31 Mayıs 2013 Cuma

Bupleurum (Bupleurum falcatum) WHO Monograph – EN

Definition
Radix Bupleuri consists of the dried root of Bupleurum falcatum L. or B. falcatum L. var.scorzonerifolium (Willd.) Ledeb. (Apiaceae) (1, 2).
Synonyms
Bupleurum chinense D.C. and B. scorzonerifolium Willd. have been treated as different species (1) but are actually synonyms of B. falcatum L. var. scorzonerifolium (3). Apiaceae are also referred to as Umbelliferae.
Selected vernacular names
Beichaihu, bupleurum root, ch'ai hu, chaifu, chaihu, chaiku-saiko, Chinese thorowax root, juk-siho, kara-saiko, mishima-saiko, nanchaihu, northern Chinese thorowax root, radix bupleur, saiko, shi ho, shoku-saiko, wa-saiko, Yamasaiko (1–5).
Description
A perennial herb up to 1m tall; base woody and the rhizome branching. Stem slender, flexuous, branches spreading. Basal leaves lanceolate, upper lamina broad, lower narrowed into a petiole, veins 7, apex acute, mucronate; middle and upper leaves linear to lanceolate, gradually shorter, falcate, veins 7–9, base slightly amplexicaul, apex acuminate. Involucre of 1–3 minute bracts or lacking. Rays 5–8. Involucel of 5 minute, 3-veined bractlets, shorter than the flowering umbellet. Pedicels shorter than the fruits. Fruit oblong, 3–4 mm long; furrows 3- vittate (4, 6).
Plant material of interest: dried roots
General appearance
Single or branched root, of long cone or column shape, 10–20 cm in length, 0.5– 1.5 cm in diameter; occasionally with remains of stem on crown; externally light brown to brown and sometimes with deep wrinkles; easily broken, and fractured surface somewhat fibrous (2).
Organoleptic properties
Odour, characteristic, slightly aromatic to rancid; taste, slightly bitter (1, 2).
Microscopic characteristics
Transverse section reveals often tangentially extended clefts in cortex, the thickness reaching a third to a half of the radius, and cortex scattered with a good many intercellular schizogenous oil canals 1.5–3.5 cm in diameter; vessels lined radially or stepwise in xylem, with scattered fibre groups; in the crown pith also contains oil canals; parenchyma cells filled with starch grains and some oil drops. Starch grains composed of simple grains, 2–10µm in diameter, or compound grains (2).
Powdered plant material
Information not available. Description to be established by appropriate national authorities.
Geographical distribution
Indigenous to northern Asia, northern China, and Europe (4, 6).
General identity tests
Macroscopic and microscopic examinations (1, 2), microchemical detection for saponins (1, 2), and thin-layer chromatographic analysis for triterpene saponins with reference to saikosaponins (2).
Purity tests
Microbiology
The test for Salmonella spp. in Radix Bupleuri should be negative. The maximum acceptable limits of other microorganisms are as follows (7–9). For preparation of decoction: aerobic bacteria-not more than 107/g; fungi-not more than 105/g; Escherichia coli-not more than 102/g.
Chemical
Contains triterpene saponins (saikosaponins). Quantitative level to be established by appropriate national authorities, but should be not less than 1.5% according to literature data.
Foreign organic matter
Not more than 10% of stems and leaves (2). No roots of B. longiradiantum Turcz., which is toxic (1, 5). Not more than 1% of other foreign matter (2).
Total ash
Not more than 6.5% (2).
Acid-insoluble ash
Not more than 2% (2).
Dilute ethanol-soluble extractive
Not less than 11% (2).
Pesticide residues
To be established in accordance with national requirements. Normally, the maximum residue limit of aldrin and dieldrin for Radix Bupleuri is not more than 0.05 mg/kg (9). For other pesticides, see WHO guidelines on quality control methods for medicinal plants (7) and WHO guidelines for predicting dietary intake of pesticide residues (10).
Heavy metals
Recommended lead and cadmium levels are no more than 10 and 0.3mg/kg, respectively, in the final dosage form of the plant material (7).
Radioactive residues
For analysis of strontium-90, iodine-131, caesium-134, caesium-137, and plutonium-239, see WHO guidelines on quality control methods for medicinal plants (7).
Other tests
Tests for moisture and for water-soluble extractive to be established by national authorities.
Chemical assays
Total saikosaponins determination by colorimetric analysis (11), and highperformance liquid chromatography analysis for saikosaponins A, B1, B2, and D (12, 13).
