Passion Flower

Scientific Name(s): Passiflora incarnata L., occasionally P. lutea L. Family: Passifloraceae

Common Name(s): Passion flower ; passion fruit , granadilla (species with edible fruit); water lemon ; Maypop , apricot vine , wild passion flower ( P. incarnatus ); Jamaican honeysuckle ( P. laurifolia ).

Uses

Passion flower has been used to treat sleep disorders and historically in homeopathic medicine to treat pain, insomnia related to neurasthenia or hysteria, and nervous exhaustion.

Dosing

No clinical trials of passion flower as a single agent have been reported; however, a daily dose of 4 to 8 g is typical.

Contraindications

Contraindications have not yet been identified.

Pregnancy/Lactation

Documented adverse effects. Avoid use. Passion flower is a known uterine stimulant.

Interactions

None well documented.

Adverse Reactions

Though no adverse effects of passion flower have been reported, large doses may result in CNS depression.

Toxicology

No major clinical trials have been conducted to assess the plant's toxicity.

Botany

The term “passion flower” connotes many of the approximately 400 species of the genus Passiflora , which are primarily vines. Some of the species are noted for their showy flowers, others for their edible fruit. Common species include P. incarnata , P. edulis , P. alata , P. laurifolia , and P. quadrangularis . Those with edible fruit include P. incarnata , P. edulis , and P. quadrangularis , the latter being one of the major species grown commercially for its fruit. 1 Passiflora species are native to tropical and subtropical areas of the Americas. In the United States, P. incarnata is found from Virginia to Florida and as far west as Missouri and Texas. The flowers of Passiflora have 5 petals, sepals, and stamens, 3 stigmas, and a crown of filaments. The fruit is egg-shaped, has a pulpy consistency, and includes many small seeds. 1 , 2

History

The passion flower was discovered in 1569 by Spanish explorers in Peru, who saw the flowers as symbolic of the passion of Christ and, therefore, a sign of Christ's approval of their efforts. This is the origin of the scientific and common names. 3 The folklore surrounding this plant possibly dates further into the past. The floral parts are thought to represent the elements of the crucifixion (3 styles represent 3 nails, 5 stamens for the 5 wounds, the ovary resembles a hammer, the corona as the crown of thorns, the petals representing the 10 true apostles, with the white and bluish-purple colors those of purity and heaven). 2 , 4 In Europe, passion flower has been used in homeopathic medicine to treat pain, insomnia related to neurasthenia or hysteria, and nervous exhaustion. Other indications have included bronchial disorders (particularly asthma), compresses for burns, inflammation, inflamed hemorrhoids, climacteric complaints, pediatric attention disorders, and pediatric nervousness and excitability. 5

Chemistry

Researchers have identified a number of constituents in different passion flower species. The official passion flower is considered to be P. incarnata , which is used for the drug. 6 Key constituents in P. incarnata include flavonoids, maltol, cyanogenic glycosides, and harman indole alkaloids. 2 Flavonoid content (2.5%) includes flavone di-C-glycosides shaftoside, isoshaftoside, isovitexin (found in highest concentration between preflowering and flowering stages in 1 report), 7 iso-orientin, vicenin, lucenin, saponarin, and passiflorine. 8 Free flavonoids include apigenin, luteolin, quercetin, and kamferol. 6 Another report confirms similar constituents by mass spectral analysis. 9 Flavonoid determination by high-performance liquid chromatography and other methods has been extensively reported. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 The stability of dried extract also has been studied. 18 P. incarnata components include phenolic, fatty, linoleic, linolenic, palmitic, oleic, and myristic acids, as well as formic and butyric acids, 5 , 19 coumarins, phytosterols, essential oil, maltol (0.05%), 6 , 20 and harman and its derivatives (0.03%). Harmala alkaloids include harmine, harmaline, and harmalol. Quantitative determination of harman and harmin in P. incarnata also has been performed. 21

