Revista Salud y Bienestar

Ginkgo Biloba en medicina deportiva

Por José Antonio Villegas García

Setratadel llamado árbol de los cuarenta escudos, es un árbol único en el mundo, sin parientes vivos, de modo que constituye uno de los mejores ejemplos de fósil viviente conocido. Tiene uno de los portes más hermosos que yo he visto (lo vi por primera vez en el parque de Quevedo y Villegas, junto al Parador Nacional San Marcos, de León).
La hoja de ginkgo se usaba en China para tratar el asma y los trastornos cardiovasculares, sin embargo, el uso tradicional de la hoja tiene un uso muy reciente en Occidente. En la actualidad, los extractos concentrados estandarizados de hoja de ginkgo se comercializan en varios países europeos y se usan para tratar déficit cognitivo, claudicación intermitente (producida generalmente por alguna enfermedad oclusiva arterial periférica), vértigo y acúfenos de origen vascular.
Suaplicaciónenmedicinadeportivasebasaenque,supuestamente,mejoralacaptación de la glucosa y el oxígeno bajo condiciones de isquemia, estimulando la glucolisis aeróbicaypromoviendoelaclaramientodellactato.Tambiénse usaenpatologíaporaltitud, particularmente en el mal de montaña.
El extracto de Ginkgo Biloba capta varias especies reactivas de oxígeno, incluidos los radicales hidroxilo, superóxido y peroxilo y se ha descrito que protege contra el estrés oxidativo inducido por el peróxido de hidrógeno, en neuronas y células granulares del cerebelo de rata (por esa razón se ha empleado en pacientes con enfermedad mental). Por otro lado, la incubación con extracto en cultivos de células del hipocampo de rata, proporcionó protección frente a la muerte celular inducida por β-amiloide, contra la toxicidad inducida por peróxido de hidrógeno, y bloqueó los procesos inducidos por β-amiloide, como la acumulación de especies reactivas de oxígeno (es el argumento de su posible uso en el Alzheimer, cosa que se pone en cuestión en la actualidad).
La sospecha actual (porque no se puede hablar de certeza científica) es que los mecanismos de defensa del Ginkgo y su alta esperanza de vida (del propio árbol), se deben a cinco substancias que se encuentran solo en los Ginkgos, los ginkgolidos (compuestos de seis anillos con cinco átomos de carbono, que están enlazados mutuamente en una manera insólita). Las pruebas que se han realizado con uno o algunos componentes de las hojas de Ginkgo han tenido resultados decepcionantes, lo que induce a pensar en un efecto sinérgico y único.
Mi experiencia en medicina deportiva (en neurología utilizan el Ginkgo para mejorar la función cognitiva), la he obtenido en dos campos, por un lado en el tratamiento del asma de esfuerzo, en colaboración con medidas higiénicas (calentamiento previo, ejercicio en medio húmedo y cálido etc) y en sinergismo con el DHA (Brudy Plus). De otro lado, su uso en la prevención del mal de montaña, en donde también ha sido muy satisfactorio, aunque en este tema también hay factores que contaminan la experiencia, ya que uno no sabe bien la jerarquía exacta en el conjunto de medidas entre las que se incluyen aclimatación, descanso, experiencia previa etc.
En cualquier caso, el extracto de Ginkgo Biloba cuando es de confianza y se usa por profesionales con experiencia, es muy útil. Sin embargo, cuando se usa por autoprescripción o por personal no experto, puede ser peligroso, ya que puede causar hemorragias, disminuir el umbral convulsivo en pacientes predispuestos o alterar la metabolización de fármacos en el hígado (citocromo P450)
Interaccionesy efectos secundariosNo se debe administrar junto a anticoagulantes (warfarina); hierba de San Juan; Ibuprofeno
Hayquetenercuidadocuandosedaconjuntamenteconalprazolam,antiepilépticos, buspirona, fluoxetina e hidroclorotiazida
Un enlace de un enamorado del árbol:
http://kwanten.home.xs4all.nl/espindex.htm

Bibliografía (para los más interesados)