Major chemical constituents
The major constituents are triterpene saponins, including saikosaponins A, B1–4, D, E, F and H and related compounds including saikogenins A–G (5, 14). Two biologically active polysaccharides, bupleurans 2IIb and 2IIc, have also been isolated from the roots of B. falcatum (15, 16). Representative structures of saikosaponins are presented in the figure.
Dosage forms
Decoction (5). Store crude plant material in a dry environment protected from moths, light, and moisture (1, 2).
Medicinal uses
Uses supported by clinical data
None.
Uses described in pharmacopoeias and in traditional systems of medicine
Treatment of fever, pain, and inflammation associated with influenza, and the common cold (1, 2, 5). The drug is also used as an analgesic for the treatment of distending pain in the chest and hypochondriac regions, and for amenorrhoea (1). Extracts have been used for the treatment of chronic hepatitis, nephrotic syndrome, and autoimmune diseases (1, 5).
Uses described in folk medicine, not supported by experimental or clinical data
Treatment of deafness, dizziness, diabetes, wounds, and vomiting (5).
Pharmacology
Experimental pharmacology
Antipyretic and analgesic activity
A number of in vivo studies have confirmed the antipyretic activity of Radix Bupleuri in the treatment of induced fevers in animals. Oral administration of a Bupleurum decoction (5 g/kg) to rabbits with a heat-induced fever decreased body temperature to normal levels within 1.5 hours (5). Subcutaneous injection of an aqueous ethanol extract of Bupleurum roots (2.2 ml/kg, 1.1 g crude drug/ml) significantly reduced fevers in rabbits injected with Escherichia coli (17).
Oral administration of saikosaponins to rats produced hypothermic and antipyretic effects (5). Furthermore, intraperitoneal injection of the volatile oil (300mg/kg) or saponins (380 and 635 mg/kg) isolated from B. chinense (B. falcatum) roots effectively decreased fever in mice induced by yeast injections (18). Oral administration of 200–800mg/kg of a crude saponin fraction to mice produced sedative, analgesic, and antipyretic effects, but no anticonvulsant effect or reduction in muscle tone was observed (14). Saikosaponins are believed to be the major active antipyretic constituents in Radix Bupleuri extracts.
Analgesic activity of Bupleurum extracts is also supported by in vivo studies. Injections of a crudeBupleurum extract or purified sapogenin A inhibited writhing induced by intraperitoneal injection of acetic acid in mice (5). The saikosaponins appear to be the active analgesic constituents of the drug. Intraperitoneal injection of mice with a total saponin fraction derived from B. chinense (B. falcatum) produced a marked analgesic effect on the pain induced by electroshock (5). Moreover, orally administered saikosaponins were reported to have an analgesic effect in mice (tail pressure test) (5).
Sedative effects
In vivo studies have also confirmed the sedative effects of Radix Bupleuri. Both the crude saikosaponin fraction and saikogenin A are reported to have signifi- cant sedative effects (5). In vivo studies, using the rod climbing test, demonstrated that the sedative effect of the saikosaponins (200–800mg/kg) in mice was similar to that of meprobamate (100mg) (5). Oral administration of saikosides extracted fromB. chinense (B. falcatum) or saikosaponin A has also been reported to prolong cyclobarbital sodium-induced sleep (5). Furthermore, intraperitoneal injection of saikogenin A inhibited rod climbing in mice and antagonized the stimulant effects of metamfetamine and caffeine (5).
Anti-inflammatory activity
Anti-inflammatory activity of Radix Bupleuri has been demonstrated by in vivo studies. Intraperitoneal injection of the saponin fraction, the volatile oil, or a crude extract from B. chinense (B. falcatum) significantly inhibited carrageenin-induced rat paw oedema (5). The saikosaponins are the active antiinflammatory constituents of the drug (19, 20). Oral administration of a crude saikosaponin fraction (2 g/kg) from B. falcatum inhibited dextran-, serotonin-, or croton oil-induced rat paw oedema (5, 21). Structure–activity correlations have revealed that saikosaponins A and D both have anti-inflammatory activity, while saikosaponin C does not (22). The potency of anti-inflammatory activity of the saikosaponins is similar to that of prednisolone (5).
