The 10th International Conference on Herbal Medicine Hosted by the Naturopaths and Herbalists Association of Australia (NHAA); 17-19 March 2017, Sofitel Brisbane, Queensland, Australia ACCEPTED ABSTRACTS Vitamin D – The sunshine vitamin: implications and use in chronic disease Ms Rebecca Walton1,2 1Goulds Natural Medicine, Hobart, Australia, 2University of Tasmania, Sandy Bay, Australia Biography: Rebecca is a naturopath, nutritionist and herbalist at Gould's Natural Medicine in Hobart, Tasmania. She also has a position at the University of Tasmania, assisting with the teaching of evidence-based complementary medicine. She holds a Bachelor of Naturopathy and a Bachelor of Clinical Sciences with a double major in Human Nutrition and Complementary Medicine from Southern Cross University. She completed the Gould's internship program in 2014, and now works in private clinical practice and in the busy over-the-counter apothecary. Introduction: Vitamin D is attracting research across multiple fields and applications. Clinically, vitamin D has a role in the treatment and prevention of chronic diseases, including cancer, diabetes, arthritis, fertility challenges and miscarriage, cardiovascular disease, dementia and depression. Focus of Discussion: According to the Australian Bureau of Statistics, 1 in 4 Australians are deficient in Vitamin D; however, what constitutes true deficiency may not be so clear cut. Advisory bodies in Australia and internationally differ in their recommendations around vitamin D, and a clear understanding of these differences is necessary to fully understand vitamin D safety and prescribing. Naturopaths and herbalists hold a unique position in health care – we are able to look at preventative and total physiological health and apply this holistic understanding to vitamin D absorption, distribution and deficiency. Looking at the evidence base for vitamin D sufficiency, we can explore the blood level required to prevent disease, the role of individualising dosage prescriptions, the role it plays in preventative health and its clinical application in the treatment of multiple chronic diseases. Consideration for where and how we absorb vitamin D according to seasonal, regional and environmental variations, as well as who is at risk for true deficiency will be explored. Implications: An understanding of the far-reaching implications for the use of vitamin D and clarity around optimal blood levels, including how this is obtained, are both crucial for effective evidence-based prescribing. Does herbal medicine assist breastfeeding mothers with an insufficient milk supply? Ms Diana Bowman1,2 1University of Technology Sydney, Australia, 2Endeavour College of Natural Health, Brisbane, Australia Biography: Diana Bowman is a naturopath, medical herbalist, lecturer, mum and grandma. She loves family and is passionate about education and plants, growing them and using them medicinally. Originally a teacher in New South Wales, she moved to Queensland 25 years ago and started a new career in naturopathy. She opened her first multi-modality practice centred on family wellbeing in 1996, where her practice focused primarily on children’s health, as it still does today. Returning to the classroom in 2000 with Endeavour College of Natural Health (formally Australian College of Natural Medicine), she teaches botany and herbal medicine as well as supervising student clinics. In 2016 she combined her passions into a series of speaking engagements entitled ‘Healthy, Happy Kids’ and was accepted as a PhD candidate with the University of Technology Sydney. Her research project is investigating the use herbal medicine to promote breastfeeding. Diana is affiliated with Endeavour College of Natural Health, University of Technology Sydney and practices in Herbs on the Hill in Brisbane. Introduction: Inadequate breast milk supply has been identified as a significant issue, often resulting in the cessation of breastfeeding, with few effective therapies known to benefit women with the problem. Previous studies reveal women who use herbal medicines during their pregnancy are more likely to initiate breast feeding and continue for more than 6 months. This literature review examined whether the use of herbal galactagogues have a role in improving milk production in puerperal women experiencing insufficient milk supply (IMS). Methods: A systematic literature review is being conducted to provide accurate and broadly representative estimates of the clinical efficacy of herbal galactagogues in IMS. Electronic searches were conducted in Medline, Embase, Cochrane Library, AMED, MANTIS, PsycINFO, Maternity and Infant Care and unpublished trial data on clinical trial registers (2000 to 2016). Results: The database search yielded over 2000 articles; however, very few of these were specific to the literature review’s criteria of improving milk supply with herbal medicine. Most notably, Trigonella foenum-graecum (fenugreek), Foeniculum vulgare (fennel), Illicium verum (star anise) and Zingiber officinale (Ginger) have received recent research attention to complement their long, traditional history of use as herbal galactagogues. Discussion/Conclusion: Current research examining herbal medicine for women with IMS is sparse and needs to be understood in relation to its clinical usefulness. Future research needs to focus on repeatable results, which can assure the practitioner of not