fiber. 1 , 8 , 9 , 11 Artichoke extracts also may exert mild diuretic activity. Cynarase has been used commercially to curdle milk during cheese-making processes, clotting milk at a dilution of 1 part in 150,000. 7
Artichoke seed oil was suggested to be of use as a component in making soaps, shampoos, resins, and polishes. 66
 
Administration & Dosage
Artichoke leaf extract at 1.5 g/day was found to lower serum cholesterol and triglycerides in a postmarketing survey study. 67
 
Pregnancy/Lactation
Generally recognized as safe or used as food. Avoid dosages above those found in food because safety and efficacy are unproven.
 
Interactions
None well documented.
 
Adverse Reactions
In a 143-patient study, no adverse events were reported from artichoke administration, indicating excellent tolerability of dry extract. 61 Frequent contact with artichoke and other Asteraceae family plants, however, has caused allergic reactions in sensitive individuals. Reports of contact dermatitis 68 and urticaria syndrome from occupational contact with artichoke have been documented, identifying the responsible components as cynaropicrin and other sesquiterpene lactones. 68 , 69 , 70 One study in guinea pigs demonstrated no skin or eye irritation with one artichoke preparation. 71 Another article by the same authors found no injury or stimulating effects in gonad morphology caused by artichoke when administered to male rats. 72
According to the German Commission E Monographs, contraindications to the use of artichoke include allergy to Asteraceae family plants and any bile duct obstruction. Presence of gallstones warrants a physician's consultation. 15
 
Toxicology
Lack of toxicity data suggests limiting use of artichoke during pregnancy and lactation. 14
 
References
 

1. Ensminger A, et al. Foods and Nutrition Encyclopedia . 2nd ed. Boca Raton, FL: CRC Press; 1994:116-118, 964-965.

 

2. Chevallier A. The Encyclopedia of Medicinal Plants . New York, NY: DK Publishing; 1996:96-97.

 

3. Fleming T, ed. PDR for Herbal Medicines . Montvale, NJ: Medical Economics Company; 1998:793-794.

 

4. http://www.rain-tree.com/artichoke.htm .

 

5. Bianchini F. Health Plants of the World . Milan, Italy: Arnoldo Mondadori Editore; 1975.

 

6. http://www.prweb.com/releases/1998/prweb3080.htm .

 

7. Schauenberg P, et al. Guide to Medicinal Plants . New Canaan, CT: Keats Publishing; 1977.

 

8. Moharram Y, et al. Artichoke bracts (Cynara scolymus L.), as a source of protein. Dev Food Sci . 1984;9:181-187.

 

9. Lattanzio V, et al. Chemical composition and nutritive value of artichoke (Cynara scolymus L.). Cent Stud Ortic Ind Cnr (Italian conference). Studi Carciofo [Congr Int]. 3rd ed. 1981:117-125.

 

10. Gross K, et al. Fruits and vegetables are a source of galactose: implications in planning the diets of patients with galactosaemia. J Inherit Metab Dis . 1991;14:253-258.  PubMed

 

11. Femenia A, et al. Cauliflower ( Brassica oleracea L.), globe artichoke ( Cynara scolymus ) and chicory witloof ( Cichorium intybus ) processing byproducts as sources of dietary fiber. J Sci Food Agric . 1998;77:511-518.

 

12. Granado F, et al. Major fruit and vegetable contributors to the main serum carotenoids in the Spanish diet. Eur J Clin Nutr . 1996;50:246-250.  PubMed

 

13. Bogaert J, et al. Organic acids, principally acid-alcohols, in Cynara scolymus L. [in French]. Ann Pharm Fr . 1972;30:401-408.  PubMed

 

14. Newall C, et al. Herbal Medicines . London, England: Pharmaceutical Press; 1996:36-37.

 

15. Blumenthal M, ed. The Complete German Commission E Monographs . Austin, TX: American Botanical Council; 1998:84-85.

 

16. Dranik L, et al. Phenol compounds from some plants of the Compositae family. Artichoke ( Cynara scolymus ). Fenol'nye Soedin. Ikh Biol. Funkts, Mater vses Simp. 1st ed. 1968:53-60.

 

17. Adzet T, et al. High-performance liquid chromatography of caffeoylquinic acid derivatives of Cynara scolymus L. leaves. J Chromatogr . 1985;348:447-453.

 

18. Hammouda F, et al. HPLC evaluation of the active constituents in the newly introduced Romanian strain of Cynara scolymus cultivated in Egypt. Planta Med . 1991;57(suppl 2):A119.

 

19. Puigmaciá M, et al. Spectroscopic study of caffeoylquinic acid derivatives of Cynara scolymus . Planta Med . 1986;52:529.  PubMed

 

20. Ben-Hod G, et al. Cynarin and chlorogenic acid content in germinating seeds of globe artichoke ( Cynara scolymus L.). J Genet Breed 1992;46:63-67.