Immune regulation activity
In vitro studies have demonstrated that a hot-water extract from the root of B. falcatum enhanced the antibody response and inhibited mitogen-induced lymphocyte transformation (23). An acidic pectic polysaccharide, bupleuran 2IIb, isolated from the roots of B. falcatum, was found to be a potent enhancer of immune complex binding to macrophages (24). The activity of this polysaccharide appeared to be due to its ability to enhance the Fc receptor function of macrophages. This study has shown that the binding of glucose oxidase– antiglucose oxidase complexes (a model of immune complexes) to murine peritoneal macrophages was stimulated by treatment with the polysaccharide (24). Bupleuran 2IIb appears to up-regulate both FcRI and FcRII receptor expression on the macrophage surface in a dose-dependent manner (25). The upregulation of the Fc receptor by bupleuran 2IIb depends on an increase in intracellular calcium and activation of calmodulin (25). Only saikosaponin D has been shown to enhance Fc receptor expression of thioglycollate-elicited murine peritoneal macrophages in vitro (26). This activity appears to be due to the translocation of FcR from the internal pool to the cell surface. In vitro studies with saikosaponin D have shown that this compound was able to control bidirectionally the growth response of T lymphocytes stimulated by concanavalin A, anti-CD3 monoclonal antibody, and calcium ionophore A23187 plus phorbol 12-myristate 13-acetate (27). Saikosaponin D also promoted interleukin-2 production and receptor expression, as well as c-fos gene transcription (28). The results of this study suggest that saikosaponin D exerts its immunostimulant effects by modification of T lymphocyte function (28).
Antiulcer activity
Antiulcer activity of Radix Bupleuri has been demonstrated both in vivo and in vitro. A polysaccharide fraction of a hot-water extract of the root of B. falcatum was reported to inhibit significantly hydrochloric acid- or ethanol-induced ulcerogenesis in mice (15). The polysaccharide fraction (BR-2, 100mg/kg) had potent antiulcer activity, and its activity was similar to that of sucralfate (100 mg/kg) (29). BR-2 significantly protected against a variety of gastric lesions, water-immersion stress ulcer and pylorus-ligation ulcer in mice and rats (29). By oral, intraperitoneal, or subcutaneous administration, BR-2 was further found to be effective against hydrochloric acid- or ethanol-induced gastric lesions suggesting that BR-2 acted both locally and systemically (29). The mechanism of antiulcer action appears to be due to a reinforcement of the protective mucosal barrier as well as an antisecretory action on acid and pepsin (30). Saponins isolated from B. falcatum root have also been reported to have weak antiulcer activity in the pylorus-ligation ulcer model (30).
Hepatoprotectant activity
Crude saponins of B. falcatum, administered orally to rats at a daily dose of 500mg/kg for 3 days, normalized liver functions as determined by serum alkaline phosphatase levels in rats treated with carbon tetrachloride (31). Treatment of rats with saikosaponins 2 hours before treatment with D-galactosamine inhibited the increase in serum aspartate aminotransferase and alanine aminotransferase levels produced by damage of liver tissues (31). Conversely, saikosaponins did not affect an increase in serum alanine aminotransferase and experimental cirrhosis in rats caused by carbon tetrachloride intoxication (32).
Clinical pharmacology
Antipyretic activity
The antipyretic activity of B. chinense (B. falcatum) has been investigated in patients with fevers caused by the common cold, influenza, malaria, and pneumonia (5). In one clinical study of 143 patients treated with the herb, fevers subsided within 24 hours in 98.1% of all cases of influenza, and in 87.9% of all cases of the common cold (5, 33). In another study, 40 patients with fever of pathological origin had a significant reduction in fever (1–2°C), but the antipyretic effect of Radix Bupleuri in these patients was transient unless combined with antibiotic therapy (5, 34).
Contraindications
No information available.
Warnings
Radix Bupleuri causes sedation when used in large doses (5); therefore, patients should be cautious when operating a motor vehicle or hazardous machinery.
Precautions
Drug interactions
The use of alcohol, sedatives and other central nervous system depressants in conjunction with Radix Bupleuri may cause synergistic sedative effects. No clinical studies have evaluated this possible interaction; however, patients should be cautioned about taking the drug with alcohol, sedatives, or other drugs known to cause depression of the central nervous system.
Carcinogenesis, mutagenesis, impairment of fertility
Methanolic extracts of B. chinense (B. falcatum) were not mutagenic in the modified Ames test usingSalmonella typhimurium TA 98 and TA 100, in the presence or absence of rat liver S-9 mix (35, 36). Furthermore, hot-water extracts of Bupleurum were shown to have antimutagenic activity in AFB1-induced mutagenesis in the mouse Salmonella typhi/mammalian microsomal system (Ames test) (strain TA 98) and in the in vivo mouse bone marrow cell chromosome aberration and mouse bone marrow eosinophil micronucleus test (37). There is one report that a hot-water extract of B. falcatum enhanced the mutagenic activity of Trp-P-1 with S9 mix in Salmonella typhimurium (38).
