Green Tea Catechins: Biologic Properties, Proposed Mechanisms of Action, and Clinical Implications

November 2012 | Volume 11 | Issue 11 | Original Article | e55 | Copyright © 2012

Abstract

Botanical products, including and especially green tea leaves, have a wide range of both reputed and demonstrated health benefits and have been used medicinally for thousands of years. This paper focuses on green tea catechins, principally reviewing their known biologic properties and potential mechanisms of action (MOAs). The primary objective is to discuss the proposed antiviral, antiproliferative, and immunostimulatory activity of catechins based on strong evidence from in vitro and in vivo studies conducted to date, including two preclinical in vitro studies with sinecatechins, a proprietary mixture of catechins. This review also discusses the clinical implications of catechins for the treatment of external genital and perianal warts (EGWs) and other conditions caused by human papillomavirus (HPV). While the MOA of catechins in the treatment of EGWs and other HPV-related conditions may be related to or associated with postulated or proven antiviral and immunostimulatory activity, the precise clinical significance of the various in vitro findings remains largely unknown.

J Drugs Dermatol. 2012;11(11)e55-e60.

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BACKGROUND

Botanicals have dominated pharmacopoeias across the globe for thousands of years and continue to serve as a valuable source of therapeutic compounds because of their vast biosynthetic capacity.1 They are not only an important source of new pharmaceuticals, but also have a long history of safe human use. Botanicals were among the first pharmaceuticals to be used in the United States.2 In the 1800s, for example, herbalists, midwives, and physicians of all types were explicitly trained in the use of plants as medicinal agents. However, the use of botanicals has steadily declined since the early 1900s (Figure 1). This decline was largely triggered by the Flexner Report of 1910, commissioned by the American Medical Association and the Carnegie Foundation, which suggested that only trained physicians should be permitted to prescribe medications. Moreover, Flexner allegedly doubted the validity of all forms of therapy other than those based on extensive scientific research, including direct examination of a treatment's effect on human physiology and biochemistry; he deemed training in any other approach to medicine as tantamount to quackery. Thus, many training institutions that stressed the use of what would now be called complementary or alternative medical disciplines were closed down. Concurrent with the loss of training institutions as champions of such agents as botanical derivatives, an increasingly more challenging regulatory environment followed the establishment of the precursor to the US Food and Drug Administration (FDA) in 1906, as well as numerous legal restrictions on the use of nonpatent medications (eg, the Food, Drug, and Cosmetic Act of 1938). In this milieu, the myriad of unknown information related to botanical products conceivably translated to the low prescription botanical drug availability in the United States compared with other nations.3-5 Despite published guidelines by the FDA and support from several agencies, including the World Health Organization, the Office of Dietary Supplements, and the National Center for Complementary and Alternative Medicine, development of botanical drugs continues to be a challenging process.6-9 In fact, only about 25% of prescription drugs used today are derived directly from plants.1

Green Tea Catechins

Green tea is recognized worldwide for its wide array of health benefits, most of which are attributed to the polyphenols or flavonoids.10 Catechins are the major flavonoids in green tea leaves, comprising approximately 30% to 40% of the dry leaf weight.10-12 During the fermentation process, green tea leaves are quickly heated after harvesting to inactivate the main oxidizing enzyme, polyphenol oxidase. This procedure prevents oxidation and preserves most of the constituent catechins.13,14 Epigallocatechin gallate (EGCG), epigallocatechin (EGC), epicatechin gallate (ECG), and epicatechin (EC) are the four major catechins found in green tea (Table 1).14Among these, EGCG is present in the highest concentration and considered the principal therapeutic agent of green tea leaves. Even though the beneficial effects of catechins are most frequently attributed to EGCG, the various catechins may work in synergy to efficiently modulate complex biologic pathways. In cultured human cervical carcinoma cell lines (HeLa cells), the amount of EGCG required to prevent cell growth and inhibit a cancer-associated, cell surface-located nicotinamide adenine dinucleotide phosphate oxidase was reduced 10 times by combination with EC, EGC, or ECG, thus supporting the synergistic activity between several catechins.15

Catechins are well-known for their antioxidant properties and primarily characterized by their ability to scavenge reactive oxygen species.10,13 They may also function indirectly as antioxidants through their effects on several transcription factors and

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