Bupleurum is used in herbal formulas such as Sho-saiko-to that may be effective in treating heptatitis and liver cancer.
Compounds called saikosaponins, isolated from bupleurum, are considered responsible for the plant’s medicinal activities. In laboratory studies, saikosaponins are able to interfere with the processes that cause inflammation, as well as cause cell death (apoptosis) in cancer cells by increasing the expression of tumor-suppressor genes. Saikosaponin-d in particular has shown ability to enhance mouse T-lymphocytes function in laboratory tests. It is not known whether these effects occur in the human body.
Many of the clinical studies of bupleurum have been performed in Japan using formulas such as Sho-saiko-to.
NOTE: The following uses and descriptions of effectiveness apply to bupleurum only. Please see our monograph on Sho-saiko-to for information regarding the effectiveness of bupleurum in combination with other herbs.
To treat cancer
Components of bupleurum can cause cancer cell death (apoptosis) in laboratory experiments, but it is not known whether this effect occurs in humans. No clinical trials have been performed to test this use.
To treat liver diseases, including hepatitis and cirrhosis of the liver
Although bupleurum is used in traditional Chinese medicine to treat liver diseases, no scientific evidence supports this use.
To treat the common cold
Bupleurum may have antiviral activity, but clinical trials have not been conducted.
As a fever reducer
Although bupleurum is used in traditional Chinese medicine to reduce fever, there are no clinical data to back this claim.
To treat infections
Bupleurum may have anti-bacterial activity, but human studies are lacking.
To reduce inflammation
Laboratory studies show that components of bupleurum interfere with the processes that cause inflammation. Human studies are needed.
To treat malaria
Bupleurum may have anti-viral activity, but human data are lacking.
Bupleurum is the major ingredient in an herbal formula, Sho-saiko-to, which has been associated with interstitial pneumonitis (lung disease characterized by increased scarring of lung tissue).
Do Not Take If
You are taking drugs that are substrates of cytochrome P450 2C9 substrates: Bupleurum extracts may increase the risk of side effects of these drugs.
Bupleurum is an important herb used in traditional Chinese and Japanese medicine. It is frequently prescribed in combination with other herbs to treat cold, fever, malaria, gastrointestinal disorders and chronic liver diseases.
In vitro studies show that Bupleurum has antiviral (4)(7), hepatoprotective (16), anti-inflammatory (17), antiproliferative (11), and chemopreventive (12)(13) properties. Bupleurum also demonstrated inhibitory effects against allergic asthma in animal studies (10).
Saikosaponins, the major components, were found to enhance the cytotoxicity of cisplatin against solid tumors (15). Herbal formulas such as Xiao Chai Hu Tang (Sho-saiko-to), which contain bupleurum as major ingredient, were found effective in treating hepatitis and liver cancers.
However, poor quality control is a major concern with commercial herbal products. A sample of Bupleurum was found contaminated with a nephrotoxic drug, aristolactone (18).
Mechanism of Action
The saikosaponins in bupleurum are mainly responsible for the plant’s medicinal activities. In vitro studies indicate that saikosaponins exert anti-inflammatory effects by inhibiting arachidonic acid metabolism (4). The anti-inflammatory activity of bupleurum polysaccharides is attributed to their inhibitory effect on LPS-mediated Toll like receptor 4 (TLR4) signaling (17).
Saikosaponin-d promotes interleukin-2 production and receptor expression as well as modulating T-lymphocyte function (3)(14). The anti-epileptic effects of saikosaponin a were shown to be via enhancing the transient inactivating potassium current in rat hippocampal CA1 neurons (19).
In an animal model, bupleurum showed weak antihistamine activity (10).
The herb’s apoptotic effects are thought to be partly mediated by increases in c-myc and p53 mRNA levels accompanied by a decrease in bcl-2 mRNA level (6) and by inhibition of telomerase activity (9). In addition, bupleurum demonstrated anti-adhesive and hemolytic effects in some solid tumor cells (5)(8).
Bupleurum is the major ingredient in an herbal formula, Sho-saiko-to, which has been associated with interstitial pneumonitis.
Cytochrome P450 2C9 substrates: Bupleurum extracts inhibit CYPC29 and can affect the intracellular concentration of drugs metabolized by this enzyme (20).
Dosage (OneMSK Only)
Bensky D, Gamble A. Chinese Herbal Medicine: Materia Medica. Revised Ed. Seattle: Eastland Press; 1993.
Huang KC. The Pharmacology of Chinese Herbs, Second Ed. New York: CRC Press; 1999.