Pregnancy: teratogenic and non-teratogenic effects
No data available; therefore, B. falcatum should not be administered during pregnancy.
Nursing mothers
Excretion of the drug into breast milk and its effects on the newborn infant have not been established; therefore, Bupleurum should not be administered to nursing women.
Paediatric use
Guidelines for the administration of the drug to children are not available.
Other precautions
No information available concerning general precautions or drug and laboratory test interactions.
Adverse reactions
Mild lassitude, sedation, and drowsiness have been reported as frequent sideeffects (5). Large doses have also been reported to decrease appetite and cause pronounced flatulence and abdominal distension. Three incidents of allergic reactions were reported in patients given intramuscular injections of the drug (5).
Posology
Generally, doses of 3–9g/day (1).
References
1. Pharmacopoeia of the People's Republic of China (English ed.). Guangzhou, Guangdong Science and Technology Press, 1992.
2. The Pharmacopoeia of Japan XII. Tokyo, The Society of Japanese Pharmacopoeia, 1991.
3. Wolf H. Umbelliferae-Apioideae-Bupleurum, Trinia et reliqceae Ammineae hecteroclitae. In: Engler A, ed. Pflanzenreich IV. Leipzig, Verlag von Wilhelm Engelmann, 1910.
4. Keys JD. T, Chinese herbs, their botany, chemistry and pharmacodynamics. Rutland, VT, CE Tuttle, 1976.
5. Chang HM, But PPH, eds. Pharmacology and applications of Chinese materia medica, Vol. 2. Singapore, World Scientific Publishing, 1987.
6. Nasir E. Umbelliferae. In: Nasir E, Ali SI, eds. Flora of West Pakistan. Karachi, Pakistan, Stewart Herbarium, 1972:60.
7. Quality control methods for medicinal plant materials. Geneva, World Health Organization, 1998.
8. Deutsches Arzneibuch 1996. Vol. 2. Methoden der Biologie. Stuttgart, Deutscher Apotheker Verlag, 1996.
9. European Pharmacopoeia, 3rd ed. Strasbourg, Council of Europe, 1997.
10. Guidelines for predicting dietary intake of pesticide residues, 2nd rev. ed. Geneva, World Health Organization, 1997 (unpublished document WHO/FSF/FOS/97.7; available from Food Safety, WHO, 1211 Geneva 27, Switzerland).
11. Hiai S et al. A simultaneous colorimetric estimation of biologically active and inactive saikosaponins in Bupleurum falcatum extracts. Planta medica, 1976, 29:247– 257.
12. Shimizu K, Amagaya S, Ogihara Y. Separation and quantitative analysis of saikosaponins by high-performance liquid chromatography. Journal of chromatography, 1986, 268:85–91.
13. Han DS, Lee DK. Separation and determination of saikosaponins in Bupleuri Radix with HPLC.Korean journal of pharmacognosy, 1985, 16:175–179.
14. Tang W, Eisenbrand G, eds. Chinese drugs of plant origins, chemistry, pharmacology and use in traditional and modern medicine. Berlin, Springer-Verlag, 1992.
15. Yamada H. Purification of anti-ulcer polysaccharides from the roots of Bupleurum falcatum. Planta medica, 1991, 57:555–559.
16. Yamada H, Hirano M, Kiyohara H. Partial structure of an anti-ulcer pectic polysaccharide from the roots of Bupleurum falcatum L. Carbohydrate research, 1991, 219:173– 192.
17. Zhu Y. Pharmacology and applications of Chinese medicinal materials. Beijing, People's Medical Publishing House, 1958.
18. Zhou ZC et al. Chinese pharmaceutical bulletin, 1979, 14:252 (article in Chinese).
19. Yamamoto M, Kumagai A, Yamamura Y. Structure and actions of saikosaponins isolated fromBupleurum falcatum L. I. Anti-inflammatory action of saikosaponins. Arzneimittel-Forschung, 1974, 25:1021–1023.
20. Abe H et al. Pharmacological actions of saikosaponins isolated from Bupleurum falcatum. 1. Effects of saikosaponins on liver function. Planta medica, 1980, 40:366– 372.
21. Shibata M et al. Pharmacological studies on the Chinese crude drug saiko, Bupleurum falcatum. Hoshi yakka daigaku kiyo, 1974, 16:77.
