by Loukiani Chatzinasiou 

ABSTRACT

Roman chamomile (Anthemis nobilis L.) presents a valuable medicinal plant, mainly due to its admirable safety profile. It has been used throughout the world for over two thousand years, and continuous to be very popular in the West for its relaxing, anti-inflammatory and antimicrobial effects. More recently, it has been reported in animal studies as having additional pharmacological properties, including hypoglycemic effects. It is applied to a variety of cosmetic and food products providing a pleasant aroma and flavour, respectively. Despite the broad field of applications, the available scientific evidence is limited. Therefore, more human studies are needed to investigate the properties of this plant (EMA 2012; Edwards et al. 2015).

INTRODUCTION

Roman or English chamomile, more formally known as Chamaemelum nobile (L.) All., (or under its synonym Anthemis nobilis L.) is one of the most widely used species of the daisy family. It grows wild in temperate to warmer regions of Europe, Africa, Asia and Northern America. In Europe it is mainly cultivated in England, Ireland, France, Belgium and Germany (EMA 2012; Fauconnier et al. 1996). It is a perennial herb spreading on the ground. Depending on the morphology, the flowers are presented in two botanical categories, the white-headed or double flowered and the yellow-headed, which produce essential oils with different concentration of active ingredients. The primary source of the herbal drug is the sterile double flowered plants, which are reproduced from suckers (Al-Snafi 2016; Vaughan & Judd 2003). Flowers are white to pale yellow in colour and arranged around a yellow center. They possess a characteristic aroma and usually bloom from June to September (EMA 2012; Fauconnier et al. 1996). All Anthemis species present some scales among florets, but in the case of Roman chamomile these scales are short and round, and therefore, it can be identified (Grieve 1978).

Roman chamomile has been used for many centuries, due to its remarkable medicinal properties. It is applied both externally and internally and has a variety of effects such as antibacterial, anti-inflammatory, relaxing and antioxidant activity (Edwards et al. 2015; Al-Snafi 2016). It is often confused with the equally well-known German chamomile (M. chamomilla, commonly known as Scented Mayweed). However, their chemical composition, morphology and applications are rather different (Edwards et al. 2015; Craker & Simon 1986). Its flowers constitute a registered herbal drug, which is included in several pharmacopoeias (EMA 2012). In the UK, it is widely used in the food and cosmetic industry, as well as sold as a traditional herbal medicine “for the relief of flatulence, bloating and mild upset stomach” (Edwards et al. 2015).

 

ETYMOLOGY

The origin of the word “chamomile” can be attributed to Greeks, with “chamos” translated as ground and “melos” as apple, due to the apple-like fragrance of Roman chamomile’s flowers. The word “Roman” is derives from ancient Rome, where the plant was used widely (Vaughan & Judd 2003; Murti et al. 2012). The therapeutic properties of this plant are sometimes considered to be superior compared to those of German chamomile, and thus it was also named as “nobile” (Latin, noble) (EMA 2012; Hiller & Melzig 1999).

HISTORICAL AND MODERN USES

Roman chamomile’s applications can be traced back for well over 2000 years (Trease & Evans 1989). In ancient Egypt, it was used for its healing properties against fever and as a sign of dedication to Gods (Cupp 2000). Ancient Greek texts illustrate the extensive therapeutic use of this herb by Hippocrates and Dioscurides (EMA 2012; Franke & Schilcher 2005). Romans also exploited its therapeutic characteristics to treat intestinal and rheumatic disorders (Vaughan & Judd 2003). It was recorded for the first time in the Württemberg Pharmacopoeia 1741, as a pain-relieving, diuretic, carminative agent, as well as for the treatment of gastrointestinal symptoms (EMA 2012; Lukacs 1990). In recent years, it has also been applied to alleviate symptoms of nausea, anorexia, stress and pain during menstrual bleeding (Bradley 1992).

Today, Roman chamomile is available in many different forms for both internal and external use. It is most frequently ingested orally as a cold or hot infusion (tonic or herbal tea) to provide calmness, as well as mildly treat insomnia and colds. Various herbal preparations of Roman chamomile exist on the market for the symptomatic treatment of stomach pain and digestive problems (EMA 2012; Edwards et al. 2015). In addition, it is very commonly used in complementary and alternative medicine, and especially in aromatherapy (Cho et al. 2013; Wilkinson et al. 1999). Its activity towards sore throats and oral diseases has also been reported. Therefore, it is often applied as a mouth rinse. Externally, it is added to different topical formulations in order to treat skin conditions, including cracks and eczemas (Bisset 1994).

