Bryophyllum pinnatum poisoning of cattle

Repurposing of Bryophyllum pinnatum for dysmenorrhea treatment: a systematic scoping review and case series

Dysmenorrhea affects women throughout their reproductive years but there has been a lack of effective and well-tolerated treatment options. Pain symptoms mainly result from inflammatory processes and increased contractile activity in the myometrium. The reported use of Bryophyllum pinnatum preparations against inflammation and pain in ethnomedicine as well as current pharmacological data on their inhibition of myometrial contractility led us to hypothesize that this medicinal plant might be a new treatment option for dysmenorrhea. In the first part of the present work, clinical, in vivo, and in vitro studies on the anti-nociceptive and anti-inflammatory, as well as on myometrium relaxing properties of B. pinnatum are reviewed. In the second part, cases of five women with dysmenorrhea who were tentatively treated with a B. pinnatum product are described. The review revealed thirty-three experimental in vivo and in vitro studies, but no clinical study, reporting anti-nociceptive and anti-inflammatory effects of B. pinnatum extracts and compounds in a wide range of conditions. Moreover, sixteen publications on smooth muscle contractility revealed relaxing effects. The latter consisted of clinical evidence, as well as of in vivo and in vitro data. The evidence reviewed therefore provided a rational basis for the use of B. pinnatum in the treatment of dysmenorrhea. We subsequently set out to tentatively treat patients with a well-tolerated B. pinnatum product that is registered (without indication) and commonly used in obstetrics and gynecology in Switzerland. All five treated patients reported a reduction in pain symptoms and 4 out of 5 indicated a reduced intake of painkillers during menstruation. Taken together, the reviewed information on the pharmacological properties and clinical evidence of B. pinnatum extracts and compounds as well as the outcomes of all five patients in the case series support our hypothesis in favor of B. pinnatum as a new, well-tolerated therapeutic approach for dysmenorrhea. Prospective clinical studies are urgently needed.

Effects of Bryophyllum pinnatum Administration on Wistar Rat Pregnancy: Biochemical and Histological Aspects

INTRODUCTION

Bryophyllum pinnatum is widely used in folk medicine. It has neuropharmacological, anti-inflammatory, immunomodulatory, antidiabetic, hepatoprotective, and nephroprotective effects, among others. It also acts on uterine contractility. It is prescribed by practitioners of anthroposophic medicine for preterm labor, insomnia, and emotional disorders, and has other potential uses in obstetrics. As all drugs currently used in preterm labor have side effects, new tocolytic agents remain an area of active research.

OBJECTIVE

To evaluate the effect of B. pinnatum mother tincture (MT) on albino rats and their offspring throughout pregnancy from a biochemical and histological standpoint.

METHODS

Longitudinal, prospective, randomized controlled bioassay. This is the second stage of a trial that investigated 60 animals distributed across six equal groups: controls C1 and C2, which received 1 and 25 times the vehicle dose (30% ethanol), B1 and B2 (1- and 25-fold doses of B. pinnatum MT), and B3 and B4 (which received 50- and 100-fold doses of B. pinnatum concentrate). At this stage, blood chemistry parameters (glucose, alanine aminotransferase [ALT], aspartate aminotransferase [AST], creatinine, and blood urea nitrogen) were measured in dams, as well as histological aspects of dam liver, kidney, placenta, and uterine tissue and fetal liver, kidney, heart, and brain.

RESULTS

No differences were found between group B1 (therapeutic dose) and its control C1 in relation to glucose, AST, ALT, and creatinine. Group B2 exhibited lower glucose levels than groups C1, B3, and B4. There was no difference in AST across groups. Groups B3 and B4 exhibited higher ALT levels than groups C1 and B1. Groups B1-B4 exhibited higher urea nitrogen levels than group C1. Creatinine levels were higher in groups B2 and B3 than group C1. On morphological evaluation, fatty infiltration of the liver was observed in the alcoholic vehicle control groups (C1 and C2).

CONCLUSIONS

Daily administration of B. pinnatum at therapeutic doses (group B1) to pregnant albino rats appears to be safe, with reduced glucose at dose B2, elevated ALT at doses B3 and B4, and increased urea at doses B1 to B4 and creatinine at B2 and B3, but never exceeding the normal reference range. It was not associated with histological changes in specimens of the maternal or fetal structures of interest.