22. Shibata S. Medicinal chemistry of triterpenoid saponins and sapogenins. Proceedings of the 4th Asian Symposium on Medicinal Plants and Spices. Bangkok, Mahidol University, 1981:59–70.
23. Mizoguchi Y et al. Effects of saiko on antibody response and mitogen-induced lymphocyte transformation in vitro. Journal of medical and pharmaceutical society for WAKAN-YAKU, 1985, 2:330–336.
24. Matsumoto T et al. The pectic polysaccharide from Bupleurum falcatum L. enhances immune-complexes binding to peritoneal macrophages through Fc receptor expression. International journal of immunopharmacology, 1993, 15:683–693.
25. Yamada H. Pectic polysaccharides from Chinese herbs-structure and biological activity.Carbohydrate polymers, 1994, 25:269–276.
26. Matsumoto T, Yamada H. Regulation of immune complex binding of macrophages by pectic polysaccharide from Bupleurum falcatum L.-pharmacological evidence for the requirement of intracellular calcium/calmodulin on Fc receptor up-regulation by bupleuran 2iib. Journal of pharmacy and pharmacology, 1995, 47:152–156.
27. Ushio Y, Abe H. Effects of saikosaponin-D on the functions and morphology of macrophages.International journal of immunopharmacology, 1991, 13:493–499.
28. Kato M et al. Characterization of the immunoregulatory action of saikosaponin D. Cellular immunology, 1994, 159:15–25.
29. Sun XB, Matsumoto T, Yamada H. Effects of a polysaccharide fraction from the roots of Bupleurum falcatum L. on experimental gastric ulcer models in rats and mice. Journal of pharmacy and pharmacology, 1991, 43:699–704.
30. Shibata M et al. Some pharmacological studies on the crude drugs possessing antiinflammatory properties of the Bupleurum and the leaves of fig. Shoyakugaku zasshi, 1976, 30:62–66.
31. Arichi S, Konishi H, Abe H. Studies on the mechanism of action of saikosaponin. I. Effects of saikosaponin on hepatic injury induced by D-galactosamine. Kanzo, 1978, 19:430–435.
32. Zhao MQ et al. Preventive and therapeutic effects of glycyrrhizin, glycyrrhetic acid and saikosides on experimental cirrhosis in rats. Yao hsueh hsueh pao, 1983, 18:325– 331.
33. Nanjing Medical College. Encyclopedia of Chinese materia medica, Vol. 2. Shanghai, Shanghai People's Publishing House, 1978:3763.
34. Wuxi First People's Hospital. Wuxi yiyao [Wuxi medical journal], 1973, 1:42 (article in Chinese).
35. Yamamoto H, Mizutani T, Nomura H. Studies on the mutagenicity of crude drug extracts. I.Yakugaku zasshi, 1982, 102:596–601.
36. Sakai Y et al. Effects of medicinal plant extracts from Chinese herbal medicines on the mutagenic activity of benzo[a]pyrene. Mutation research, 1988, 206:327–334.
37. Liu DX. Antimutagenicity screening of water extracts from 102 kinds of Chinese medicinal herbs.Chung-kuo tung yao tsa chih, 1990, 15:640–642.
38. Niikawa M et al. Enhancement of the mutagenicity of TRP-P-1, TRP-P-2 and benzo[alpha]pyrene by Bupleuri radix extract. Chemical and pharmaceutical bulletin, 1990, 38:2035–2039.

30 Mayıs 2013 Perşembe

Brucea (Brucea Javanica) WHO Monograph - EN

Definition
Fructus Bruceae consists of the dried ripe fruits of Brucea javanica (L.) Merr. (Simaroubaceae) (1, 2).
Synonyms
Brucea amarissima Desv. ex Gomes, B. sumatrana Roxb., Gonus amarissimus Lour., Lussa amarissima O. Ktze (2, 3).
Selected vernacular names
Biji makassar, bulah makassar, Java brucea, k'u-shen-tzu, kho sam, ko-sam, kusheng- tzu, nha dàm tùr, raat cha dat, raat dat, ratchadat, sàu dau rùng, xoan rùng, ya tan tzu, ya-dan-zi, yadãnzi (17).
