The plant
Tanacetum parthenium, also known as Chrysanthemum parthenium, is the Latin name for feverfew, a member of the Asteraceae family. The English call it " feverfew ", this name is not due to a febrifuge effect, but rather to a deformation of the word " featherfoil " which alludes to the shape of the leaf which recalls that of a feather (Houdret et al . 2009).
Its flowering period is between July and September, where pollination ensures its reproduction. It has a strong camphor odor and traditionally it is taken with honey to mask its bitter taste (Houdret et al. 2009).
There are three varieties of medicinal chamomile , but only Tanacetum parthenium has properties in the treatment of migraine . Chamomile chamomile (Matricaria recutita) and Roman chamomile (Chamaemeium nobile) differ in the shape of their leaves and the absence of parthenolide in their actives (Luder et al. 2019). Tanacetum parthenium is native to Asia Minor and the Balkans, then was exported to North Africa.
Later, it was introduced in the British Isles, then in continental Europe where, first cultivated for medicinal and ornamental purposes, it gradually became naturalized. It was then transported to North America by European settlers.
History of Feverfew
At the beginning of our era, the texts of Dioscorides described feverfew as a plant capable of treating “ all hot inflammations, of the body and of the head ” (Dioscorides of Anazarbe 1555). In the 1525 book " Banckes's Herbal " it is described to fight heartburn and/or insect bites (Banckes's 1525). The English botanist John Gérard analyzed several varieties of chamomile, which he mentioned as useful in the treatment of colic, kidney stones and vertigo .
Subsequently, the herbalist Culpeper wrote in 1653 that Tanacetum parthenium was the best remedy for female gynecological disorders, and today it is still used to fight amenorrhea (Houdret et al. 2009).
It was only at the beginning of the 1700s that Professor John Hill put forward the plant for the treatment of headaches : " in the worst headaches this herb excels in relief more than any other known substance " (Van Niekerk and 2015). Its use then fell into disuse.
Scientific interest in Tanacetum parthenium resurfaced in the late 1970s, when the wife of a senior English National Coal Commission official chewed leaves of the plant to soothe her migraines . The story goes that it was the miners who regularly used Tanacetum parthenium to reduce their headaches. As the lady's migraines almost completely ceased, her physician, Dr Stewart Johnson of the London Migraine Clinic , began a series of clinical trials that helped restore the herb's reputation (Houdret et al. 2009).
According to traditional Indian and Chinese medicine, feverfew is often used in combination with other ingredients with anti-inflammatory properties . In India, the plant boswellia serata and turmeric are very often associated with Tanacetum parthenium, as well as the bark of Salix Alba.
Composition of Tanacetum parthenium:
The active ingredients responsible for the virtues of feverfew are numerous. Among the constituents which could contribute to the pharmacological action, the sesquiterpene lactones appear in first position, mainly represented by parthenolide .
Then come essential oils and flavonoids which, synergistically, can participate in the activity of Tanacetum parthenium (Allais et al. 2008). Essential oils represent 0.5 to 0.9% of the plant; they are responsible for its strong smell and contain a majority of camphors.
Parthenolide is considered the main active ingredient in the plant . It was first isolated in 1965 (Atta-ur-Rahman 2018). It is absorbed by the intestinal mucosa via a passive diffusion system. While sesquiterpene lactones have mainly been studied to explain the anti-inflammatory activity of Tanacetum parthenium , they are not solely responsible for its effects.
Researchers interested in the flavonoids of the plant have shown an inhibitory activity of cyclo-oxygenases (role in inflammation) (Williams et al. 1999; Long et al. 2003).
Chrysanthemum parthenium in the treatment of migraine
Feverfew has long been used to treatmigraines , but clinical trials report mixed results.
In 2004, a review of the literature based on five clinical trials for a total of 343 patients failed to conclude that the plant was effective in preventing seizures (Pittler et al. 2004).
Another study reported a reduction in the frequency of attacks. However, no difference was observed in the duration and intensity of the attack.
More recently in 2020, a research project showed significant results in preventing migraines. This Inserm laboratory with a company from Auvergne have developed two preventive treatments to relieve migraines . The first is in capsule form ( Herba MIG ) and the second in nasal spray ( MIG SPRAY )
The variable results of studies evaluating the effectiveness of Tanacetum parthenium in the prevention of migraine are essentially due to a methodological problem . Either the duration of the study is too short, because the benefits of the plant are only felt after several months ; or the inclusion criteria are not correctly defined. The extract of the plants used also intervenes in the variability of the results obtained.
Few studies quantify the quantity of active principles and particularly of parthenolide contained in their extract . However, depending on the extract (whole plant, leaves or flowers), the percentage of parthenolide varies greatly (0 to 5%) (Heptinstall et al. 1992). The efficacy observed in the study may be due to this particularity of extraction, which gives the ingredient a higher level of active ingredient than those used in other clinical trials (Diener et al. 2005).
Besides its anti-inflammatory effects, several other mechanisms could explain the plant's effectiveness in preventing migraines . The amount of parthenolide present in the plant varies from 0 to 0.5%. This variation is mainly explained by the geographical origin of the plant, its maturity at the time of harvest and the extraction process used (Majdi et al. 2015; Majdi et al. 2011).
Some patients are therefore likely to stop their treatment due to lack of efficacy, whereas a high quality plant, rich in active ingredients, could have been a great help!