only a herb’s safety, but its efficacy in delivering desired treatment results. An evidence-based guide for the development of a traditional liquid reishi extract Ms Kristie Harper1, Mr George Stefanovski1 1The Herbal Extract Company of Australia, Minto, Australia Biography: Kristie Harper is an author, researcher and product developer. She is a specialist and innovator of liquid herbal extraction methods, with a background in medical science. George Stefanovski is a research supervisor, scientist and technical manager, with over 10 years’ experience in herbal medicine manufacturing, having a background in chemistry and nanotechnology. Introduction: Development of an experimental method for extracting reishi mushroom extract will be detailed to provide the herbal industry with an evidence-based guide for creating a traditional herbal extract. The overall goal was to use an evidence-based strategy for establishment of a manufacturing method that provides the highest extraction efficiency whilst maintaining a “traditional broad-spectrum, non-standardisation” philosophy, therefore producing high quality, low processed traditional herbal extracts. Methods: Herbal ratio determination: 1:3, 1:4 vs 1:5. Temperature determination: ~24°C vs 45°C. Cut size determination: 1-2cm vs 1-2mm. Time determination compared 24, 48 and 72- hour processing. Results: 1:5 was the ideal herbal ratio. 45°C was the ideal temperature. Milled (1-2mm) was the ideal cut size. A 2-day extraction process was the ideal timeframe. Discussion: Without an evidence-based guide for extracting the reishi mushroom, the ideal ratio, temperature, cut size and time to extract would be unknown. This method provides the best practice for development of a traditional extract whilst utilising science to guide the process. DNA barcoding in the authentication of herbal materials and products – a valid and useful approach? Dr Hans Wohlmuth1,2, Dr David Leach1,3, Dr Ken McGrath4, Mr Peter Mouatt5, Prof Kerry Bone1, Prof James De Voss2 1Integria Healthcare, Ballina, Australia, 2University of Queensland, St. Lucia, Australia, 3Western Sydney University, Campbelltown, Australia, 4Australian Genome Research Facility, St Lucia, Australia, 5Southern Cross University, Lismore, Australia Biography: Hans Wohlmuth, PhD is a pharmacognosist with over 30 years’ experience in herbal medicine. Now the Research & Development Manager for Integria Healthcare, he spent 16 years at Southern Cross University, where he established the university’s Medicinal Plant Herbarium and co-founded the Herbal Authentication Service. Hans has published over 50 scientific articles on medicinal plants, natural products and complementary medicine and was a member of the Therapeutic Goods Administration's Advisory Committee on Complementary Medicines from 2010 to 2015. He is an adjunct associate professor at the University of Queensland and serves on the Advisory Board of the American Botanical Council. Introduction: The use of DNA barcoding as a herbal authentication technique has received much attention since February 2015, when the New York Attorney General controversially forced four major retailers to cease selling a range of herbal products based on DNA barcoding results allegedly showing that 79% either did not contain the labelled herbal species or contained other non-labelled plant materials. Methods: We assessed the validity and utility of standard DNA barcoding in the quality control of raw materials, extracts and finished products in 61 samples using four universal barcodes (matK, rbcL, trnH-psbA and ITS2). Samples were chemically profiled and marker compounds identified by UPLC-MS. Extracted target DNA was amplified by PCR and Sanger sequenced. Results were compared to sequences in GenBank using BLAST. Results: The rate of successful amplification and sequencing varied with barcode and sample type but was low overall. Identification to species was achieved for 18% (trnH-psbA), 15% (rbcL), 5% (matK) and 0% (ITS2) across all samples. Of dried materials, 53% were correctly identified by at least one barcode. Importantly, only one extract out of 21 yielded amplifiable DNA and could be identified. In contrast, the phytochemical integrity of all samples was confirmed by UPLC-MS. Discussion/Conclusion: The results demonstrate that DNA barcoding using universal barcode sequences, which are relatively long, is not suitable for routine authentication of raw materials, extracts or finished herbal medicinal products, most likely due to DNA degradation arising from drying and processing. The use of shorter, species-specific sequences may yield better results. Natural exportin-1 (XPO1) inhibitors as antiviral agents against respiratory syncytial virus (RSV) Ms Cynthia Mathew1, Prof Reena Ghidlyal1, Dr Andrea Bugarcic2 1University of Canberra, Canberra, Australia, 2Endeavour College of Natural Health, Fortitude Valley, Australia Biography: Cynthia is a PhD student interested in molecular virology of respiratory viruses. She is currently working on an NIH funded project looking into the development of a treatment against RSV and using medicinal plants as therapeutic agents against respiratory viruses that induce asthma in infants. Introduction: Human respiratory syncytial virus (RSV) is the major cause of respiratory tract infections in infants, young children, elderly and the immunocompromised. The matrix (M) protein of RSV is essential for