Comparative studies

Thin layer chromatographic methods to differentiate P. incarnata from P. edulis and P. caerulea have been described. 19 Quantitative analysis of different plant parts from P. incarnata and P. edulis indicate that P. edulis leaves have the highest alkaloid content, and that fruit rinds contain approximately 0.25% alkaloids. Seeds and root tissue have the lowest alkaloid content. These findings may have economic importance. P. edulis fruit rinds, by-products of passion fruit juice production, may provide an economical source of alkaloids. 22 Flavonoids from P. trinervia and P. sanguinolenta also have been reported. 23 A review of the chemical constitution of Passiflora species is available. 24

Uses and Pharmacology

Passion flower has been researched for its sedative and anxiolytic effects. 2 , 6 , 8 A 1986 survey of British herbal sedatives revealed passion flower as the most popular. Other popular species included Valeriana officinalis , Humulus lupulus , and Scutellaria lateriflora . 25 , 26 Martindale, The Extra Pharmacopoeia lists many multi-ingredient preparations from other countries. 27

The pharmacological activity of Passiflora is attributed primarily to the alkaloids and flavonoids. The harmala alkaloids inhibit monoamine oxidase, which may account for part of their pharmacologic effect. 20

Sedative/anxiolytic
Animal data

Animal studies have shown that Passiflora extracts have a complex action on the central nervous system (CNS), inducing dose-dependent stimulation and depression. 28 A report describes CNS-receptor binding sites of P. incarnata . 29

Passiflora species exhibit sedative activity in animals 30 and anxiolytic activity in mice. 31 When given to rats, P. incarnata extract led to diminished general activity when tested in a 1-arm, radial maze. 32 In mice, P. incarnata 's sedative and anxiolytic properties were associated with aqueous extracts of aerial plant parts. 33 The sedative effect of Passiflora may require both the alkaloids and flavonoids to be present. 22 Mice injected subcutaneously with 400 mg/kg of maltol and ethyl maltol showed reduced spontaneous activity, bradycardia, hypothermia, relaxation of skeletal muscle, and diminished pinna, corneal, and ipsilateral flexor reflexes. An ethylene chloride-soluble fraction at 2 mg/mL reduced brain oxygen consumption and the effect with the acid-soluble fraction was greater. Maltol and ethyl maltol potentiated the sleep-inducing effect of hexobarbital and counteracted the convulsive effects of pentylene or strychnine. These findings indicate that maltol and ethyl maltol may mask the stimulant effects of harmala alkaloids in Passiflora . 20

Other Passiflora species exhibit similar effects. P. coerulea has sedative actions. 34 Constituent chrysin, isolated from this same species (a central benzodiazepine [BZ] ligand) has anxiolytic effects, due in part to this role as a partial agonist of central BZ receptors. 35 Tranquilizing effects have been seen with alkaloids from the harman group in P. edulis species. 36

Clinical data

Human studies of Passiflora species as a sedative/anxiolytic have been conducted. A case report using the plant in a combination natural product, Calmanervin , for successful sedation before surgery was reported. 37 In a multicenter, double-blind trial of 91 patients, Passiflora (in combination, Euphytose ) exhibited statistically significant differences when compared with placebo in the treatment of adjustment disorder with anxious mood. 38 A study of Passiflora in the combination product Compoz contradicts these last 2 studies. It was not possible to differentiate between aspirin or placebo when tested as a daytime sedative. However, the duration of this study was only 2 weeks. 39

Miscellaneous uses

Passion flower's ability to reduce anxiety makes it useful for asthma, palpitations, and other cardiac rhythm abnormalities, high blood pressure, insomnia, neurosis, nervousness, pain, and other conditions. 2 , 6 , 8 However, no clinical data is available to support any of these potential uses.