  1. Van Beek TA et al. Ginkgo biloba L. Fitoterapia 1998; 69: 195–244.
  2. Van Beek TA , ed. Ginkgo. The Genus Ginkgoaceae. Amsterdam: Harwood Academic Publishers, 1998.
  3. Victoire C et al. Isolation of flavonoid glycosides from Ginkgo biloba leaves. Planta Med 1988; 54: 245–247.
  4. Schenne A , Holzl J . 6-Hydroxykynurensaure, die erste N- haltige Verbindung aus den Blattern von Ginkgo biloba . Planta Med 1986; 52: 235–236.
  5. Nasr C , et al. 2-Quinoline carboxylic acid-4,6-dihydroxy from Ginkgo biloba . Paper presented at the Phytochemical Society of Europe Symposium: Biologically Active Natural Products, Lausanne, 1986, p. 9.
  6. Briancon-Scheid F et al. HPLC separation and quantitative determination of biflavones in leaves from Ginkgo biloba . Planta Med 1983; 49: 204–220.
  7. Vanhaelen M , Vanhaelen-Fastre R . Kaempferol-3-O-β-glucoside (astragalin) from Ginkgo biloba . Fitoterapia 1988; 59: 511.
  8. Braquet P . The ginkgolides: potent platelet-activating factor antagonists isolated from Ginkgo biloba L.: Chemistry, pharmacology and clinical applications. Drugs of the Future 1987; 12: 643–699.
  9. Anonymous. Extract of Ginkgo biloba (EGb 761). Presse Med 1986; 15: 1438–1598.
  10. Huang X et al. Characteristics and antifungal activity of a chitin binding protein from Ginkgo biloba . FEBS 2000; 478: 123–126.
  11. Wada K et al. Studies on the constitution of edible medicinal plants. 1. Isolation and identification of 4-O-methylpyridoxine, toxic principle from the seed of Ginkgo biloba L. Chem Pharm Bull 1988; 36: 1779–1782.(Medline)
  12. Wang H , Ng TB . Ginkbilobin, a novel antifungal protein from Ginkgo biloba seeds with sequence similarity to embryo-abundant protein. Biochem Biophys Res Commun 2000; 279: 407–411.(Medline)
  13. DeFeudis FV . Ginkgo biloba. From Chemistry to Clinic. Wiesbaden, Germany: Ullstein Medical, 1998.
  14. Clostre F , De Feudis FV , eds. Cardiovascular Effects of Ginkgo biloba Extract (EGb761). Advances in Ginkgo biloba Extract Research, vol 3. Paris: Elsevier, 1994: 1–162.
  15. Reuter HD . Ginkgo biloba – botany, constituents, pharmacology and clinical trials. Br J Phytother 1995/6; 4: 3–20.
  16. Christen Y , ed. Ginkgo biloba Extract (EGb 761) as a Neuroprotective Agent: From Basic Studies to Clinical Trials. Advances in Ginkgo biloba Extract Research, vol 8. Paris: Elsevier, 2001.
  17. Winter JC . The effects of an extract of Ginkgo biloba, EGb 761, on cognitive behaviour and longevity in the rat. Physiol Behav 1998; 63: 425–433.(Medline)
  18. Hasenörhl RU et al. Dissociation between anxiolytic and hypomnestic effects for combined extracts of Zingiber officinale and Ginkgo biloba, as opposed to diazepam. Pharmacol Biochem Behav 1998; 59: 527–535.(Medline)
  19. Christen Y et al., eds. Effects of Ginkgo biloba Extract (EGb 761) on Neuronal Plasticity. Advances in Ginkgo biloba Extract Research, vol 5. Paris: Elsevier, 1996.
  20. Papadopoulos V et al. Adaptive Effects of Ginkgo biloba Extract (EGb 761). Advances in Ginkgo biloba Extract Research, vol 6. Paris: Elsevier, 1997.
