Scientific Name(s): Trichosanthes kirilowii Maxim.
Common Name(s): Chinese cucumber, Chinese snake gourd, Compound Q, Gua-lou, Radix trichosanthis, Tian-hua-fen, Tolidostena japonica
Chinese cucumber root extract has been traditionally used to induce abortion. Antiviral activity and potential application in cancer therapy is being investigated; however, a lack of clinical trials and toxicity of the plant’s root limit use.
In traditional Chinese medicine, Chinese cucumber is most commonly administered as part of a polyherbal preparation. In a clinical trial in HIV patients, trichosanthin 1.2 mg intravenously (IV) weekly, then monthly, was used. In another study, the plant seeds (20 g of seed kernels per day for 28 days) were eaten as a dietary source of conjugated linolenic acid.
Avoid use. Extracts of the root possess abortifacient activity and are toxic to the fetus.
None well documented.
Available published clinical studies are limited. However, one trial reported myalgia, fever, elevated liver function tests, and mild to moderate anaphylactic reactions.
Extracts of the Chinese cucumber are extremely toxic (death has occurred), particularly with parenteral use.
The Chinese cucumber is one of more than 40 recognized species of Trichosanthes, including the snake or serpent gourd, Trichosanthes cucumerina. It is a member of the gourd family, and the root, fruit, seeds, stems, and peel have been traditionally used. While T. kirilowii is the plant of this species most often referred to in Chinese Materia Medica, a number of related species are often used as adulterants.1, 2
T. kirilowii has a long history in traditional Chinese medicine and has been used to reduce fever, swelling, and cough. A starch extracted from the root is used for abscesses, amenorrhea, jaundice, and polyuria. Modern Chinese medicinal uses include the management of diabetes and use as an abortifacient. The plant has been used for centuries in the treatment of tumors.2, 3
The most studied component of T. kirilowii is the protein trichosanthin, which is found in the root of the plant. At least 2 ribosome-inactivating proteins, the trichosanthins, have been identified (sometimes referred to as "compound Q"), with T. kirilowii appearing to have the highest content. A highly purified form of trichosanthin has been investigated under the name GLQ-223. The trichosanthins possess abortifacient activity and are toxic to the fetus. The plant seeds contain hydroxylated sterols, fatty acids, and lignans.3, 4, 5, 6, 7, 8
Uses and Pharmacology
Studies in rats and guinea pigs demonstrated antiviral activity of trichosanthin.9 In vitro studies demonstrated activity against herpes simplex virus, HIV, and hepatitis B.10, 11 In vitro studies to determine potential applications are ongoing.12
Early interest in trichosanthin as an agent in HIV treatment appears to have lost momentum. The compound was reported to block HIV replication and destroy HIV-infected macrophages. A single clinical trial published findings on the addition of trichosanthin to standard therapy, which resulted in a median gain of 1.1 CD4+ cells/mm3/month.8
Multiple in vitro studies have investigated both trichosanthin and cucurbitacin D using human cancer cell lines,13, 14, 15, 16 with much interest focusing on breast cancer.17, 18, 19, 20, 21, 22 Other tumor cell lines used include hepatoma and lung tumor.23, 24, 25
In vivo animal studies included use in lung, nasopharyngeal, and cervical cancers, among others.26, 27, 28, 29
Trichosanthin was reported to have been used to treat choriocarcinoma and cervical cancer, but clinical studies are lacking.29
In rodent and in vitro experiments, trichosanthin and cucurbitacin D demonstrated an inhibitory effect on lymphocytes, upregulation of CD4 T cells, and modulation of macrophages.30, 31, 32 In a study in mice, trichosanthin delayed allograft rejection.32 Anti-inflammatory effects of the related T. cucumerina against induced paw edema have also been demonstrated in rats.33
Research reveals no clinical data regarding the use of T. kirilowii for immune suppression, such as preventing graft-versus-host disease.
Antioxidant activity has been demonstrated in vitro and in vivo in rodents.34, 35, 36, 37
Extracts from the related T. cucumerina plant demonstrated antidiabetic and hypolipidemic activity in rats.38, 39
In rats, the seed oil is a source of linolenic acid,40 while in a clinical study, T. kirilowii seeds (20 g of seed kernels per day for 28 days) were eaten as a dietary source of conjugated linolenic acid.41
Extracts from the related T. cucumerina plant were gastroprotective in rats.42
In traditional Chinese medicine, Chinese cucumber is most commonly administered as part of a polyherbal preparation.