The applications of Roman chamomile in the cosmetic and food industry are numerous. Due to its colour-lightening and moisturizing effect, it is main ingredient of many shampoos, conditioners and shower gels (Bruneton 1999). It is also used in perfumes providing a characteristic delicate fragrance. In the food industry, it provides flavouring properties in a variety of foods and drinks. Other uses include its application as s ground cover in gardening due to its short height and pleasant aroma.

PHYTOCHEMISTRY

Roman chamomile contains a wide variety of chemical compounds responsible for its beneficial effects. The main classes of compounds found in the plant are flavonoids, sesquiterpenes, esters, coumarins, catechins, phenolic acids, steroids and polysaccharides (Fauconnier et al. 1996; Guimarães et al. 2013; Lebanna 2005). It is characterized by a significant amount of valuable proteins and carbohydrates. Its pharmacological effects can be mainly attributed to flavonoids, such as apigenin, luteonin and quercetin, as well as the ingredients of the essential oil, including a-bisabolol, oxides and azulenes (Al-Snafi 2016). Chamazulene and α-bisabolol, the most important terpenoids of the oil, seem to be responsible for its anti-inflammatory effect. Chamazulene is not naturally found in Roman chamomile, but generated during its distillation, giving a blue colour to the produced oil (Murti et al. 2012). Other important constituents of the essential oil are considered to be apigenin, angelic and tiglic acid esters and anthemic acid. Roman chamomile has the highest amount of esters compared to others, with angelic and tiglic acid esters composing 85% of the oil (Craker & Simon 1986).

PHARMACOLOGY AND ANTIBIOTIC ACTIVITY

Anti-inflammatory effect
Roman chamomile has been investigated widely in animal studies for its anti-inflammatory properties. It is generally considered to be effective towards the alleviation and treatment of the injuries and gastrointestinal inflammations. The mechanism of action is still unidentified (Al-Snafi 2016).

The polysaccharides isolated from the aqueous extract of its flowers were tested for anti-inflammatory activity in rats. The oedema, which was generated by the injection of viscarine into their paw, was substantially reduced when treated with the polysaccharides (Lukacs 1990). In another study, the volatile oil was examined towards carrageenan-induced paw oedemas in rats. The experiment led to the effective inhibition of the swelling after 2-3 hours. These results support the ones of the first study (Rossi et al. 1988).

Antimicrobial effect
Antimicrobial agents are compounds that eliminate or inhibit the development of microorganisms (Britannica Academic 2009). Roman chamomile has been examined widely as a potential antimicrobial agent.

The extract and the volatile oil of the flowers were tested, using disk diffusion, against Porphyromonas gingivalis, a microorganism responsible for some periodontal diseases. The results showed the efficient inhibition of the microorganism by both the extract and the oil, and thus revealed their ability to treat or prevent periodontitis (Saderi et al. 2005). Another clinical trial illustrated the capability of this plant to reduce the duration of mouth ulcers (Aphtous stomatitis) (Jafari et al. 2003).

The essential oil of Roman chamomile from the Provence was examined towards a variety of Gram-positive bacteria (Staphylococcus aureus, Enterococcus faecalis) and Gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa, Proteus vulgaris, Klebsiella pneumonia, Salmonella sp.). It was also tested against the fungus Candida albicans. The results led to the effective inhibition of all the investigated bacteria (Al-Snafi 2016; Bail et al. 2009). In another study, the essential oil reduced the growth of other types of Gram-positive bacteria (Bacillus subtilis, B. anthracis, Micrococcus glutamicus, B. sacchrolyticus, B. thuringiensis, Sarcina lutea, B. stearothermophilus, Lactobacillus plantarum, Staphylococcus aureus, Staphylococcus sp., L. casei), while it was inactive towards some Gram-negative bacteria (Escherichia coli and Salmonella group B). The growth of dermatophytes, a group of fungi associated with skin diseases, was also inhibited (Hansel et al. 1993).

Effect on the nervous system
The herbal tea of this plant has been consumed for many years, as a sleep aid. The relaxing effect of its essential oil in the nervous system was investigated in rats. It was found that one of its constituents, apigenin, has the ability to bind to benzodiazepine receptors, creating the feeling of tranquility and mobility difficulty in rats (Al-Snafi 2016; Rossi et al. 1988).

Hypotensive effect
Hypertension is a common condition characterized by augmented levels of blood pressure, which is closely associated with serious heart diseases including heart failure, atherosclerosis and kidney disease. A recent preclinical study illustrated the possible blood-pressure lowering activity of Roman chamomile (Britannica Academic 2007).
Its aqueous extract was tested in rats. Spontaneously hypertensive rats were treated with the extract. The results highlighted the significant decline of their blood pressure after 24h (single dose oral administration) or after 8 days (daily oral administration) of the treatment. This study revealed a new, promising property of the plant, however clinical studies should be conducted to verify this activity in humans (Zeggwagh et al. 2009).