  21. Liebgott T et al. Complementary cardioprotective effects of flavonoid metabolites and terpenoid constituents of Ginkgo biloba extract (EGb 761) during ischemia and reperfusion. Basic Res Cardiol 2000; 95: 368–377.(Medline)
  22. Janssens D et al. Protection by bilobalide of the ischaemia-induced alterations of the mitochondrial respiratory activity. Fund Clin Pharmacol 2000; 14: 193–201.
  23. Zhang WR et al. Protective effect of Ginkgo extract on rat brain with transient middle cerebral artery occlusion. Neurol Res 2000; 22: 517–521.(Medline)
  24. Dutta-Roy AK et al. Inhibitory effect of Ginkgo biloba extract on human platelet aggregation. Platelets 1999; 10: 298–305.
  25. Hosford D, et al. Natural antagonists of platelet-activating factor. Phytother Res 1988; 2: 1–17.
  26. Maitra I et al. Peroxyl radical scavenging activity of Ginkgo biloba extract EGb 761. Biochem Pharmacol 1995; 49: 1649–1655.(Medline)
  27. Lee S-L et al. Superoxide scavenging effect of Ginkgo biloba extract on serotonin-induced mitogenesis. Biochem Pharmacol 1998; 56: 527–533.(Medline)
  28. Oyama Y et al. Ginkgo biloba extract protects brain neurons against oxidative stress induced by hydrogen peroxide. Brain Res 1996; 712: 349–352.(Medline)
  29. Wei T et al. Hydrogen peroxide-induced oxidative damage and apoptosis in cerebellar granule cells: protection by Ginkgo biloba extract. Pharmacol Res 2000; 41: 427–433.(Medline)
  30. Bastianetto S et al. The ginkgo biloba extract (EGb 761) protects hippocampal neurons against cell death induced by β-amyloid. Eur J Neurosci 2000; 12: 1882–1890.(Medline)
  31. Zhou L-J , Zhu X-Z . Reactive oxygen species-induced apoptosis in PC12 cells and protective effect of bilobalide. J Pharmacol Exp Ther 2000; 293: 982–988.(Medline)
  32. Calapai G et al. Neuroprotective effects of Ginkgo biloba extract in brain ischaemia are mediated by inhibition of nitric oxide synthesis. Life Sci 2000; 67: 2673–2683.(Medline)
  33. Rasetti MF et al. Extracts of Ginkgo biloba L. leaves and Vaccinium myrtillus L. fruits prevent photo induced oxidation of low density lipoprotein cholesterol. Phytomedicine 1996/97; 3: 335–338.
  34. Drieu K et al. Effect of the extract of Ginkgo biloba (EGb 761) on the circulating and cellular profiles of polyunsaturated fatty acids: correlation with the anti-oxidant properties of the extract. Prostaglandins Leukot Essent Fatty Acids 2000; 63: 293–300.
  35. Bridi R et al. The antioxidant activity of standardized extract of Ginkgo biloba (EGb 761) in rats. Phytother Res 2001; 15: 449–451.(Medline)
  36. Bahcecioglu IH et al. Protective effect of Ginkgo biloba extract on CCl4-induced liver damage. Hepatol Res 1999; 15: 215–224.
