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• Anticancer agent and immunopotentiator: Cellobiose 2-epimerase from Ruminococcus albus
converts lactose to epilactose. Supplementation with epilactose increases cecal contents, decreases pH,
enhances Lactobacilli and Bifidobacteria populations, and inhibits the conversion of primary to
secondary bile acids (colon cancer promoters). SCFAs from fermentation are also known to stimulate
apoptosis, and propionate specifically has shown anti-inflammatory effects on colon cancer cells.

Cardiovascular diseases (CVD)

English Hawthorn (Crataegus laevigata)

• Habitat/Names: Indigenous to temperate northern zones (Europe, Asia, North America). Also known
as Haw or Whitethorn.

• Chemical constituents: Flavonoids, Oligomeric proanthocyanidins (2.4%), Biogenic amines (e.g.,
tyramine), Triterpenes (0.6%).

• Effects: The active principles (procyanidins and flavonoids) cause an increase in coronary blood flow
by dilating vessels, improving myocardial blood flow. The drug is positively inotropic (increases
contraction force) and positively chronotropic (increases heart rate). This cardiotropic effect is thought
to be caused by increased membrane permeability to calcium and inhibition of phosphodiesterase,
which increases intracellular cAMP. High doses may cause sedation, attributed to the procyanidins.

• Indications (Commission E): Decrease in cardiac output (Stage II NYHA). Used for senile heart and
mild forms of bradycardia or arrhythmias.

• Unproven Uses: Folk medicine uses include cardiotonic, hypertension, heart ischemia, and sedative.
Its high flavonoid content is used to prevent collagen destruction in joints, decrease inflammation, and
reduce capillary fragility. In China, it is used to reduce food stagnancy.

• Precautions/Interactions: Should be prescribed and monitored by a physician. High doses can cause
hypotension, cardiac arrhythmia, and sedation.
o Drug Interactions: May potentiate cardiac glycosides (like digoxin; dosage may need
adjustment). May cause a hypotensive effect with beta-blockers. Action is similar to Class III
antiarrhythmics; use with other antiarrhythmics is discouraged. It inhibits potassium channels,
increasing action potential in cardiac cells; drugs that act similarly (e.g., cisapride) should not
be taken concurrently.

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