the formation of infectious virus and is thus a good target for antiviral drug development. Previous work has shown that leptomycin B, a bacterial compound, is effective in inhibiting M function; however, this compound is very toxic and cannot be used in the clinic. Focus of discussion: We aim to screen extracts of medicinal plants used in traditional medicine with similar activity to leptomycin B but with reduced toxicity in order to identify suitable antiviral drugs for RSV disease. The successful application of these XPO1 inhibitors against cancer gives support to their potential as antiviral agents. Herbal products with confirmed clinical safety features are attractive starting material for the identification of new antiviral activities. Implications: Herbal medicines and purified natural products provide a rich resource for novel antiviral drug development. Many natural products and herbal ingredients possess robust antiviral activity and can be developed further to produce effective derivatives and therapeutic leads. As many studies in this domain are only preliminary, further exploration in characterising the bioactive ingredients, defining the underlying mechanisms, and assessing the efficacy and potential application in vivo is needed to help develop effective antiviral treatments. Identification of effective, safe, anti-RSV strategies has implications for the overall human population, especially for newborn babies and the elderly who are most at risk of serious RSV disease. Why are mental health disorders higher in the vegetarian/vegan (veg*n) population? Ms Candace Borg1 1Northcote Natural Therapies, Northcote, Australia Biography: Candace Borg is a qualified vegan naturopath, Natural Fertility Educator, and Hypnobirthing practitioner. Studying both a Bachelor of Biological Science (Biomedical Science) and Bachelor of Health Science (Naturopathy) has given Candace the unique ability to assess health from not only a medical but also a naturopathic perspective. Candace is an active member of the Mental Health Professionals Network (MHPN) and the vegan community, regularly presenting to various organisations and vegan groups on various health topics. It is Candace's goal to help those she sees reach and maintain a high level of health, without complicated or radical changes to their lifestyle. Introduction: Australia is the third fastest growing vegan market in the world. Currently 11.2% of the population identifies as veg*n. Research has shown the prevalence of mental disorders are 15% higher in those following a veg*n diet. Much research has been done on causative factors of mental disorders; however, there hasn’t been much emphasis on correlating this data to the veg*n demographic. With the veg*n population and the incidence of mental health predicted to continue to rise, it is important to not only understand what is influencing this demographic but what is contributing to their mental health. Focus of discussion: In this presentation, we will discuss the social aspects of the veg*n demographic and how this influences not only the psychological but also the environmental causes of mental disorders. You will learn about how their diet may be influencing their health, what makes certain supplements non-veg*n and why this demographic is so strict on what their supplements contain. Being vegan for the last 4 years, I have seen the number of patients in my clinic that identify themselves as veg*n increase. Largely, this is due to other practitioners not supporting their veg*n patient (via dietary or supplement suggestions). I will discuss with you why this is and how you can support this demographic. Implications: With the growing rate of veg*n and mental health disorders predicted to continue to rise, it is paramount that we understand the needs and wants of our patients and also have the tools to help treat them. Mistletoe extract and lectin reduce melanoma growth through promotion of apoptosis and phagocytosis Ms Bilquis Ara1, Prof Reena Ghidlyal1, Dr Luby Simson1, Dr Gero Leneweit2, Dr Christoph Heyder2 1University of Canberra, Canberra, Australia, 2Carl Gustav Carus-Institut, Niefern-Öschelbronn, Germany Biography: Ms Ara graduated from Bangladesh and worked as an assistant professor at Dhaka Medical College/Shurawardee Medical College, Bangladesh. She has been working at University of Canberra for the past 4 years and is passionate about cancer immunology. Introduction: Mistletoe (Viscum album Q, VA) extract and mistletoe lectin (ML) are two of the most prescribed alternative drugs for cancer in Europe. Most studies agree that they improve quality of life and survival of cancer patients, which is also associated with eosinophil infiltration at the tumour site. But the underlying molecular mechanism is far more complex and not yet fully elucidated. Effects of mistletoe therapy on immune parameters are also confounding and do not explain improved survival, quality of life in cancer patients or the presence of eosinophils at the tumour site. Methods: Melanoma-bearing C57Bl6 mice treated with VA/ML developed the smallest tumours compared to untreated mice with reduced subcutaneous melanoma and increased eosinophil accumulation at the tumour site. Results: The results from the animal model were validated in vitro; VA/ML showed significant growth reduction of B16F1 in vitro compared to untreated cells in a time and concentration dependent