  37. Agha AM et al. Chemopreventive effect of Ginkgo biloba extract against benzo(a)pyrene-induced fore stomach carcinogenesis in mice: amelioration of doxorubicin cardiotoxicity. J Exp Clin Cancer Res 2001; 20: 39–50.(Medline)
  38. Papadopoulos V et al. Drug-induced inhibition of the peripheral-type benzodiazepine receptor expression and cell proliferation in human breast cancer cells. Anticancer Res 2000; 20: 2835–2848.(Medline)
  39. Naidu MUR et al. Ginkgo biloba extract ameliorates gentamicin-induced nephrotoxicity in rats. Phytomedicine 2000; 7: 191–197.(Medline)
  40. White HL et al. Extracts of Ginkgo biloba leaves inhibit monoamine oxidase. Life Sci 1996; 58: 1315–1321.(Medline)
  41. Sasaki K et al. Effects of bilobalide on gamma-aminobutyric acid levels and glutamic acid decarboxylase in mouse brain. Eur J Pharmacol 1999; 367: 165–173.(Medline)
  42. Itokawa H et al. Antitumour principles from Ginkgo biloba L. Chem Pharm Bull 1987; 35: 3016–3020.(Medline)
  43. Kleijnen J , Knipschild P . Ginkgo biloba for cerebral insufficiency. Br J Clin Pharmacol 1992; 34: 352–358.(Medline)
  44. Oken BS et al. The efficacy of Ginkgo biloba on cognitive function in Alzheimer disease. Arch Neurol 1998; 55: 1409–1415.(Medline)
  45. Ernst E , Pittler MH . Ginkgo biloba for dementia. A systematic review of double-blind, placebo-controlled trials. Clin Drug Invest 1999; 17: 301–308.
  46. Ernst E , Stevinson C . Ginkgo biloba for tinnitus: a review. Clin Otolaryngol 1999; 24: 164–167.(Medline)
  47. Pittler MH , Ernst E . Ginkgo biloba extract for the treatment of intermittent claudication: a meta-analysis of randomized trials. Am J Med 2000; 108: 276–281.(Medline)
  48. Kanowski S et al. Proof of efficacy of the Ginkgo biloba special extract Egb 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia. Phytomedicine 1997; 4: 3–13.
  49. Le Bars P et al. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. JAMA 1997; 278: 1327–1332.(Medline)
  50. Winther K et al. Effects of Ginkgo biloba extract on cognitive function and blood pressure in elderly subjects. Curr Ther Res 1998; 59: 881–888.
  51. Brautigam MRH et al. Treatment of age-related memory complaints with Ginkgo biloba extract: a randomized double blind placebo-controlled study. Phytomedicine 1998; 5: 425–434.
  52. Itil TM et al. The pharmacological effects of Ginkgo biloba, a plant extract, on the brain of dementia patients in comparison with tacrine. Psychopharmacol Bull 1998; 34: 391–397.(Medline)
  53. Kennedy DO et al. The dose-dependent cognitive effects of acute administration of Ginkgo biloba to healthy young volunteers. Psychopharmacology 2000; 151: 416–423.(Medline)
  54. Subhan Z , Hindmarsh I . The psychopharmacological effects of Ginkgo biloba extract in normal healthy volunteers. Int J Clin Pharmacol Res 1984; 4: 89–93.(Medline)
  55. Rigney U et al. The effects of acute doses of standardized Ginkgo biloba extract on memory and psychomotor performance in volunteers. Phytother Res 1999; 13: 408–415.(Medline)
  56. Mix JA , Crews WD . An examination of the efficacy of Ginkgo biloba extract EGb 761 on the neuro psychological functioning of cognitively intact older adults. J Altern Complement Med 2000; 6: 219–229.(Medline)
  57. Cockle SM et al. The effects of Ginkgo biloba extract (LI 1370) supplementation on activities of daily living in free living older volunteers: a questionnaire survey. Hum Psychopharmacol 2000; 15: 227–235.
  58. Drew S , Davies E . Effectiveness of Ginkgo biloba in treating tinnitus: double blind, placebo controlled trial. BMJ 2001; 322: 73–75.(Medline)
  59. Ernst E . Marketing studies and scientific research must be distinct. BMJ 2001; 322: 1249.(Medline)
  60. Bukovics K et al. Vergleich von Ginkgo biloba und 6% HES 200/0,5 in der Behandlung des akuten Hörsturzes. J Pharmakol Ther 1999; 2: 48–56.
