Abstract
The bark of Salix species contains several prodrugs of salicylate, mainly salicin. The aim of this
study was to investigate if during pain treatment with Salicis cortex extract platelet
aggregation was affected. A total of 51 patients were enrolled in the study. Thirty-five
patients suffering from acute exacerbations of chronic low back pain received randomly
and double-blind either Salicis cortex extract with 240 mg salicin/day (n = 19) or
placebo (n = 16). Further sixteen patients with stable chronic ischemic heart disease
were given 100 mg acetylsalicylate per day. Platelet aggregation was studied using
an aggregometer. As aggregating agents, arachidonic acid (500 μg/ml), adenosine di-phosphate
(2 × 10-5 M) and collagen (0.18 μg/ml) were used. The mean maximal arachidonic acid induced
platelet aggregation was 61 %, 78 % and 13 % in the Salicis cortex extract, placebo
and acetylsalicylate groups. Acetylsalicylate had a significant inhibitory effect
on platelet aggregation compared to Salicis cortex extract (p = 0.001) and placebo
(p = 0.001). There was also a significant difference between the placebo and the willow
bark-treated groups in the maximal platelet aggregation induced by arachidonic acid
(p = 0.04) and ADP (p = 0.01). No statistical difference was found between the groups
when collagen was applied to the human platelets. Daily consumption of Salicis cortex
extract with 240 mg salicin per day affects platelet aggregation to a far lesser extent
than acetylsalicylate. Further investigation needs to clarify if this finding is of
clinical relevance in patients with impaired thrombocyte function.
Key words
Salicis cortex extract -
Salix daphnoides
-
Salix purpurea
- Salicaceae - placebo - acetylsalicylate - thrombocycte aggregation - clinical study
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N. Krivoy MD
Clinical Pharmacology Unit
Rambam Medical Center
Haifa
Israel
eMail: N_Krivoy@rambam.health.gov.il
Fax: 972-4-8543252
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