Dichroa Root

Scientific Name(s): Dichroa febrifuga Lour. Family: Saxifragaceae.

Common Name(s): Dichroa root , ch'ang shan (Chinese), huang ch'ang-shan ( yellow alum root ), t'u ch'ang-shan ( native alum root ), chi-ku feng , chi-ku ch'ang-shan ( chicken-bone alum root ), pai ch'ang-shan ( white alum root ), ta chin-tao ( big golden sword ), chi-fen ts'ao ( chicken-droppings grass ).

Uses

Dichroa root has been used to treat malaria for centuries in China.

Dosing

There are no recent clinical studies of dichroa root to provide a basis for dosage recommendations.

Contraindications

Contraindications have not yet been identified.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking. Avoid use.

Interactions

None well documented.

Adverse Reactions

Possible adverse effects include nausea, vomiting, and diarrhea.

Toxicology

Little information concerning toxicity of dichroa root is available. 1

Botany

Dichroa root comes from a deciduous shrub that prefers damp areas such as wooded valleys or stream edges. The roots and leaves are used medicinally. The plant bears light-blue flowers and blue-colored berries. 1 , 2

History

For many centuries in China, dichroa root was used to treat malaria. 3 , 4 One of the earliest recorded uses of “plants as medicine” include dichroa root. 5 Chinese scholar/emperor Shen Nung (c. 2735 BC) recorded the plant's effectiveness in treating fevers caused by malaria parasites. 6

Chemistry

Alkaloid febrifugine and its isomer isofebrifugine were isolated during World War II in order to study their effects against malaria. 3 , 4 Febrifugine is the main alkaloidal constituent present. 7

Uses and Pharmacology

Antimalarial

With drug resistance from medications such as chloroquine and quinine becoming prevalent, researchers sought other possible antimalarial sources. Isolates of D. febrifuga , febrifugine, and isofebrifugine were found to be the active principles against malaria. However, chemists could not separate adverse effects such as nausea, vomiting, and diarrhea from its beneficial actions. 6 , 8 , 9

Animal data

Febrifugine and isofebrifugine in certain preparations (eg, acetone extract) demonstrated high antimalarial activity against Plasmodium falciparum and P. berghei . 4 Aqueous extract of dichroa studied in mice against P. berghei demonstrated an inhibition of infection rate and an increase in mean survival time. 10 Two reports suggest that dichroa extracts alter nitric oxide (NO) concentrations. It was found that infected mice administered febrifugine at 1 mg/kg/day orally increased NO production, thus contributing to host defense against malaria infection. Febrifugine reduced mortality and parasitemia, as well as increased plasma NO concentrations. 7 Febrifugine had the same NO increasing effects in mouse peritoneal macrophages with dose-dependent activations. 11 However, another report demonstrates aqueous extract of dichroa decreasing NO production as well as tumor necrosis factor, which plays a role in endotoxin-mediated shock and inflammation. In mouse macrophages, NO synthase and NO serum levels were decreased by the extract, suggesting a suppression of inflammatory response and possible use as an anti-inflammatory drug. 12

Clinical data

Research reveals no clinical data regarding the use of dichroa for malaria.

Other uses

Changrolin, a Chinese antiarrhythmic drug derived from dichroa, has been studied for its antiarrhythmic effects in small mammal cardiac cells. 13

Other claims from animal studies for dichroa root include its use for bronchitis to remove sputum, as an emetic, and as an antipyretic. 1 , 3

Dosage

There are no recent clinical studies of dichroa root to provide a basis for dosage recommendations.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking. Avoid use.

Interactions

None well documented.

Adverse Reactions

Nausea, vomiting, and diarrhea has been reported. 6 , 14

Toxicology

Little information concerning toxicity of dichroa root is available. 6 , 14

Bibliography

1. A Barefoot Doctor's Manual: Practical Chinese Medicine and Health. Bethesda, MD: US Department of Health, Education & Welfare; 1977;878.
2. http://www.gardenbed.com/D/4564.cfm .
3. Hocking, G. A Dictionary of Natural Products . Medford, NJ: Plexus Publishing, Inc.; 1977;253.
4. Takaya Y, et al. New type of febrifugine analogues, bearing a quinolizidine moiety, show potent antimalarial activity against Plasmodium malaria parasite. J Med Chem . 1999;42:3163-3166.
5. Taylor J. Introductory Medicinal Chemistry . Chichester, UK: Ellis Horwood Ltd.; 1981.
6. Burger, A. Understanding Medications. What the Label Doesn't Tell You. Washington, DC: American Chemical Society Publication; 1999.
7. Murata K, et al. Potentiation by febrifugine of host defense in mice against Plasmodium berghei NK65. Biochem Pharmacol . 1999;58(10):1593-1601.
8. Zhao C. Effect of Dichroa febrifuga L. on chloroquinsensible and chloroquinresistant malaria parasites. [German]. J Tongji Med Univ . 1986;6(2):112-115.
9. Zeng, Y. Development of plant derived drugs in China. Pharm Week . 1982;117:1037-1043.
10. Gopal H, et al. Effect of Dichroa febrifuga on Plasmodium berghei . Indian J Pathol Microbiol . 1982;25(4):269-272.
11. Murata K, et al. Enhancement of NO production in activated macrophages in vivo by an antimalarial crude drug, Dichroa febrifuga . J Nat Prod . 1998;61(6):729-733.
12. Kim Y, et al. The production of nitric oxide and TNF-alpha in peritoneal macrophages is inhibited by Dichroa febrifuga Lour. J Ethnopharmacol . 2000;69(1):35-43.
13. Lu L, et al. Electrophysiological effects of changrolin, an antiarrhythmic agent derived from Dichroa febrifuga , on guinea pig and rabbit heart cells. Clin Exp Pharmacol Physiol . 1995;22(5):337-341.
14. http://ascaris.med.tmd.ac.jp/JSP/68meeting/program2.html .

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