In vitro experiments have demonstrated that Passiflora kills a wide variety of molds, yeasts, and bacteria. Group A hemolytic streptococci are much more susceptible than Staphylococcus aureus , with Candida albicans being intermediate in susceptibility. The antimicrobial activity of Passiflora disappears rapidly from dried plant residues but fades more gradually in aqueous extracts. Addition of dextran, milk, or milk products has a stabilizing effect on dry Passiflora . 40 , 41 A later report describes the P. tetrandra component, 4-hydroxy-2-cyclopentenone, as having antipseudomonal actions. This constituent was also found to be cytotoxic to P388 murine leukemia cells. 42

Other uses of passion flower include herbal treatment for menopausal complaints 43 and as a flavored syrup to mask drug taste. 44

Dosage

No clinical trials of passion flower as a single agent have been reported; therefore, the typical daily dose of 4 to 8 g is not supported.

Pregnancy/Lactation

Use of passion flower is contraindicated during pregnancy because of the uterine stimulant action of its alkaloids harman and harmaline, and the content of the cyanogenic glycoside gynocardin. 45 , 46 , 47

Interactions

None well documented.

Adverse Reactions

Extracts produced no adverse effects in mice when administered intravenously. 40 Cyanogenesis from species P. edulis has been suggested. 48 The plant's known actions may reduce arterial pressure affecting circulation and increasing respiratory rate. 8 There are no controlled human trials using single herb preparations of Passiflora extracts before the mid-1990s. 49 There have been cases of vasculitis 50 and altered consciousness in 5 patients taking the herbal product Relaxir , produced mainly from P. incarnata fruits. 51 Occupational asthma and rhinitis may occur from the species P. alata , which was substantiated by skin testing and Western blotting in vivo and in vitro studies. 52

Toxicology

Little information is available on the clinical toxicity of Passiflora . P. adenopoda fruits may produce some toxic effect. 53

