Table 2 Characteristics and results of ex vivo cytokine studies

Kirichenko 2016 [15, 39]

Comparative before and after study

Participants were healthy volunteers but number of participants is not clear.

Participants received elderberry tincture and diclofenac.

Cytokines were measured before and 2, 4, and 8 h after oral tincture of elderberry and also before and 2, 4, and 8 h after oral diclofenac.

IL-1 and TNF-alpha

After elderberry, reductions from baseline in IL-1 were seen at 2, 4, and 8 h after intake and reductions from baseline in TNF-alpha were seen at 2 h. After diclofenac, reductions from baseline in both IL-1 and TNF-alpha were statistically significant at 2, 4, and 8 h. With elderberry the mean percentage ± SEM from baseline for IL-1 was 68.0 ± 2.6 at 2 h, 70.7 ± 2.4 at 4 h, and 88.3 ± 2.0 at 8 h. The decrease was statistically significant (p < 0.05) at each point. TNF-alpha levels were 80.3 ± 2.0 at 2 h, 98.0 ± 14.1 at 4 h, and 121.7 ± 21.6 at 8 h. The decrease was significant (p < 0.05) only at 2 h. With diclofenac, IL-1 levels were 78.0 ± 5.5 at 2 h, 73.3 ± 7.9 at 4 h, and 51.0 ± 21.8 at 8 h and TNF-alpha levels were 80.0 ± 10.0 at 2 h, 88.0 ± 7.5 at 4 h, and 61.3 ± 6.6 at 8 h. The effects of diclofenac were significant (p < 0.05) for both cytokines at each time point.

Ivanova 2015 [38]

Before and after study

N = 22 healthy volunteers drank elderberry tea for 30 days.

Cytokines were measured at baseline and after treatment.

IL-beta, CRP, IL-6, TNF-alpha

After 30 days of elderberry, there were reductions in IL-beta and in CRP but little or no reductions in IL-6 and TNF-alpha. IL-beta (mean ± SEM) (data read from Fig. 2) was 16 ± 3.7 pg/mL at day 0 and 12 ± 2.2 pg/mL at day 30 (p < 0.05), CRP was 1.25 ± 0.41 mg/L at day 0 and 0.84 ± 0.32 mg/L at day 30 (p < 0.05). IL-6 was 18.33 ± 4.10 pg/mL at baseline and 15.09 ± 3.04 pg/mL at day 30). TNF-alpha was 21.13 ± 10.73 pg/mL at day 0 and 10.79 ± 2.67 pg/mL at day 30)

Curtis 2009 [37]

RCT

N = 52 healthy postmenopausal women took either elderberry capsules (n = 26) or placebo capsules (n = 26) for 12 weeks.

Cytokines were measured at baseline and after treatment.

CRP, TNF-alpha, IL-6

After 12 weeks of supplementation with elderberry or placebo, there was no difference in plasma levels of cytokines. The mean ± SD of IL-6 (ng/L) was 1.0 ± 1.4 at baseline and 0.9 ± 0.9 at 12 weeks in placebo group, compared to 1.0 ± 0.9 at baseline and 1.0 ± 0.6 at 12 weeks in elderberry group. TNF-alpha (ng/L) was 14.8 ± 9.3 at baseline and 13.0 ± 9.2 at 12 weeks in placebo group, compared to 15.3 ± 11.1 at baseline and 10.5 ± 5.5 at 12 weeks in elderberry group. CRP (mg/L) was 0.9 ± 0.9 at baseline and 0.9 ± 0.7 at 12 weeks in placebo group, compared to 1.3 ± 1.0 at baseline and 1.3 ± 1.1 at 12 weeks in elderberry group