Impact of drying processes on Bryophyllum pinnatum phenolic constituents and its anti-inflammatory and antioxidative activities in human erythrocytes

The effect of drying on the phytoconstituents, antioxidative, and anti-inflammatory properties of Bryophyllum pinnatum leaves was investigated. The phenolic constituents were characterized using HPLC-DAD. The aqueous extraction was done and various assays (Inhibition of membrane stabilization, albumin Denaturation and heat-induced hemolysis, malondialdehyde (MDA), and reduced glutathione (GSH) contents, as well as superoxide dismutase (SOD) activity), were carried out on human erythrocytes. The fresh portion (89.12 µg/ml) exhibited the highest potential to inhibit heat-induced hemolysis compared to the standard drug-Diclofenac (91.51 µg/ml). Freeze-dried sample showed the highest inhibitory potential on albumin denaturation ([Freeze-dried-330.72 µg/ml], [Diclofenac-318.63 µg/ml]) and membrane destabilization ([Freeze-dried-331.93 µg/ml], [Diclofenac-289.57 µg/ml]) when compared with Diclofenac. Similarly, the freeze-dried sample showed the highest GSH and SOD level and lowest MDA level when human erythrocytes challenged with tertiary butyl hydroperoxide (tBHP) were treated with the extract. This study confirms the retention of a considerable quantity of bioactive constituents of plants when freeze-dried. PRACTICAL APPLICATIONS: The ideal method of drying Bryophyllum pinnatum and possible anti-inflammatory potential was investigated. This work may apply to the development of anti-inflammatory agents from a natural source with little or no side effect in managing inflammation.

Cytotoxic and genotoxic effects of Kalanchoe pinnata (Lam.) Pers. fresh leaf juice in the cultured human blood lymphocytes

This is the first investigation on the in vitro cytotoxicological and genotoxicological effects of Kalanchoe pinnata (Lam.) Pers. fresh leaf juice, for establishing a safe and effective quantity for use. Peripheral blood of 6 healthy, non-addicted males between 20 and 25 years of age was used for toxicity assessment by 3-(4, 5-dimethylthazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT), mitotic index (MI), sister chromatid exchanges (SCEs) and Cytokinesis Blocked Micronucleus (CBMN) assays. The IC₅₀ of the leaf juice calculated by MTT assay was 155.1 µl. The 50 and70 µl of the juice concentrations were decided after standardization by MI and showed non-significant and significant decrease respectively when compared to control. The SCEs/Cell and SCEs/Chromosome were increased non-significantly (50 µl) and significantly (70 µl),while cell cycle proliferative index, Average generation time and Population doubling time values were non-significant for both doses when compared to the controls. In CBMN assay, the Cytokinesis block proliferation index, cytotoxicity, Micronuclei, Nuclear bud, Nucleoplasmic bridge frequencies and total DNA damage biomarkers showed non-significant changes for both 50 and 70 µl. The changes observed were significant only at 70 µl for MI and SCEs, which were significantly lower than that by positive control indicating a non genotoxic effect. Hence, the fresh leaf juice can be used pharmaceutically as well as traditionally, but for long durations and higher doses should be used with caution, as it can have mutagenic effect at particularly high levels.

Intravenous tocolysis with Bryophyllum pinnatum is better tolerated than beta-agonist application

OBJECTIVE

To compare tolerability and tocolytic outcome between i.v. infused plant extract, Bryophyllum pinnatum, and beta-agonists.

STUDY DESIGN

In a retrospective study, 67 pairs of pregnant women in preterm labor treated with intravenous B. pinnatum or beta-agonists were closely matched for maternal age, gestational age at tocolysis, CTG recorded contractions, cervical effacement, preterm premature rupture of the membranes, and history of preterm labor. Endpoints were prolongation of pregnancy, gestational age at delivery, pre- and postpartum duration of hospitalization, maternal tolerability, neonatal outcome and morbidity.

RESULTS

Pregnant women with B. pinnatum and beta-agonists were equal in the prolongation of pregnancy (6.2 versus 5.4 days, NS), the gestaional age at delivery (38.0 versus 37.1 weeks, NS) and the duration of hospitalisations, but had less adverse effects (34.3 versus 55.2% with palpitation or dyspnea, P=0.02). The neonatal outcome and morbidity in the B. pinnatum group were equal or better (oxygen use 10.4 versus 44.8%, P<0.001; respiratory distress syndrome 4.5 versus 19.4%, P=0.01).

CONCLUSION

In the management of preterm labor B. pinnatum is no less effective than beta-agonists, but is significantly better tolerated.

Effect of Bryophyllum pinnatum versus fenoterol on uterine contractility

OBJECTIVE

To characterise the phytotherapeutic tocolytic Bryophyllum pinnatum in vitro versus the conventional betamimetic, fenoterol, in human myometrium.

STUDY DESIGN

Contractility (endpoints: area under the curve (AUC), amplitude and frequency of isometric force development) was measured in strips of term myometrium biopsied at caesarean section in 14 women and exposed to increasing concentrations of B. pinnatum versus +/- oxytocin 1 U/l.

RESULTS

Inhibition of spontaneous contraction by B. pinnatum was concentration-dependent: 16% at maximum concentration (10(4) mg/l), or 53% that with fenoterol 5 x 10(-8)mol/l. B. pinnatum increased contraction frequency by 91% at constant amplitude and inhibited oxytocin-stimulated contractions by 20% (AUC) at constant amplitude with slightly decreased frequency. Fenoterol decreased contraction AUC by 50% with a significant decrease in frequency.

CONCLUSION

Our in vitro data confirm the tocolytic activity of B. pinnatum observed in alternative medicine centres and may justify further clinical studies.