Bibliography

1. Seymour EL. The Garden Encyclopedia . New York, NY: W. H. Wise; 1941.
2. Chevallier A. Encyclopedia of Medicinal Plants . New York, NY: DK Publishing; 1996;117.
3. Encyclopedia Americana . Danbury, CT: Grolier; 1987.
4. Tyler V. The New Honest Herbal . Philadelphia, PA: G.F. Stickley Co; 1987.
5. Lutomski J, Segiet E, Szpunar K, Grisse K. The importance of the passionflower in medicine [in German]. Pharm Unserer Zeit . 1981;10:45-49.
6. Bruneton J. Pharmacognosy, Phytochemistry, Medicinal Plants . Paris, France: Lavoisier Publishing Inc.; 1995:284-285.
7. Menghini A, Mancini LA. TLC determination of flavonoid accumulation in clonal populations of Passiflora incarnata L. Pharmacol Res Commun . 1988;20(suppl 5):113-116.
8. Duke J. CRC Handbook of Medicinal Herbs . Boca Raton, FL: CRC Press; 1985: 347.
9. Li QM, van den Heuvel H, Delorenzo O, et al. Mass spectral characterization of C-glycosidic flavonoids isolated from a medicinal plant ( Passiflora incarnata ). J Chromatogr . 1991;562:435-446.
10. Bennati E. Identification, by thin-layer chromatography, of liquid extract of Passiflora incarnata [in Italian]. Boll Chim Farm . 1967;106:756-760.
11. Glotzbach B, Rimpler H. Flavonoids from Passiflora incarnata L., Passiflora quandrangularis L., and Passiflora pulchella H.B.V. A chromatographic study [in German]. Planta Med . 1968;16:1-7.
12. Bennati E, Fedeli E. Gas chromatography of fluid extract of Passiflora incarnata [in Italian]. Boll Chim Farm . 1968;107:716-720.
13. Lutomski J, Malek B, Stachowiak Z. Pharmacochemical investigation of the raw materials from Passiflora genus. 1. New method of chromatographic separation and fluorometric-planimetric determination of alkaloids and flavonoids in harman raw materials [in German]. Planta Med . 1974;26:311-317.
14. Pietta P, Manera E, Ceva P. Isocratic liquid chromatographic method for the simultaneous determination of Passiflora incarnata L. and Crataegus monogyna flavonoids in drugs. J Chromatogr . 1986;357:233-237.
15. Schmidt P, Ortega GG. Passion flowers: assay of the total flavonoid contents in passiflorae herba. Dtsch Apotheker-Zeitung . 1993;133:17-20, 23-26.
16. Rehwald A, Meier B, Sticher O. Qualitative and quantitative reversed-phase high-performance liquid chromatography of flavonoids in Passiflora incarnata L. Pharm Acta Helv . 1994;69:153-158.
17. Bokstaller S, Schmidt PC. Comparative study on the content of passionflower flavonoids and sesquiterpenes from valerian root extracts in pharmaceutical preparations by HPLC. Pharmazie . 1997;52:552–557.
18. Ortega GG, Schmidt PC. Stability studies on dried extracts of passion flower ( Passiflora incarnata L.) STP Pharm Sci . 1995;5:385-389.
19. Brasseur T, Angenot L. The pharmacognosy of the passion flower [in French]. J Pharm Belg . 1984;39:15-22.
20. Aoyagi N, Kimura R, Murata T. Studies on Passiflora incarnata dry extract. I. Isolation of maltol and pharmacological action of maltol and ethyl maltol. Chem Pharm Bull . 1974;22:1008-1013.
21. Bennati E. Quantitative determination of harmane and harmine in extract of Passiflora incarnata [in Italian]. Boll Chim Farm . 1971;110:664-669.
22. Lutomski J, Malek B. Pharmacological investigations on raw materials of the genus Passiflora [in German]. Planta Med . 1975;27:381.
23. Ulubelen A, Mabry TJ. Flavonoids from Passiflora trinervia and P. sanguinolenta . J Nat Prod . 1983;46:597.
24. Turkoz S. Chemical constitution and medical usage of Passiflora L. species. Parmasotik Bilimler Derg . 1994;19:79-84.
25. Tyler V. Herbs of Choice: The Therapeutic Use of Phytomedicinals . Binghamton, NY: Pharmaceutical Products Press; 1994:119.
26. Ross MS, Anderson LA. Selection of plants for phytopharmacological study based on modern herbal practice. Int J Crude Drug Res . 1986;24:1-6.
27. Reynolds J, ed. Martindale, The Extra Pharmacopoeia , 31st ed. King of Prussia, PA: Royal Pharmaceutical Press; 1996:1739.
28. Speroni E, Minghetti A. Neuropharmacological activity of extracts from Passiflora incarnata . Planta Med . 1988;54:488-491.