Hypoglycemic effect
Hyperglycemia is a condition characterized by increased glucose in the blood plasma. It is the cause of diabetes mellitus, a disorder related to either the inefficient production of insulin or the deficient response of the cells to the existing insulin, the hormone responsible for the metabolism of glucose (Britannica Academic 2007). Roman chamomile was examined as a potential hypoglycemic agent in vivo.

Chamaemeloside, a glucoside separated from Roman chamomile flowers, was tested in mice 4 hours after the administration of a specific dosage (100 mg/kg, orally administered). Although, the results were positive, the quantity of this compound in the plant is extremely low, and, therefore, the recommended dose cannot have the same effect in humans (Konig et al. 1998). The aqueous extract of the flowers was also investigated in rats with streptozotocin-induced diabetes. The level of their blood glucose was calculated after both the single and daily oral dose for 15 days. The quantity of glucose in the blood of both healthy and diabetic rats was remarkably decreased in both types of administration, within 6 hours and after 15 days respectively (Eddouks et al. 2005). Thus, this plant can affect glucose levels in animal models, whilst it should be further studied clinically to understand whether it is capable of preventing or treating diabetes in humans.

CLINICAL EVIDENCE

Although Roman chamomile possesses an extensive tradition in alleviating the symptoms described above, the existing clinical evidence is limited. The majority of human studies focus on German chamomile, a different species of the same family (Edwards et al. 2015). However, there are some clinical trials that partially prove some of its therapeutic uses.

A small trial involving 20 volunteers took place, in order to observe the healing and protective effects of this herb towards UV-induced erythema (sunburn). The irritated skin areas were treated with oil/water emulsions of its alcoholic extract and compared to placebo emulsions. Indeed, the use of Roman chamomile’s emulsions resulted in a faster healing of the irritations (Schrader, Eckey & Rohr 1997).

This species was also tested towards treating asthma, a common inflammatory disorder of the lungs (Rogers 2011). In an open trial in 54 patients suffering from respiratory asthma, Roman chamomile increased the total expiratory volume, as well as improved their breathing ability and asthma symptoms (Al-Jawad et al. 2012).

As mentioned before Roman chamomile is often applied in aromatherapy. A randomized uncontrolled study in 103 cancer patients assessed the effects of a massage with its volatile oil. The study showed that the massage with Roman chamomile’s oil was more effective to reduce the anxiety symptoms, than the simple massage without the oil. However, these random results cannot efficiently prove its activity towards anxiety (Wilkinson et al. 1999).

SAFETY

Roman chamomile is generally safe, while its oil and extract are considered to be non-toxic by the FDA (Opdyke 1974). Only some rare cases of allergic symptoms were reported including eczemas, head rush, fast heart rate and nausea, but they were not serious (McGeorge & Steele 1991; Giordano-Labadie, Schwarze & Bazex 2000; Maddocks-Jennings 2004). However, care should be taken especially when people are allergic to it or to other members of the Asteraceae (Daisy’s family), as it is composed of many active ingredients that could possibly interact with other medicines or cause undesirable effects (Lebanna 2005).

CONCLUSION

Roman chamomile has a long history of use in many regions of the world. Its applications in the food and cosmetic industry are plentiful. Its herbal tea, one of the most famous products in the market, is widely consumed before bedtime to provide calmness and de-stress after a difficult day. Its chemical constituents are linked to several pharmacological effects of Roman chamomile. However, as with other herbal medicines, one must keep the variability of the plant and the diverse ways of production in mind. This will result in chemically diverse products. Medicinally it is marketed as a traditional herbal product for the relief of digestive disorders, as the available clinical trials are lacking. Therefore, its use is based on empirical evidence and tradition only. Due to the excellent safety profile, it presents a safe choice for people to try it, when they want to alleviate any of minor ailments described above. With recent studies emphasizing several new, potential properties of Roman chamomile, there is an increased need for further exploration of its medicinal potentials in humans.
Disclaimer: In this essay we do not advise or recommend herbs for medicinal or health use. This information is intended for educational purposes only and should not be considered as a recommendation or an endorsement of any particular medical or health treatment. The use of any such product should be based on the appropriate advice of a health care professional or based on the information available in the patient information leaflets (i.e. THR products).

© Loukiani Chatzinasiou 2017. All rights reserved

Loukiani Chatzinasiou is an MSc student in Medicinal Natural Products and Phytochemistry at the UCL School of Pharmacy.

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