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Can Birch Bark Extract Help with Herpes?

Updated: Feb 18, 2021

Here is the unsettling truth: at any given moment, either you or somebody around you is most likely infected with herpes – a virus that comes in nine different variations and affects 90 percent of the population at once (1). The two most widespread kinds are Herpes Simplex Virus 1 (HSV-1) and Herpes Simplex Virus 2 (HSV-2), which are characterized by sores that appear around the mouth and/or genitals (HSV-1), or just around the genitals (HSV-2).

The reason why these viruses are so prevalent in the world is because of their unique ability to switch between two different states: active and dormant (2).


When the virus is active, it infects new cells and reproduces, causing an immune reaction that may show up in the form of sores around the body or experiencing flu like symptoms. It may become active when the infected person’s immune system is compromised – usually by another sickness or during times of stress.


When it’s dormant, it acts as though it is “asleep,” remaining inside the body but not damaging new cells or causing any symptoms. This distinctive characteristic allows the virus to stay in the body undetected, causing it to be incurable and people to unknowingly pass it onto each other.


Because oral and genital herpes can never escape the body, some very serious complications can occur as a result of being infected:



If you have HSV-1 or HSV-2


You may develop:

  • Meningitis (inflammation of the tissue that surrounds the brain and spinal cord)

  • Encephalitis (inflammation of the brain) (3)

  • Blindness (4)


You are at a higher risk of developing:

  • Alzheimer’s (5)

  • Atherosclerosis (harmful buildup of fatty molecules in the blood vessels that can lead to heart disease/attack and stroke)

  • Cervical Cancer (7)


Sometimes, herpes can be transmitted from the mother to the fetus which can cause loss of pregnancy or developmental issues for the baby at birth, such as trouble breathing, seizures, microcephaly (abnormally small head), or malfunction of any of the vital organs (8).


Current Herpes Treatments:

In order to prevent herpes outbreaks (sore formation) and control the active infection, antiviral drugs such as acyclovir and its analogues (valacyclovir and famciclovir) are generally prescribed. For other types of herpes infections (not HSV-1 or 2), like chickenpox and shingles, vaccination is available (9).


But there is a problem with these medications. Neither option kills the virus nor flushes it out of the body. Moreover, herpes virus strains have emerged in recent years that are resistant to acyclovir and its analogues, and the pharmaceutical industry did not invest into development of new anti-viral drugs until the current Covid-19 pandemic (10). As a result, billions of people are infected, yet none are cured, living day to day with increased risk of health problems (11).


Natural compounds that come from plants have recently emerged as potential supplementary treatments for herpes. Many plant-derived compounds have shown promise both in the laboratory and in studies carried out in humans.


Betulin:

One of these natural compounds is betulin (and its close relative betulinic acid (BA)). It is one of the major components of the bark of the birch tree, and in fact, is responsible for the tree’s characteristic white color (12). For centuries, people around the world have been using the bark, sap and leaves of the birch tree in traditional medicine for their antimicrobial, anti-inflammatory, and wound-healing properties (13).


Betulin’s known medicinal effects caught the attention of the scientific community, leading to extensive research and significant discoveries around its antiviral activity. BA, a derivative of betulin also present in birch bark, has even been recently explored as a potential therapy against SARS CoV2 (COVID-19) (14).


In 2011, scientists uncovered the molecular target of betulin: a protein called sterol regulatory element-binding protein (SREBP) (15). SREBP is responsible for the production of lipid molecules (fats), which is something that enveloped viruses (among them are influenza A and B, Hepatitis B, measles, and herpes) need to build their coat before they exit the host cell and go on to infect other cells. Without this fatty shell, the enveloped virus cannot propagate or continue the infection.

Betulin and Herpes:

As expected, due to its historically widespread use and pharmaceutical potential, betulin’s antiviral properties have been tested numerous times against herpes.


Work from a group at University of Heidelberg, Germany, presented strong evidence that betulin and betulinic acid inhibit the early phase of viral infection and have antiviral activity against herpes strains that are resistant and sensitive to acyclovir (16). A collaborative study led by Canadian and American scientists showed that betulin inhibits both HSV-1 and HSV-2 types and boosts the antiviral activity of acyclovir when used in combination ( 17).


Several multi-center human studies were conducted to assess the efficacy of betulin oleogel (a mix of betulin and oily inactive ingredient) in treating superficial wounds, burns and actinic keratosis (a skin condition, usually in the elderly, consisting of rough scaly skin patches that can become cancerous). The results of these clinical studies were reviewed by the European Medical Agency (a regulatory agency in Europe, like the FDA in the U.S) leading to approval of betulin oleogel in 2016 as a drug for treatment of wounds and burns (18 , 19 , 20, 21).


