Holly

Scientific Name(s): Ilex aquifolium L. (English Holly), Ilex opaca Aiton. (American Holly), and Ilex vomitoria Aiton. (Yaupon). Family: Aquifoliaceae (Holly)

Common Name(s): Holly , American holly , English holly , Oregon holly , Appalachian tea , cassena , Christmas berry , deer berry , Indian holly , Indian black drink , yaupon

Uses

Primarily used as a holiday decoration. No clinical applications exist for holly. Historically, some species have been used in teas as an emetic and CNS stimulant.

Dosing

There are no clinical applications for holly to form a basis for dosing.

Contraindications

Contraindications have not yet been identified.

Pregnancy/Lactation

Documented adverse effects. Avoid use.

Interactions

None well documented.

Adverse Reactions

The spines of some leaves may tear or puncture skin or mucus membranes.

Toxicology

Although no fatalities have been reported, case reports exist of human toxicity. Ingestion can cause vomiting or diarrhea, and may lead to dehydration and electrolyte imbalance. Stupor has been associated with poisoning.

Botany

Ilex species are evergreen trees or shrubs with stiff leathery leaves. The flowers are often white and produce fruits that range in color from black to bright red or yellow. The genus Ilex consists of over 400 species and requires a wet and equable climate. Worldwide distribution exists, except in arctic or arid regions. The major areas of distribution are Central and South America. The North American species are largely ornamental and derived from Central and South American varieties. 1 , 2

History

The plants in the holly family have been used as ornamentals and in herbal medicine for centuries. Historical records show pre-Christian European pagans offering holly branches as gifts during the Roman festival of Saturnalia. Early Christians decorated their homes with holly during the Christmas season, a practice that still continues today. Settlers in the southeastern United States made yaupon tea from I. vomitoria , reserving a stronger decoction for use as an emetic. I. opaca fruit tea was used as a cardiac stimulant by the American Indians; the Chinese used it to treat coronary disease. One of the most economically important species, Ilex paraguayensis or maté tea (see the Maté monograph), has long been cultivated and used in Brazil and Paraguay as a caffeine-containing beverage. The mixed leaves of Ilex cassine , I. vomitoria , and Ilex dahoon have also been used for a hot drink called yaupon or black drink. Drinkers used it ceremonially to “cleanse” themselves, probably due to its sweat- and vomit-inducing effects. Another beverage made from the leaves of I. cassine and I. vomitoria was used as a stimulant in the southern United States during the Civil War. 2 , 3

Chemistry

Most species contain tannins. Analyses of the leaves of I. aquifolium found tannic acid, a bitter glycoside (ilicin), ilexanthin (rutin), and ilicic acid. Some members of the genus, such as I. paraguayensis , contain xanthine alkaloids, such as caffeine, in levels as high as 2%. Other species contain saponins and triterpenes. One review of the chemistry of Ilex documented hundreds of isolated compounds. Selected examples of the various classes of chemical constituents include the following: phenols and phenolic acids (p-hydroxybenzoic acid, arbutin), anthocyanins (pelargondin 3-bioside, cyanidin 3-glucoside), flavonols and flavons (rutin, kaempferol), terpenoids (alpha-amyrin, ursolic acid), sterols (sitosterol, ergosterol), purine alkaloids (caffeine, theobromine), amino acids (aspartic acid, glutamic acid), miscellaneous nitrogen compounds (trigonelline, choline), fatty acids (oleic, linolenic), alkanes and alcohols (nonacosane, mellisyl alcohol), carbohydrates (sugar alcohols, sucrose), vitamins and carotenoids (ascorbic acid, thiamine). 2 , 4 , 5 , 6 , 7

Uses and Pharmacology

Chemical studies to elucidate the constituents of the Ilex species, including I. pubescens , I. vomitoria , and I. asprella , and thereby any potential pharmacological effects, are ongoing. 3 , 5 , 7 However, clinical trials for holly are lacking. For I. paraguayensis see the Maté monograph.

Dosage

There are no clinical applications for holly to form a basis for dosing.

Pregnancy/Lactation

Documented adverse effects. Avoid use. Low birth weight, birth defects, and premature birth have been recorded for the related species I. paraguayensis (maté). 8

Interactions

None well documented.

Adverse Reactions

The leaves of most species are generally considered to be nontoxic, although the spines of some leaves may tear or puncture skin and mucous membranes.

Toxicology

Although no fatalities have been reported, case reports exist of human toxicity. Ingestion of the holly berry can cause vomiting or diarrhea, and may lead to dehydration and electrolyte imbalance. Stupor has been associated with poisoning. Saponins are found in some species of Ilex , but their absorption through intact mucosa is minimal. Saponins generally cause severe diarrhea and GI upset. 9 , 10 , 11

Bibliography

1. Ilex L. USDA, NRCS. 2007. The PLANTS Database ( http://plants.usda.gov , 08 June 2010). National Plant Data Center, Baton Rouge, LA 70874-4490 USA.
2. Alikaridis F. Natural constituents of Ilex species. J. Ethnopharmacol . 1987;20(2):121-144.
3. Yaupon. USDA, NRCS. 2007. The PLANTS Database ( http://plants.usda.gov , 08 June 2010). National Plant Data Center, Baton Rouge, LA 70874-4490 USA.
4. West LG, McLaughlin JL, Eisenbeiss GK. Saponins and triterpenes from Ilex opaca . Phytochemistry . 1977;16(11):1846-1847.
5. Kashiwada Y, Zhang DC, Chen YP, et al. Antitumor agents, 145. Cytotoxic asprellic acids A and C and asprellic acid B. New p-coumaroyl triterpenes, from Ilex asprella . J Nat Prod . 1993;56(12):2077-2082.
6. Nahar L, Russell WR, Middleton M, Shoeb M, Sarker SD. Antioxidant phenylacetic acid derivatives from the seeds of Ilex aquifolium . Acta Pharm . 2005;55(2):187-193.
7. Palumbo MJ, Putz FE, Talcott ST. Nitrogen fertilizer and gender effects on the secondary metabolism of yaupon, a caffeine-containing North American holly. Oecologia . 2007;151(1):1-9.
8. Ernst E. Herbal medicinal products during pregnancy: are they safe? BJOG . 2002;109(3):227-235.
9. Rodrigues TD, Johnson PN, Jeffrey LP. Holly berry ingestion: case report. Vet Hum Toxicol . 1984;26(2):157-158.
10. Arena JA. Questions and answers: are holly berries toxic? JAMA . 1979;242(21):2341.
11. HolidayHint: poison plant prevention. Child Health Alert . 2004;22:2.

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