29. Burkard W, Kopp B, Krenn L, Berger D, Schaffner W. Receptor binding studies in the CNS with extracts of Passiflora incarnata . Pharm Pharmacol Lett . 1997;7:25-26.
30. Geppert B, Iwaszkiewicz J. Pharmacological evaluation of medicinal plant preparations for sedative action. Herba Pol . 1985;31:67-75.
31. Della Loggia R, Tubaro A, Redaelli C. Evaluation of the activity on the mouse CNS of several plant extracts and a combination of them [in Italian]. Riv Neurol . 1981;51:297-310.
32. Sopranzi N, De Feo G, Mazzanti G, Tolu L. Biological and electroencephalographic parameters in rats in relation to Passiflora incarnata L [in Italian]. Clin Ter . 1990;132:329-333.
33. Soulimani R, Younos C, Jarmouni S, Bousta D, Misslin R, Mortier F. Behavioral effects of Passiflora incarnata L. and its indole alkaloid and flavonoid derivatives and maltol in the mouse. J Ethnopharmacol . 1997;57:11-20.
34. Medina JH, Paladini AC, Wolfman C, et al. Chrysin (5,7-di-OH-flavone), a naturally-occurring ligand for benzodiazepine receptors, with anticonvulsant properties. Biochem Pharmacol . 1990;40:2227-2231.
35. Wolfman C, Viola H, Paladini A, Dejas F, Medina JH. Possible anxiolytic effects of chrysin, a central benzodiazepine receptor ligand isolated from Passiflora coerulea . Pharmacol Biochem Behav . 1994;47:1-4.
36. Lutomski J, Malek B, Rybacka L. Pharmacochemical investigations of the raw materials from Passiflora genus. Planta Medica . 1975;27:112-121.
37. Yaniv R, Segal E, Trau H, Auslander S, Perel A. Natural premedication for mast cell proliferative disorders. J Ethnopharmacol . 1995;46:71-72.
38. Bourin M, Bougerol T, Guitton B, Broutin E. A combination of plant extracts in the treatment of outpatients with adjustment disorder with anxious mood: controlled study vs placebo. Fundam Clin Pharmacol . 1997;11:127-132.
39. Rickels K, Hesbacher PT. Over-the-counter daytime sedatives: a controlled study. JAMA . 1973;223:29-33.
40. Nicolls JM, Birner J, Forsell P. Passicol, an antibacterial and antifungal agent produced by Passiflora plant species: qualitative and quantitative range of activity. Antimicrob Agents Chemother . 1973;3:110-117.
41. Birner J, Nicolls JM. Passicol, an antibacterial and antifungal agent produced by Passiflora plant species: preparation and physiocochemical characteristics. Antimicrob Agents Chemother . 1973;3:105-109.
42. Perry NB, Alberson GD, Blunt JW, Cole AL, Munro MH, Walker JR. 4-Hydroxy-2-cyclopentenone: and anti- Pseudomonas and cytotoxic component from Passiflora tetrandra . Planta Med . 1981;57:129-131.
43. Israel D, Youngkin EQ. Herbal therapies for perimenopausal and menopausal complaints. Pharmacotherapy . 1997;17:970-984.
44. Puffer HW, Virji AS, Phipps JD. Comparison of pharmaceutical flavorants extracted from selected subtropical fruits. Am J Hosp Pharm . 1971;28:633-635.
45. Brinker FJ. Herb Contraindications and Drug Interactions . 2nd ed. Sandy, OR: Eclectic Medical Publications; 1998:109-110.
46. Newall CA, Anderson LA, Phillipson JD, eds. Herbal Medicines: A Guide for Health-Care Professionals . London: Pharmaceutical Press; 1996.
47. Ernst E. Herbal medicinal products during pregnancy: are they safe? BJOG . 2002;109:227-235.
48. Spencer KC, Seigler DS. Cyanogenesis of Passiflora edulis . J Agric Food Chem . 1983;31:794-796.
49. Schulz V, Hänsel R, Tyler VE. Rational Phytotherapy: A Physician's Guide to Herbal Medicine , 3rd ed. Berlin, Germany: Springer Verlag; 1998:83-84.
50. Smith GW, Chalmers TM, Nuki G. Vasculitis associated with herbal preparation containing Passiflora extract. Br J Rheumatol . 1993;32:87-88.
51. Solbakken AM, Rorbakken G, Gundersen T. Nature medicine as intoxicant [in Norwegian]. Tidsskr Nor Laegeforen . 1997;117:1140-1141.
52. Giavina-Bianchi PF Jr, Castro FF, Machado ML, Duarte AJ. Occupational respiratory allergic disease induced by Passiflora alata and Rhamnus purshiana . Ann Allergy Asthma Immunol . 1997;79:449-454.
53. Saenz JA, Nassar M. Toxic effect of the fruit of Passiflora adenopoda D. C. on humans: phytochemical determination. Rev Biol Trop . 1972;20:137-140.

Copyright © 2009 Wolters Kluwer Health

Hide
(web5)