 

21. Nichiforesco E. Variation of caffeic acid type o-dihydroxyphenolic derivatives of the artichoke ( Cynara scolymus L.) during its period of vegetation [in French]. Ann Pharm Fr 1966;24:451-456.  PubMed

 

22. Dranik L. Spectral investigation of phenolcarboxylic acids of Cynara scolymus [in Russian]. Khim Prir Soedin . 1966;2:303-306.

 

23. Bogaert J, et al. Characterization and analysis of hydroxymethylacrylic acid in the leaves of Cynara scolymus (Compositae). Plant Med Phytother . 1974;8:199-203.

 

24. Bernhard H, et al. Quantitative determination of bitter sesquiterpenes from Cynara scolymus L. (artichoke) and Cynara cardunculus L. (Kardone) (Compositae) [in German]. Pharm Acta Helv . 1982;57:179-180.

 

25. Barbetti P, et al. Grosulfeimin and new related guaianolides from Cynara scolymus L. Ars Pharm . 1992;33:433-439.

 

26. Barbetti P, et al. Grosulfeimin and new related guaianolides from Cynara scolymus L. Nat Prod Lett . 1993;3:21-30.

 

27. Drozdz B. Sesquiterpene lactones. IV. Isolation of cynarolide, a new sesquiterpenic lactone from the leaves of Cynara scolymus L. Diss Pharm Pharmacol . 1968;20:217-219.

 

28. Hammouda F, et al. Flavonoids of Cynara scolymus L. cultivated in Egypt. Plant Foods Hum Nutr . 1993;44:163-169.  PubMed

 

29. El-Negoumy S, et al. Flavonoid glycosides of Cynara scolymus . Fitoterapia . 1987;58:178-180.

 

30. Hinou J, et al. Polyphenolic substances of Cynara scolymus L. leaves [in French]. Ann Pharm Fr . 1989;47:95-98.  PubMed

 

31. Aubert S, et al. Analysis of phenolic compounds in artichoke ( Cynara scolymus L.) by high-performance liquid chromatography. Fr Bull Liaison - Groupe Polyphenols . 1986;13:553-555.

 

32. Buttery R, et al. Volatile aroma components of cooked artichoke. J Agric Food Chem . 1978;26:791-793.

 

33. Kuliev A, et al. Fatty acid composition of the oil of Cynara scolymus L. fruits cultivated in the Nakhichevan ASSR. Rastit Resur . 1985;21:346-349.

 

34. Choudhary D, et al. Globe artichoke ( Cynara scolymus L.) oil — a potential new source of essential polyunsaturated fatty acids. Res Ind . 1992;37:29-30.

 

35. Aubert S, et al. Color and anthiocyanic pigmentation in the artichoke ( Cynara scolymus L.). Studi Carciofo [Congr Int]. 3rd. 1981 French Conference, 1979:57-76.

 

36. Cardinali A, et al. Separation of ribulose-1,5-diphosphate carboxylase subunits from artichoke leaves [in Italian]. Boll Soc Ital Biol Sper . 1986;62:565-569.  PubMed

 

37. Miceli A, et al. Determination of the number of sylfhydryl residues of ribulose-1,5-diphosphate carboxylase purified from artichoke leaves [in Italian]. Boll Soc Ital Biol Sper . 1986;62:571-576.  PubMed

 

38. Leoni O, et al. Polyphenol oxidase from artichoke ( Cynara scolymus L.). Food Chem . 1990;38:27-39.

 

39. Espin J, et al. Monophenolase activity of polyphenol oxidase from artichoke heads ( Cynara scolymus L.). Food Sci Technol . 1997;30:819-825.

 

40. Llorente B, et al. Presence of milk clotting proteinases in Cynara scolymus L. CV. green globe (Asteraceae). Acta Hortic, 501 (Second World Congress on Medicinal and Aromatic Plants for Human Welfare). 1999;249-257.

 

41. Petri P, et al. Report on the formation of inulin and starch in Cynara scolymus L., var sativa, tissues in vivo and in vitro at different temperatures. Studi Carciofo [Congr Int]. 3rd. 1981, 1979;127-133.

 

42. Bernhard R, et al. Identification of L-asparagine in artichokes Cynara scolymus . Lebensm-Wiss-Technol 1972;5:185-186.

 

43. Dranik L, et al. Chemical composition and medical usage of Cynara scolymus L [in Russian]. Rastit Resur . 1996;32:98-104.

 

44. Brand N, et al. Artichoke extract. Pharmaceutical aspects of a plant active substance [in German]. Dtsch Apoth Ztg . 1997;137:3564-3566, 3568, 3570, 3572-3574, 3577-3578.

 

45. Schilcher H, et al. Fresh-squeezed juice from artichoke [in German]. Dtsch Apoth Ztg . 1999;139:2725-2729.

 

46. Wiedenfeld H. Artichoke preparations — dried and extracted or freshly pressed [in German]. Pharm Ztg . 1999;144:118-120, 122, 124.

