In patients with chronic obstructive pulmonary disease (COPD), use of an extract of the thymelike plant Zataria multiforma for 2 months was associated with a significant decrease in serum levels of inflammatory cytokines and respiratory symptoms, as well as increased values on pulmonary function tests (PFTs). Results of a placebo-controlled study of Iranian patients were recently published in the Journal of Ethnopharmacology.
Z multiforma has been used in Iranian traditional and folk medicine as an antiseptic, carminative, diuretic, diaphoretic, antispasmodic, and analgesic herbal medicine. It has also been used to relieve the cough associated with the common cold and respiratory tract infections. Building upon prior animal and clinical studies reporting on the anti-oxidant and anti-inflammatory properties of Z multiforma in respiratory tract disorders, the researchers of the current study sought to evaluate the use of Z multiforma extract in individuals with COPD.
The researchers enrolled 41 participants with COPD into 3 study groups: (1) placebo group (P; n=13), (2) Z multiforma 3 mg/kg/day (Z3; n=14), and (3) Z multiforma 6 mg/kg/day (Z6; n=14). For all study participants, inflammatory cytokines, PFT values, and respiratory symptoms were evaluated prior to treatment (stage 0), 1 month after treatment (stage I), and 2 months after treatment (stage II).
With respect to respiratory symptoms, the researchers found that in stages I and II, cough and modified Medical Research Council (mMRC) scores were significantly decreased in both Z3 and Z6, compared with stage 0 (P <.01 and P <.001, respectively). In the placebo group, the researchers observed no significant changes in respiratory symptoms across the 3 stages of the study.
Further, cough in the Z6-treated arm and mMRC score in the Z3-treated arm in stage II were both significantly decreased compared with stage I (P <.05 for both). A significant reduction in chest tightness was reported after 1 month and 2 months of treatment with low-dose Z multiforma (P <.05 and P <.01, respectively), but only after 2 months of treatment with high-dose Z multiforma (P <.01).
Additionally, the percent changes in cough in both stage I and stage II, compared with stage 0, in both of the treated groups were significantly higher than the change in those in the placebo group (P <.01) for all cases. In stage II compared with stage 0, the percent change in chest tightness in the Z3-treated and the Z6-treated groups was also significantly higher than that in the placebo group (P <.01 for both). Moreover, the percentage changes in mMRC scores in stage II compared with stage 0 and stage II compared with stage I in the Z3-treated and the Z6-treated groups were significantly higher than that in those in the placebo group (P <.05 and P <.01, respectively).
Values of PFTs (ie, forced vital capacity [FVC], peak expiratory flow [PEF], and forced expiratory volume in 1 second [FEV1]) did not change significantly during the 3 stages of the study, said researchers; however, they noted that FVC and FEV1 were significantly increased in both the Z3-treated and the Z6-treated groups in stage II vs stage 0 (P <.05 and P <.01, respectively). Further, in the Z3-treated group, FVC was significantly increased in stage II compared with stage I (P <.01). PEF was significantly increased in the Z6 group in stage I compared with stage 0 (P <.05).
With respect to change in serum cytokines, the serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin-8 (IL-8) were both significantly decreased in stage II vs stage 0 in the Z3-treated and the Z6-treated groups (P <.01 for both). Additionally, the percent change in TNF-α and IL-8 in both of the treated groups in stage II relative to stage 0 were significantly higher than in the placebo group (P <.05 and P <.01, respectively).
The researchers concluded that Z multiforma may be a potential therapeutic agent for the treatment of various pulmonary inflammatory illnesses, such as COPD.
Ghorani V, Khazdair MR, Mirsadraee M, Rajabi O, Boskabady MH. The effect of two-month treatment with Zataria multiflora on inflammatory cytokines, pulmonary function testes and respiratory symptoms in patients with chronic obstructive pulmonary disease (COPD). J Ethnopharmacol. Published online April 6, 2022. doi:10.1016/j.jep.2022.115265