The Biological Effects of Kambo: Is There a Relationship Between its Administration and Sudden Death?

KAMBO: NATURAL DRUG OR POTENTIAL TOXIC AGENT? A LITERATURE REVIEW OF ACUTE POISONING CASES

Kambo is the name of a natural substance derived from the glandular secretions of the amphibian Phyllomedusa bicolor, a species native to regions in South America. The communities living in these areas administer the substance generally transdermally during rituals for religious-purifying purposes, producing small skin burns. The scientific literature has reported some cases of intoxication following the use of Kambo but this aspect is still poorly understood. In fact, no shared therapy protocols exist for these events nor any real legislation on Kambo. The purpose of this work was to examine all cases of acute intoxication resulting from the administration of Kambo and published over the last 10 years, illustrating clinical signs, laboratory findings, instrumental tests, and therapy. The several cases identified in our review confirm that acute Kambo intoxication can occur, with serious and life-threatening effects. We developed a protocol aimed at the early diagnosis of cases of suspected acute intoxication by creating a treatment algorithm. The study aims to investigate the pathophysiology of these events in humans, proposing a protocol for the diagnosis and treatment of these cases that can be used by healthcare professionals.

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The use of Kambo has spread for distribution worldwide through numerous websites.

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The literature review confirmed that acute Kambo intoxication include possible side effects.

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Intoxication may affect various systems with laboratory or instrumental alterations.

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Intoxication may be reversible if promptly diagnosed and treated.

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An algorithm with adequate triage can support diagnosis and treatment.

Review of the physiological effects of Phyllomedusa bicolor skin secretion peptides on humans receiving Kambô

Kambô is an Amazonian ritual which includes the application of the defensive secretion of the Phyllomedusa bicolor frog to superficial burns made on the skin of human participants. The secretion, which contains a range of biologically active linear peptides, induces a short purgative experience that is extensively reported by participants to leave them with positive physical, emotional and spiritual after-effects. Various peptides identified in the secretion exert analgesic, vascular, and gastric effects in vivo, and antimicrobial and anti-cancer effects, among others, in vitro. While there has been some investigation into the physiological effects of various individual peptides isolated from the P. bicolor secretion, very little is known about the putative synergistic effects of concurrent administration of the complete substance through the transdermal methods used traditionally in the Kambô ritual. In this review and commentary, the authors summarize the existing biological information from animal research on peptides from the P. bicolor secretion, then consider the evidence in the context of Kambô administration to humans. The presented information suggests that specific peptides are likely to contribute to analogous physiological effects of Kambô in humans. The possibility that beyond their physiological action, the experiential or phenomenological component of these effects may have therapeutic applications is discussed, concluding with a consideration of the feasibility of human clinical research.

Connected to the spirit of the frog: An Internet-based survey on Kambô, the secretion of the Amazonian Giant Maki Frog (Phyllomedusa bicolor): Motivations for use, settings and subjective experiences

BACKGROUND/AIM

Kambô is a name for the secretion of the Giant Maki Frog (Phyllomedusa bicolor), which has been used by indigenous cultures from the Amazonas basin and has recently become popular in alternative healing circles in Western countries, with a certain overlap with psychedelic self-exploration.

METHODS

We carried out an online-based survey in English (54.92%) and German investigating motivations for using Kambô, settings in which rituals take place, and subjective experiences during and after the application.

RESULTS

Participants (n = 386, mean age: 38.08 years, (standard deviation = 9.95)) were well-educated individuals with an increased lifetime prevalence of the use of ayahuasca (67.88%). A plethora of motivations for using Kambô was reported, including general healing, detoxification and spiritual growth. Acute effects included severe physical reactions and mild psychoactive effects, most surprisingly, the feeling of being connected to the frog's spirit (41.97%), whereas predominantly positive persisting psychological effects were reported. Few participants reported long-lasting physical (2.85%) or mental (1.81%) health problems which they attributed to Kambô. Of the participants, 87.31% reported an increase in personal well-being or life satisfaction, and 64.26% considered Kambô to have been at least of 'very much' spiritual significance for their lives.

CONCLUSIONS

The majority of users claimed beneficial effects including more health-orientated behaviors, whereas only very few participants complained about new health problems which they ascribed to Kambô. In retrospect, Kambô was given a high personal and spiritual significance by many participants. Additional research is needed to determine in how far reported effects are modulated by setting and subjective expectations.

Kambô-Induced Systemic Inflammatory Response: A Case Report of Acute Disease Progression of Cholangiocarcinoma

Kambô is a cleansing ritual involving the application of a toxin produced by the giant leaf frog (Phyllomedusa bicolor). The Kambô ritual has increasingly been adopted among cancer patients in Europe. Accumulating data indicate various adverse effects. We report another severe adverse reaction to Kambô, a systemic inflammatory response syndrome mimicking disease progression in a patient with cholangiocarcinoma. We describe a systemic reaction to Kambô, manifested as tachycardia, tachypnea, impaired liver cholestatic enzymes, and enlargement of lymphadenopathy mimicking disease progression. The clinical features and onset of symptoms, the rapid reaction, and the lack of other identified causes make the diagnosis of Kambô-induced SIRS highly probable. This case report calls for future studies examining standard oncological care such as chemotherapy, radiotherapy, and immunotherapy in conjunction with alternative therapy. Additionally, greater awareness and physician education should be promoted, encouraging inquiry of oncology patients’ administration of alternative, complementary, and integrative medicine.