 

47. Hammouda F, et al. Quantitative determination of the active constituents in Egyptian cultivated Cynara scolymus . Int J Pharmacogn . 1993;31:299-304.

 

48. Brown J, et al. Luteolin-rich artichoke extract protects low density lipoprotein from oxidation in vitro. Free Radic Res . 1998;29:247-255.  PubMed

 

49. Agarwal R, et al. Cancer chemoprevention by polyphenols in green tea and artichoke. Adv Exp Med Biol . 1996;401:35-50.  PubMed

 

50. Mukhtar H, et al. Skin cancer chemoprevention. J Investig Dermatol Symp Proc . 1996;1:209-214.  PubMed

 

51. Yasukawa K, et al. Inhibitory effect of taraxastane-type triterpenes on tumor promotion by 12-O-tetradecanoylphorbol-13-acetate in two-stage carcinogenesis in mouse skin. Oncology . 1996;53:341-344.  PubMed

 

52. Agarwal R, et al. Inhibitory effect of silymarin, an anti-hepatotoxic flavonoid, on 12-O-tetradecanoylphorbol-13-acetate-induced epidermal ornithine decarboxylase activity and mRNA in SENCAR mice. Carcinogenesis . 1994;15:1099-1103.  PubMed

 

53. Maros T, et al. Effects of Cynara scolymus extracts on the regeneration of rat liver [in German]. Arzneimittelforschung . 1966;16:127-129.  PubMed

 

54. Maros T, et al. Effect of Cynara scolymus-extracts on the regeneration of rat liver [German]. Arzneimittelforschung . 1968;18:884-886.  PubMed

 

55. Adzet T, et al. Hepatoprotective activity of polyphenolic compounds from Cynara scolymus against carbon tetrachloride toxicity in isolated rat hepatocytes. J Nat Prod . 1987;50:612-617.  PubMed

 

56. Gebhardt R. Antioxidative and protective properties of extracts from leaves of the artichoke ( Cynara scolymus L.) against hydroperoxide-induced oxidative stress in cultured rat hepatocytes. Toxicol Appl Pharmacol . 1997;144:279-286.  PubMed

 

57. Gebhardt R, et al. Antioxidant and hepatoprotective effects of artichoke extracts and constituents in cultured rat hepatocytes. Toxicol In Vitro . 1997;11:669-672.

 

58. Gebhardt R. Inhibition of cholesterol biosynthesis in primary cultured rat hepatocytes by artichoke ( Cynara scolymus L.) extracts. J Pharmacol Exp Ther . 1998;286:1122-1128.  PubMed

 

59. Anonymous. Renewed proof: Inhibition of cholesterol biosynthesis by dried extract of artichoke leaves [German]. Forsch Komplementarmed . 1999;6:168-169.

 

60. Heckers H, et al. Inefficiency of cynarin as therapeutic regimen in familial type II hyperlipoproteinaemia. Atherosclerosis . 1977;26:249-253.  PubMed

 

61. Englisch W, et al. Efficacy of artichoke dry extract in patients with hyperlipoproteinemia [German]. Arzneimittelforschung . 2000;50:260-265.  PubMed

 

62. Kraft K. Artichoke leaf extract. Recent findings reflecting effects on lipid metabolism, liver and gastrointestinal tracts. Phytomedicine . 1997;4:369-378.

 

63. Wegener T, et al. Pharmacological properties and therapeutic profile of artichoke [German]. Wien Med Wochenschr . 1999;149:241-247.  PubMed

 

64. Gibson G. Dietary modulation of the human gut microflora using prebiotics. Br J Nutr . 1998;80:S209-S212.  PubMed

 

65. Ruppelt B, et al. Pharmacological screening of plants recommended by folk medicine as anti-snake venom — I. Analgesic and anti-inflammatory activities. Mem Inst Oswaldo Cruz . 1991;86(Suppl 2):203-205.  PubMed

 

66. Miceli A, et al. Extraction, characterization and utilization of artichoke-seed oil. Bioresour Technol . 1996;57:301-302.

 

67. Kraft K. Artichoke leaf extract—Recent findings reflecting effects on lipid metabolism, liver and gastrointestinal tracts. Phytomed . 1997;4:369-378.

 

68. von Schneider G, et al. Planta Med . 1974;25:149.

 

69. Meding B. Allergic contact dermatitis from artichoke, Cynara scolymus . Contact Derm . 1983;9:314.  PubMed

 

70. Quirce S, et al. Occupational contact urticaria syndrome caused by globe artichoke ( Cynara scolymus ). J Allergy Clin Immunol . 1996;97:710-711.  PubMed

 

71. Khalkova Z. An experimental study of the skin- and eye-irritating action of an artichoke preparation [Bulgarian]. Probl Khig . 1996;21:74-80.  PubMed

 

72. Ilieva P, et al. The action of the artichoke (Cynara scolymus) on the male gonads in an experiment [Bulgarian]. Probl Khig . 1994;19:105-111.  PubMed