Description
A shrub or small tree, 1–3 m high; younger parts softly pubescent. Leaves compound-paripinnate; leaflets 5–11, oval-lanceolate, 5–10cm long by 2–4cm wide; apex acuminate, base broadly cuneate and often somewhat oblique; margin serrate; both surfaces densely pubescent, especially the underside. Flowers minute, purple, in numerous small cymes or clusters collected into axillary panicles. Sepals 4, connate at the base. Petals 4, villous, glandular at the tips. Male flowers, stamens 4, pistil reduced to a stigma; female flowers, stamens 4, much reduced. Ovary with 4 free carpels. Fruit and drupe ovoid, black when ripe. Seeds, compressed, rugose, blackish brown (3–5).
Plant material of interest: dried ripe fruit or seed
Fruit also refers to the kernel or seed with the pulp removed (3, 4).
General appearance
The fruit is ovoid, 6–10mm long by 4–7mm in diameter. Externally black or brown, with raised reticulate wrinkles, the lumen irregularly polygonal, obviously ribbed at both sides. Apex acuminate, base having a dented fruit stalk scar, shell hard and brittle. Seeds ovoid, 5–6mm long by 3–5mm in diameter, externally yellowish white, reticulate; testa thin, cotyledons milky white and oily (1, 3, 4).
Organoleptic properties
Odour slight; taste, very bitter (1, 4).
Microscopic characteristics
The pulverized pericarp is brown. Epidermal cells polygonal, with brown cellular contents; parenchymatous cells polygonal, containing clusters of calcium oxalate prisms, up to 30 mm in diameter. Stone cells subrounded or polygonal, 14–38mm in diameter (1).
Powdered plant material
Powdered seeds yellowish white. Testa cells polygonal and slightly elongated. Endosperm and cotyledon cells contain aleurone grains (1).
Geographical distribution
Indigenous to China, India, Indonesia, and Viet Nam (3, 4).
General identity tests
Macroscopic and microscopic examinations (1, 3, 4).
Purity tests
Microbiology
The test for Salmonella spp. in Fructus Bruceae products should be negative. The maximum acceptable limits of other microorganisms are as follows (810). For preparation of decoction: aerobic bacteria-not more than 107/g; fungi-not more than 105/g; Escherichia coli-not more than 102/g. Preparations (capsules) for internal use: aerobic bacteria-not more than 105/g; fungi-not more than 104/g; enterobacteria and certain Gram-negative bacteria-not more than 103/g; Escherichia coli-0/g.
Foreign organic matter
Not more than 2% (2).
Total ash
Not more than 6% (2).
Acid-insoluble ash
Not more than 0.6% (2).
Water-soluble extractive
Not less than 18% (2).
Dilute ethanol-soluble extractive
Not less than 26% (2).
Pesticide residues
To be established in accordance with national requirements. Normally, the maximum residue limit of aldrin and dieldrin in Fructus Bruceae is not more than 0.05 mg/kg (10). For other pesticides, see WHO guidelines on quality control methods for medicinal plants (8) and guidelines on predicting dietary intake of pesticide residues (11).
Heavy metals
Recommended lead and cadmium levels are no more than 10.0 and 0.3mg/kg, respectively, in the final dosage form of the plant material (8).
Radioactive residues
For analysis of strontium-90, iodine-131, caesium-134, caesium-137, and plutonium-239, see WHO guidelines on quality control methods for medicinal plants (8).
Other purity tests
Chemical and moisture tests to be established in accordance with national requirements.
Chemical assays
Contains bruceosides and related quassinoids. Quantitative content requirement to be established. Quantitative determination of quassinoid triterpenes by a high-performance liquid chromatographic method developed for the determination of bruceoside A (12).
Major chemical constituents
Quassinoid triterpenes, including bruceantin, bruceantinol, bruceantinoside A, bruceins A–G and Q, brucein E 2-O-β-D-glucoside, bruceolide, bruceosides A– C, brusatol, dehydrobruceantinol, dehydrobruceins A and B, dehydrobrusatol, dihydrobrucein A, yadanzigan, yadanziolides A–D, and yadanziosides A–P predominate as the secondary metabolite constituents (13, 14). Representative quassinoid structures are presented in the figure.
Dosage forms
Seeds for decoction, or capsules (1, 3, 4). Store in airtight container, protected from light and moisture (1).
Medicinal uses
Uses supported by clinical data
None.
Uses described in pharmacopoeias and in traditional systems of medicine
Treatment of amoebic dysentery and malaria (1, 3, 14, 15).