Betulin’s wound healing properties proved to be antiherpetic, as described in a clinical study of betulin against a severe herpes zoster (shingles) infection. One of the patients whose affected tissues were dying and had failed all prior treatments only showed significant improvement of their condition after betulin was administered (22).


Conclusion:

Multiple human and animal studies have evidenced betulin’s versatile antiviral properties, including in the context of use as a herpes remedy. The scope of betulin’s therapeutic potential for herpes ranges all the way from ameliorating symptoms such as cold sores to actually stopping the infection at an early phase (23), all of which has finally been revealed by quality scientific and medical research. Its wound healing properties have even earned it the status of prescribed medication by one of the most respected medical regulatory bodies in the world. These examples present a promising future for betulin as a natural aid in fighting against one of the most widespread viruses in the world.


References:

  1. Wald A, Corey L. Persistence in the population: epidemiology, transmission. In: Arvin A, Campadelli-Fiume G, Mocarski E, et al., editors. Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis. Cambridge: Cambridge University Press; 2007. Chapter 36. Available from: https://www.ncbi.nlm.nih.gov/books/NBK47447/

  2. Whitley, R. J., & Roizman, B. (2001). Herpes simplex virus infections. Lancet (London, England), 357(9267), 1513–1518. https://doi.org/10.1016/S0140-6736(00)04638-9

  3. Frantzidou F, Kamaria F, Dumaidi K, Skoura L, Antoniadis A, Papa A. Aseptic meningitis and encephalitis because of herpesviruses and enteroviruses in an immunocompetent adult population. Eur J Neurol. 2008 Sep;15(9):995-7. https://doi.org/10.1111/j.1468-1331.2008.02233.x

  4. Kaye S, Choudhary A. Herpes simplex keratitis. Prog Retin Eye Res. 2006 Jul;25(4):355-80. https://doi.org/10.1016/j.preteyeres.2006.05.001

  5. Itzhaki RF. Corroboration of a Major Role for Herpes Simplex Virus Type 1 in Alzheimer's Disease. Front Aging Neurosci. 2018 Oct 19;10:324. https://doi.org/10.3389/fnagi.2018.00324

  6. Jacob HS, Visser M, Key NS, Goodman JL, Moldow CF, Vercellotti GM. Herpes virus infection of endothelium: new insights into atherosclerosis. Trans Am Clin Climatol Assoc. 1992;103:95-104. PMID: 1329303; PMCID: PMC2376689. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc2376689/

  7. Matti Lehtinen, Pentti Koskela, Egil Jellum, Aini Bloigu, Tarja Anttila, Göran Hallmans, Tiina Luukkaala, Steinar Thoresen, Linda Youngman, Joakim Dillner, Matti Hakama, Herpes Simplex Virus and Risk of Cervical Cancer: A Longitudinal, Nested Case-Control Study in the Nordic Countries, American Journal of Epidemiology, Volume 156, Issue 8, 15 October 2002, Pages 687–692, https://doi.org/10.1093/aje/kwf098

  8. David W. Kimberlin. Neonatal Herpes Infection. Clinical Microbiology Reviews. 2004, 17(1) 1-13; https://doi.org/10.1128/CMR.17.1.1-13.2004

  9. Rebecca C. Brady, David I. Bernstein. Treatment of herpes simplex virus infections. Antiviral Research. 61(2); 2004 73-81.https://doi.org/10.1016/j.antiviral.2003.09.006

  10. Treml J, Gazdová M, Šmejkal K, Šudomová M, Kubatka P, Hassan STS. Natural Products-Derived Chemicals: Breaking Barriers to Novel Anti-HSV Drug Development. Viruses. 2020, 12(2):154 https://doi.org/10.3390/v12020154

  11. Herpes simplex virus. (n.d.). Retrieved November 09, 2020, from https://www.who.int/en/news-room/fact-sheets/detail/herpes-simplex-virus

  12. Green, Brian & Bentley, Michael & Chung, Bong & Lynch, Nicholas & Jensen, Bruce. (2007). Isolation of Betulin and Rearrangement to Allobetulin. A Biomimetic Natural Product Synthesis. Journal of Chemical Education - J CHEM EDUC. 84. https://doi.org/10.1021/ed084p1985

  13. Rastogi S, Pandey MM, Kumar Singh Rawat A. Medicinal plants of the genus Betula--traditional uses and a phytochemical-pharmacological review. J Ethnopharmacol. 2015 Jan 15;159:62-83. https://doi.org/10.1016/j.jep.2014.11.010 Epub 2014 Nov 18. PMID: 25449458; PMCID: PMC7126499.