manner. B16F1 cells, co-cultured with eosinophils treated with VA/ML, showed reduced cell proliferation compared to cells co-cultured with untreated eosinophils. Conclusion: In conclusion, results of this study suggest that mistletoe extracts reduce tumour growth and improve survival through complex, multifaceted mechanisms, including direct cytotoxicity as well as promotion of apoptosis and phagocytosis. The role of herbal immunomodulators in chronic infections Ms Julianne Grant1 1Optimalrx / Naturopath (private), Melbourne, AUSTRALIA Biography: Julianne Grant is an experienced Melbourne-based naturopathic practitioner with a special interest in the management of chronic disease, including autoimmune conditions, cancer and chronic infections. Alongside her practice, Julianne is also a researcher, technical writer and educator for leading Australian herbal medicine company, OptimalRx. Julianne has worked in the health industry for over 17 years in varied roles within hospitals, sporting associations and private practice. She is passionate about education, both of her clients and of the naturopathic profession, and invests a great deal of time researching and implementing advances in natural medicine. Julianne is a full member of NHAA. Introduction: Clinically, we are seeing a rise in the number of patients with chronic infections, which are often responsible for the development of chronic disease. Pathogenic microbes, particularly stealth infections, have the ability to modulate the immune system and promote inflammation, which is crucial to their long-term survival within the host. These pathogens generally evade a normal human immune response via immunosuppression and other virulence factors. Research has found a strong association between infection with pathogens, such as mycoplasma and borrelia, and chronic disease due to the sequelae of events post-infection. Effective management of infections with immunomodulators is paramount to the long-term health of the patient. Focus of discussion: Herbal immunomodulators are crucial in the treatment of chronic infections. I will discuss the importance of the host’s ability to mount an effective immune response, maintain immunosurveillance, and reduce pro-inflammatory cytokine production for the long-term health of the patient. The focus entails the role of herbal immunomodulators for this purpose, and relevant phytomedicines will be discussed. Implications: Many practitioners focus upon eradicating the infection with herbal antimicrobials, underestimating the impact of the infection on the immune system and the resulting sequelae of adverse events. Herbal immunomodulators are of prime importance in treating chronic infections, particularly when dealing with/aiming to avoid chronic disease states. Adulteration of tea tree oil in Australia and overseas Dr Hans Wohlmuth1,2, Mr Ashley Dowell3, Mr Michael Russell3 1Integria Healthcare, Ballina, Australia, 2University of Queensland, St. Lucia, Australia, 3Southern Cross University, Lismore, Australia Biography: Hans Wohlmuth, PhD is a pharmacognosist with over 30 years’ experience in herbal medicine. Now the Research & Development Manager for Integria Healthcare, he spent 16 years at Southern Cross University, where he established the university’s Medicinal Plant Herbarium and co-founded the Herbal Authentication Service. Hans has published over 50 scientific articles on medicinal plants, natural products and complementary medicine and was a member of the Therapeutic Goods Administration's Advisory Committee on Complementary Medicines from 2010 to 2015. He is an adjunct associate professor at the University of Queensland and serves on the Advisory Board of the American Botanical Council. Introduction/Background: The quality assurance of herbal products is particularly challenging due to their chemical complexity and natural variation. Adulteration, typically economically motivated, is an ongoing challenge and a threat to the safety, effectiveness and reputation of herbal medicines. Increasingly, adulteration is so sophisticated that even official pharmacopoeial testing methods are incapable of its detection. Methods: We analysed tea tree oils labelled as pure from the Australian and overseas markets. The analysis was done by the TGA-licensed Analytical Research Laboratory at Southern Cross University. Samples were analysed by gas chromatography (GC-FID) using the method in the British Pharmacopoeia (2015) monograph for tea tree oil. Additionally, samples underwent chiral GC analysis to determine enantiomeric (+/-) ratios for terpinen-4-ol, limonene and α- terpineol. Results: Adulteration of a number of tea tree oil samples was demonstrated either by abnormal enantiomeric ratios and/or the presence of compounds that are not known to occur naturally in tea tree oil. The identity of extraneous compounds indicated that essential oils of pine, eucalyptus and basil, as well as synthetic terpinen-4-ol, are used as adulterants. Discussion/Conclusion: The results show that adulteration of “pure” tea tree oil is not uncommon and occurs in both Australian and overseas markets. This practice is a threat to an iconic Australian natural product. Of particular concern is the fact that most adulterated oils complied with the compositional specification in the current British Pharmacopoeia monograph. Our study demonstrates the need for ongoing vigilance in herbal quality assurance.