Uses described in folk medicine, not supported by experimental or clinical data
As a poultice on boils, to treat ringworm, whipworm, roundworm and tapeworm, scurf, centipede bites, haemorrhoids, and enlarged spleen (3–6). The seed and seed oil have been used in the treatment of warts and corns (1, 4). Fructus Bruceae has been used in the treatment of trichomoniasis, corns and verrucae (6).
Pharmacology
Experimental pharmacology
Amoebicidal and antibacterial activity
A number of in vitro studies have indicated that extracts of Brucea javanica kernels are effective amoebicides. In one such study, a crude butanol extract of B. javanica was highly active against Entamoeba histolytica (16). This amoebicidal activity was associated with two polar compounds isolated from the extract, bruceantin and brucein C, which are quassinoid constituents (16). (Brucea quassinoids were active against E. histolytica and other protozoa in vitro (17, 18).) The quassinoids were potent inhibitors of protein synthesis both in mammalian cells and in malaria parasites, and it has been suggested that this effect accounts for their amoebicidal activity (17). In one other investigation, brusatol, another quassinoid isolated from the seeds of B. javanica, was also reported to be effective in the treatment of dysentery (19). Extracts from the kernels of B. javanica have also been reported to possess antibacterial activity against Shigella shiga, S. flexneri, S. boydii, Salmonella lexington, Salmonella derby, Salmonella typhi type II, Vibrio cholerae inaba and Vibrio cholerae ogawa (20).
Antimalarial activity
Numerous in vitro and in vivo studies have demonstrated the antiplasmodial activity of Fructus Bruceae extracts. In vitro studies have determined that bruceantin, a quassinoid constituent of the drug, exhibited significant antiplasmodial activity against Plasmodium falciparum (21, 22). Extracts of the drug were also active in vitro against chloroquine-resistant P. falciparum (23, 24) and in vivo against P. berghei (mice) (23, 25). Nine quassinoid constituents of the drug had in vitro IC50 values of 0.046–0.0008 mg/ml against chloroquine-resistant P. falciparum strain K-1 (23). Four of these compounds were also active in vivo against P. berghei infections in mice after oral dosing (23), and three of the compounds, bruceins A–C, had in vitro activity comparable to that of the antimalarial drug mefloquine (24). Bruceolide, another quassinoid constituent of B. javanica, was also effective in vivo (mice) against P. berghei, and was reported to be more effective than chloroquine (25). A recent in vitro screening of quassinoids against various protozoa showed that brucein D and brusatol have very selective inhibitory activity against P. falciparum (17).
Quassinoids isolated from B. javanica are reported to have cytotoxic activity in vitro (17, 26, 27). Bruceantin was tested in phase I clinical cancer trials, but no tumour regression was observed (28, 29).
Clinical pharmacology
Brucea javanica fruit extracts have been used clinically in the treatment of amoebic dysentery (14, 15). These investigations indicated that the antidysenteric activity of the Brucea extract was less effective than that of emetine (14, 15).
Contraindications
Fructus Bruceae should not be administered to children or pregnant women (6).
Warnings
No information available.
Precautions
Pregnancy: teratogenic and non-teratogenic effects
No data available. Preparations containing Fructus Bruceae must not be administered to pregnant women (6).
Nursing mothers
Excretion of Fructus Bruceae into breast milk and its effects on infants have not been established; therefore this drug should not be administered to nursing women.
Paediatric use
Fructus Bruceae should not be administered to young children (6).
Other precautions
No information available about general precautions or precautions concerning carcinogenesis, mutagenesis, or impairment of fertility; drug interactions; or drug and laboratory test interactions.
Adverse reactions
Some cases of anaphylaxis have been reported after external applications of the fruits of B. javanica (30).
Posology
Daily dose to treat amoebiasis, 4–16g as a decoction or powder in three divided doses for 3–7 days (3); to treat malaria, 3–6g in three divided doses after meals for 4 or 5 days (3).
References
1. Pharmacopoeia of the People's Republic of China (English ed.). Guangzhou, Guangdong Science and Technology Press, 1992.
2. Materia medika Indonesia, Jilid I. Jakarta, Departemen Kesehatan, Republik Indonesia, 1977.
3. Medicinal plants in Viet Nam. Manila. World Health Organization Regional Office for the Western Pacific, 1990 (WHO Regional Publications, Western Pacific Series, No. 3).
4. Medicinal plants in China. Manila, World Health Organization, 1989 (WHO Regional Publications, Western Pacific Series, No. 2).
