Elderberry is thought to inhibit both bacteria and viruses, which could make it suitable for use when there are often secondary infections, such as when influenza is followed by bacterial pneumonia. It may also be effective for nosocomial infections (hospital “super-bugs”). Sambucus nigra is natively spread in European countries and is used as colorant or flavor in Juices and wines. Among different parts of Sambucus nigra, its flowers and berries are considered as medicinal parts, while elder flowers have been approved by German commission E for colds, while berries, leaves and barks are lack of approval by WHO, ESCOP, and German Commission. The potentially toxic cyanogenic glycoside “sambunigrin” is present in barks, leaves, seeds and unripe fruits. The amount of cyanogenic glycoside depends on growing conditions and the flowers have lower content of cyanogenic glycoside in comparison with other parts of plant. Elder flowers are rich of N-phenylpropenoyl-l-amino acid amides, which strongly stimulated the mitochondrial activity and cell proliferation of human keratinocytes and liver cells and deduced the adhesion of Helicobacter pylorito the human stomach without any necrotic toxicity effects. Elder-berries are containing the low amount of essential oil (0.01). Phenylacetaldehyde (32.3%), benzaldehyde (7.9%), ethyl linoleate (5.4%), 4-vinyl guaiacol (4.9%), linalool (4.5%), and phenyl ethyl alcohol (4.1%) were the main components of elderberry essential oil. Fruit ripening process can influence on the content of anthocyanin, soluble solid and titratable acid. The aroma characteristic of elderberries is used in different formulations. Aliphatic esters ((E)-β-damascenone, 2-phenyl ethanol, phenylacetaldehyde, dihy-droedulan, ethyl-9-decenoate, and nonanal) are responsible for fruity sweet characteristic aroma of elderberries. The presence of cyanidin-3-glucoside and cyanidin-3-sambubioside is responsible for dark color of European elder berries. Chemical composition of elder berries and flowers exhibited the presence of a number of health promoting compounds, which makes it as favorite supplements.

Elder flowers are generally regarded as safe. Black elder flowers are used for treatment of scarlatina and fever. Dried elder lowers have strong odor with sweet taste to slightly bitter and are used as diaphoretic agent in pharmaco-poeias and international systems for reducing the fever and chills. Elder flowers are used for treatment of conjunctivitis, constipation, diabetes, diarrhea, dry skin, headaches and rheumatism in folk medicine.Elderberry extract inhibited the Human infuenza A (H1N1) with IC50of 252 ± 34 μg/mL, the propagation of human pathogenic infuenza viruses, and immunod efficiency virus (FIV). In other study, elderberries had antiviral activity against infuenza A, infuenza B, HIV, Herpes sim-plex-1 viruses, and pathogenic chicken coronavirus. Elder flowers and leaves methanol extract had antiviral activity against dengue virus serotype-2 (400 μg/mL). Elderberry extract increased the influenza viral antibody in comparison with placebo group. Incubation of blood derived monocytes with elderberry extract significantly increased the production of IL-1β, TNF-α, IL-6, IL-8, and TNF-α. A significant increase in inflammatory cytokine of IFN-γ was observed after administration of elder in insulin deficiency diabetic and normal patients. Fever higher than 101 °F, headache, general aches; and pains are the characteristic symptoms of fu. Cough, chest congestion, sore throat, stuffy nose, fatigue, weakness, and extreme exhaustion are prevalent among patients. The antioxidant effects of elder extracts are responsible for their efficacy in reducing the pain, and fever. The polyphenols), and anthocyanins in elders are strongly responsible for the anti-oxidant activities. A combination of echinacea herb and root extract supplemented with elderberry (Sambucus nigra L.) can be as effective as the conventional antiviral medicine oseltamivir for the early treatment of influenza. Elderberries have shown antibacterial and antiviral activities.