  14. Dehelean CA, Lazureanu V, Coricovac D, Mioc M, Oancea R, Marcovici I, Pinzaru I, Soica C, Tsatsakis AM, Cretu O. SARS-CoV-2: Repurposed Drugs and Novel Therapeutic Approaches-Insights into Chemical Structure-Biological Activity and Toxicological Screening. J Clin Med. 2020 Jul 2;9(7):2084. https://doi.org/10.3390/jcm9072084 PMID: 32630746; PMCID: PMC7409030.

  15. Tang JJ, Li JG, Qi W, Qiu WW, Li PS, Li BL, Song BL. Inhibition of SREBP by a small molecule, betulin, improves hyperlipidemia and insulin resistance and reduces atherosclerotic plaques. Cell Metab. 2011 Jan 5;13(1):44-56. https://doi.org/10.1016/j.cmet.2010.12.004

  16. Yuan, S., Chu, H., Chan, J. F., Ye, Z. W., Wen, L., Yan, B., Lai, P. M., Tee, K. M., Huang, J., Chen, D., Li, C., Zhao, X., Yang, D., Chiu, M. C., Yip, C., Poon, V. K., Chan, C. C., Sze, K. H., Zhou, J., Chan, I. H., … Yuen, K. Y. (2019). SREBP-dependent lipidomic reprogramming as a broad-spectrum antiviral target. Nature communications, 10(1), 120. https://doi.org/10.1038/s41467-018-08015-x

  17. Scheffler A - The Wound Healing Properties of Betulin - from Birch Bark from Bench to Bedside.Planta Med. 2019, 85(7):524-527.

  18. Gong Y, Raj KM, Luscombe CA, Gadawski I, Tam T, Chu J, Gibson D, Carlson R, Sacks SL. The synergistic effects of betulin with acyclovir against herpes simplex viruses. Antiviral Res. 2004 Nov;64(2):127-30. https://doi.org/10.1016/j.antiviral.2004.05.006

  19. Huyke C, Reuter J, Rödig M, Kersten A, Laszczyk M, Scheffler A, Nashan D, Schempp C. Treatment of actinic keratoses with a novel betulin-based oleogel. A prospective, randomized, comparative pilot study. J Dtsch Dermatol Ges. 2009 Feb;7(2):128-33. English, German. https://doi.org/10.1111/j.1610-0387.2008.06865.x Epub 2008 Sep 19. PMID: 18808378.

  20. Agnes Schwieger-Briel, Dimitra Kiritsi, Christoph Schempp, Cristina Has, Hauke Schumann, "Betulin-Based Oleogel to Improve Wound Healing in Dystrophic Epidermolysis Bullosa: A Prospective Controlled Proof-of-Concept Study", Dermatology Research and Practice, vol. 2017, Article ID 5068969, 10 pages, 2017. https://doi.org/10.1155/2017/5068969

  21. Lipový B, Fiamoli M, Mager R, Jelínková Z, Jarkovský J, Chaloupková Z, Holoubek J, Suchánek I, Brychta P. OLEOGEL-S10 TO ACCELERATE HEALING OF DONOR SITES: MONOCENTRIC RESULTS OF PHASE III CLINICAL TRIAL. Acta Chir Plast. Spring 2018;59(3-4) 129-134. https://pubmed.ncbi.nlm.nih.gov/29651853/

  22. (2020, October 28). Episalvan. Retrieved November 10, 2020, from https://www.ema.europa.eu/en/medicines/human/EPAR/episalvan

  23. Weckesser S, Laszczyk MN, Müller ML, Schempp CM, Schumann H. Topical treatment of necrotising herpes zoster with betulin from birch bark. Forsch Komplementmed. 2010 Oct;17(5):271-3. https://doi.org/10.1159/000320592 Epub 2010 Sep 9. PMID: 20980767.

  24. Heidary Navid M, Laszczyk-Lauer MN, Reichling J, Schnitzler P. Pentacyclic triterpenes in birch bark extract inhibit early step of herpes simplex virus type 1 replication. Phytomedicine. 2014 Sep 25;21(11):1273-80. https://doi.org/10.1016/j.phymed.2014.06.007 Epub 2014 Jul 25. PMID: 25172789.



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