5. Keys JD. Chinese herbs, their botany, chemistry and pharmacodynamics. Rutland, VT, CE Tuttle, 1976.
6. Hsu HY. Oriental materia medica, a concise guide. Long Beach, CA, Oriental Healing Arts Institute, 1986.
7. Farnsworth NR, ed. NAPRALERT database. Chicago, University of Illinois at Chicago, IL, August 8, 1995 production (an on-line database available directly through the University of Illinois at Chicago or through the Scientific and Technical Network (STN) of Chemical Abstracts Services).
8. Quality control methods for medicinal plant materials. Geneva, World Health Organization, 1998.
9. Deutsches Arzneibuch 1996. Vol. 2. Methoden der Biologie. Stuttgart, Deutscher Apotheker Verlag, 1996.
10. European Pharmacopoeia, 3rd ed. Strasbourg, Council of Europe, 1997.
11. Guidelines for predicting dietary intake of pesticide residues, 2nd rev. ed. Geneva, World Health Organization, 1997 (unpublished document WHO/FSF/FOS/97.7; available from Food Safety, WHO, 1211 Geneva 27, Switzerland).
12. Chi H, Wang YP, Zhou TH. Determination of the anticancer drug bruceoside A in the Chinese drug, Yadanzi (Brucea javanica Merr.). Journal of chromatography, 1991, 543:250–256.
13. Polonsky J. Quassinoid bitter principles, II. In: Herz W et al., eds. Progress in the chemistry of organic natural products, Vol. 47. Berlin, Springer-Verlag, 1972.
14. Tang W, Eisenbrand G. Chinese drugs of plant origin, chemistry, pharmacology and use in traditional and modern medicine. Berlin, Springer-Verlag, 1992:207–222.
15. Steak EA. The chemotherapy of protozoan diseases, Vol. 1. Washington, DC, US Government Printing Office, 1972.
16. Keene AT et al. In vitro amoebicidal testing of natural products, Part I. Methodology. Planta medica, 1986, 52:278–285.
17. Wright CW et al. Quassinoids exhibit greater selectivity against Plasmodium falciparum than against Entamoeba histolytica, Giardia intestinalis or Toxoplasma gondii in vitro. Journal of eukaryotic microbiology, 1993, 40:244–246.
18. Wright CW et al. Use of microdilution to assess in vitro antiamoebic activities of Brucea javanica fruit, Simarouba amara stem, and a number of quassinoids. Antimicrobial agents and chemotherapy, 1988, 32:1725–1729.
19. Sato Y, Hasegawa M, Suto N. Identity of brusatol and yatansin, an antidysenteric agent. Agricultural and biological chemistry, 1980, 44:951–952.
20. Wasuwat S et al. Study on antidysentery and antidiarrheal properties of extracts of Brucea amarissima. Bangkok, Applied Science Research Center of Thailand, 1971:14 (Research Project Report 17/10, 2).
21. O'Neill MJ et al. Plants as sources of antimalarial drugs: in vitro antimalarial activities of some quassinoids. Antimicrobial agents and chemotherapy, 1986, 30:101– 104.
22. Ayudhaya T et al. Study on the in vitro antimalarial activity of some medicinal plants against Plasmodium falciparum. Bulletin of the Department of Medical Sciences (India), 1987, 9:33–38.
23. O'Neill MJ. Plants as sources of antimalarial drugs, Part 4. Activity of Brucea javanica fruits against chloroquine-resistant Plasmodium falciparum in vitro and against Plasmodium berghei in vivo. Journal of natural products, 1987, 50:41–48.
24. Pavanand K et al. In vitro antimalarial activity of Brucea javanica against multi-drug resistant Plasmodium falciparum. Planta medica, 1986, 2:108–111.
25. Ngo VT et al. Effectiveness of Brucea sumatrana plant against malaria. Duoc hoc, 1979, 4:15–17.
26. Darwish FA, Evan FJ, Phillipson JD. Cytotoxic bruceolides from Brucea javanica. Journal of pharmacy and pharmacology, 1979, 31:10.
27. Ohnishi S et al. Bruceosides D, E and F, three new cytotoxic quassinoid glycosides from Brucea javanica. Journal of natural products, 1995, 58:1032–1038.
28. Liesmann J et al. Phase I study on Bruceantin administered on a weekly schedule. Cancer treatment report, 1981, 65:883–885.
29. Bedikian AY et al. Initial clinical studies with bruceantin. Cancer treatment report, 1979, 63:1843–1847.
30. Zheng GQ et al. A report on three cases of anaphylaxis caused by external application of the fruit of Brucea javanica. Bulletin of the Chinese materia medica, 1986:11–12.