  61. Janssens D et al. Increase in circulating endothelial cells in patients with primary chronic venous insufficiency: protective effect of Ginkor Fort in a randomized double-blind, placebo-controlled clinical trial. J Cardiovasc Pharmacol 1999; 33: 7–11.(Medline)
  62. Pizzorno JE , Murray MT . A Textbook of Natural Medicine. Seattle, WA: John Bastyr College Publications, 1985 (looseleaf).
  63. Chung KF . Effect of a ginkgolide mixture (BN 52063) in antagonising skin and platelet responses to platelet activating factor in man. Lancet 1987; i: 248–251.
  64. Wilkens JH et al. Effects of a PAF-antagonist (BN 52063) on bronchoconstriction and platelet activation during exercise-induced asthma. Br J Clin Pharmacol 1990; 29: 85–91.(Medline)
  65. Cohen AJ , Bartlik B . Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther 1998; 24: 139–143.(Medline)
  66. Wheatley D . Ginkgo biloba in the treatment of sexual dysfunction due to antidepressant drugs. Hum Psychopharmacol 1999; 14: 511–513.
  67. Balon R . Ginkgo biloba for antidepressant-induced sexual dysfunction? J Sex Marital Ther 1999; 10: 1–2.
  68. Evans JR . Ginkgo biloba extract for age-related macular degeneration (Cochrane review). In: The Cochrane Library , Issue 3, 2001. Oxford: Update Software, 2001.
  69. Lingjaerde O et al. Can winter depression be prevented by Ginkgo biloba extract? A placebo-controlled trial. Acta Psychiatr Scand 1999; 100: 62–66.(Medline)
  70. Hemmeter U et al. Polysomnographic effects of adjuvant Ginkgo biloba therapy in patients with major depression medicated with trimipramine. Pharmacopsychiatry 2001; 34: 50–59.(Medline)
  71. Tamborini A , Taurelle R . Rev Fr Gynecol Obstet 1993; 88: 147. Cited by Bone K. Treatment of congestive symptoms of premenstrual syndrome with ginkgo. Br J Phytother 1995/96; 4: 46.
  72. Zhang XY et al. The effect of extract of Ginkgo biloba added to haloperidol on superoxide dismutase in inpatients with chronic schizophrenia. J Clin Psychopharmacol 2001; 21: 85–88.(Medline)
  73. Bombardelli E et al. Activity of phospholipid-complex of Ginkgo biloba dimeric flavonoids on the skin microcirculation. Fitoterapia 1996; 67: 265–273.
  74. Hauns B et al. Phase II study of combined 5-fluorouracil/Ginkgo biloba extract (GBE 761 ONC) therapy in 5-fluorouracil pretreated patients with advanced colorectal cancer. Phytother Res 2001; 15: 34–38.(Medline)
  75. DeFeudis FV . Safety of EGb 761-containing products. In: DeFeudis FV , ed. Ginkgo biloba Extract (EGb 761). Pharmacological Activities and Clinical Applications. Amsterdam: Elsevier, 1991.
  76. Rosenblatt M , Mindel J . Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med 1997; 336: 1108.(Medline)
  77. Vale S . Subarachnoid haemorrhage associated with Ginkgo biloba . Lancet 1998; 352: 36.(Medline)
  78. Rowin J , Lewis SL . Spontaneous bilateral subdural hematomas associated with chronic Ginkgo biloba ingestion. Neurology 1996; 46: 1775–1776.(Medline)
  79. Donadio V et al. Myoglobinuria after ingestion of extracts of guarana, Ginkgo biloba and kava. Neurol Sci 2000; 21: 124.(Medline)
  80. Houghton PJ . Ginkgo. Pharm J 1994; 253: 122–123.
  81. Braquet P , ed. Ginkgolides – Chemistry, Biology, Pharmacology and Clinical Perspectives, vol 1. Barcelona: JR Prous, 1988.
  82. Braquet P , ed. Ginkgolides – Chemistry, Biology, Pharmacology and Clinical Perspectives, vol 2. Barcelona: JR Prous, 1989.

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