Acute and subacute psychoactive effects of Kambô, the secretion of the Amazonian Giant Maki Frog (Phyllomedusa bicolor): retrospective reports

Kambô, the secretion of the Amazonian Giant Leaf Frog (Phyllomedusa bicolor) contains a plethora of bioactive peptides and was originally used by indigenous communities from the Amazon basin as medicine for improving hunting capacities. In the last 20 years, Kambô has spread to Western urban healing circles. To date it is still controversial whether the acute effects of Kambô include alterations of consciousness similar to known psychoactive substance like serotonergic psychedelics. Here we retrospectively assessed psychological effects of Kambô in a sample of anonymous users (n = 22, mean age: 39 years, ± 8.5; 45.5% female), administering standardized questionnaires for the assessment of altered states of consciousness (ASC), including the Altered States of Consciousness Rating Scale, the Phenomenology of Consciousness Inventory (PCI), the Mystical Experience Questionnaire (MEQ), the Challenging Experience Questionnaire (CEQ) for acute effects and the Persisting Effects Questionnaire (PEQ) and a scale assessing connectedness for subacute effects. The intensity of retrospectively reported acute psychological effects remained on a mild to moderate level, with no psychedelic-type distortions of perception or thinking. Conversely, persisting effects were predominantly described as positive and pleasant, revealing high scores on measures of personal and spiritual significance.

Kambo Frog Poison as a Cause of Esophageal Rupture

The authors present a case of a patient who used Kambo frog poison for body cleansing that induced severe vomiting and led to esophageal rupture followed by tension pneumothorax and septic shock. Kambo is the waxy substance secreted by the nocturnal giant tree frog Phyllomedusa bicolor. Kambo, which is poisonous, is commonly believed in South America to have cleansing and healing properties. As alternative medicine becomes more common, and as more tourists frequent our hospitals, knowledge of these types of ritual related exposures is important for the practicing emergency physician to be aware of.

Dermatomyositis induced by the secretion of Phyllomedusa bicolor or Kambô frog - A case report

The Amazonian Kambô frog, Phyllomedusa bicolor, is commonly known for the potential benefits of its secretion. The Kambô ritual consists in applying the toxin directly to a freshly burnt skin area, since it is believed by natives and shamans to purify and strengthen the body and mind of the user. We describe a 33-year old female with a history of periodic use of Kambô toxin who presented with a 3-week course of asthenia, malaise, myalgia, and proximal muscle weakness predominantly in the lower limbs. She had elevated muscle enzymes and an abnormal electromyography. We used the 2017 European League Against Rheumatism and American College of Rheumatology classification criteria to establish the diagnosis of dermatomyositis. The patient demonstrated clinical response to prednisone, with a complete recovery of signs and symptoms after 8 weeks of treatment. To our knowledge, this is the first case report of dermatomyositis possibly associated with the use of Kambô. The Kambô cleansing ritual is becoming popular in first world countries, but its use may lead to serious side-effects, sometimes life-threatening. In patients presenting with signs and symptoms suggestive of dermatomyositis and a skin line of circle-shaped burns, Phyllomedusa bicolor skin secretion exposure should be suspected.

Dermaseptins, Multifunctional Antimicrobial Peptides: A Review of Their Pharmacology, Effectivity, Mechanism of Action, and Possible Future Directions

Dermaseptins are a group of α-helical shaped polycationic peptides isolated from the Hylid frogs, with antimicrobial effects against bacteria, parasites, protozoa, viruses in vitro. Besides, anti-tumor effects have been demonstrated. However, few animal experiments and no clinical trials have been conducted thus far. This review summarizes the current knowledge on the pharmacology, ethno pharmacology, effectivity against infectious pathogens and tumors cells and the mechanism of action of the Dermaseptins. Future research should focus on further clarification of the mechanisms of action, the effectivity of Dermaseptins against several cancer cell lines and their applicability in humans.

Sudden death and Takayasu's arteritis: The role of histopathological investigation

When death is sudden and unexpected, autopsy may not provide sufficient information to be sure of the cause of death. Some causes can only be identified by microscopy. We report a case of sudden death in a woman who suffered from vertigo and hypertension. The autopsy only showed sclerosis of the thoracic aorta, abdominal aorta and coronary arteries, and the toxicological results were negative and did not explain the cause of death. A microscopic and immunohistochemical analysis of samples from various organs was carried out. The histopathological examination revealed eosinophilia in the aortic wall, consistent with a vasculitis such as Takayasu's arteritis. This case emphasises the association between systemic vasculitis and sudden death, as well as the role of histopathological investigation and the importance of post-mortem diagnosis to prevent similar fatal events among family members.

Can Overuse of Kambô Cause Psychosis?

Kambô is an emerging ritual, which involves the application of the toxin produced by Phyllomedusa bicolor to a freshly burnt area to heal chronic diseases of the mind and body. Due to the widespread use of kambô, more cases of symptomatic health conditions are being discovered. In this case study, we report a patient with psychosis potentially due to the kambô ritual.