In a clinical trial in HIV patients, trichosanthin 1.2 mg IV weekly, then monthly, was used.8
In a clinical study, T. kirilowii seeds (20 g of seed kernels per day for 28 days) were eaten as a dietary source of conjugated linolenic acid.41
Pregnancy / Lactation
Avoid use. Extracts of the root possess abortifacient activity and are toxic to the fetus. For this reason, trichosanthin has been used to resolve ectopic pregnancy in place of management via salpingectomy.43, 44
None well documented.
Available published clinical studies are limited. However, one trial reported myalgia, fever, elevated liver function tests, and mild to moderate anaphylactic reactions.8 Allergy and sensitization to trichosanthin have been reported.2
Extracts of the Chinese cucumber are extremely toxic, particularly if administered parenterally. Acute pulmonary edema, cerebral edema and hemorrhage, myocardosis, and death have been reported.2 Extracts of the root possess abortifacient activity and are toxic to the fetus.43
1. Trichosanthes cucumerina
. USDA. NRCS. 2014. The PLANTS database (http://plants.usda.gov
, December 2014). National Plant Data Center, Greensboro, NC 27401-4901 USA. Accessed January 7, 2015.
2. Duke JA. Handbook of Medicinal Herbs
. 2nd ed. Boca Raton, FL: CRC Press; 2002.
3. Fan XM, Chen G, Sha Y, et al. Chemical constituents from the fruits of Trichosanthes kirilowii
. J Asian Nat Prod Res
4. Duke J. Dr. Duke's Phytochemical and Ethnobotanical Databases
. Agricultural Research Service website. http://www.ars-grin.gov/duke
. Updated June 13, 1996. Accessed December 15, 2014.
5. Lian L, Fan XM, Chen G, et al. Two new compounds from the fruits of Trichosanthes kirilowii
maxim. J Asian Nat Prod Res
6. Lee DH, Seong S, Kim SS, Han JB. A case of stage IV non-small cell lung cancer treated with Korean medicine therapy alone. Case Rep Oncol
7. de Virgilio M, Lombardi A, Caliandro R, Fabbrini MS. Ribosome-inactivating proteins: from plant defense to tumor attack. Toxins (Basel)
8. Byers VS, Levin AS, Malvino A, Waites L, Robins RA, Baldwin RW. A phase II study of effect of addition of trichosanthin to zidovudine in patients with HIV disease and failing antiretroviral agents. AIDS Res Hum Retroviruses
9. Shaw PC, Lee KM, Wong KB. Recent advances in trichosanthin, a ribosome-inactivating protein with multiple pharmacological properties. Toxicon
10. He D, Zheng Y, Tam S. The anti-herpetic activity of trichosanthin via the nuclear factor-ΚB and p53 pathways. Life Sci
11. Wong KL, Wong RN, Zhang L, et al. Bioactive proteins and peptides isolated from Chinese medicines with pharmaceutical potential. Chin Med
12. Fang EF, Ng TB, Shaw PC, Wong RN. Recent progress in medicinal investigations on trichosanthin and other ribosome inactivating proteins from the plant genus Trichosanthes
. Curr Med Chem
13. Yin D, Wakimoto N, Xing H, et al. Cucurbitacin B markedly inhibits growth and rapidly affects the cytoskeleton in glioblastoma multiforme. Int J Cancer
14. Dat NT, Jin X, Hong YS, Lee JJ. An isoaurone and other constituents from Trichosanthes kirilowii
seeds inhibit hypoxia-inducible factor-1 and nuclear factor-kappaB. J Nat Prod
15. Mi SL, An CC, Wang Y, et al. Trichomislin, a novel ribosome-inactivating protein, induces apoptosis that involves mitochondria and caspase-3. Arch Biochem Biophys
16. Li CT, Lin CH, Kao TY, et al. The mechanisms of action of Tianhua
on antitumor activity in lung cancer cells. Pharm Biol
17. Yang L, Wu S, Zhang Q, Liu F, Wu P. 23,24-dihydrocucurbitacin B induces G2/M cell-cycle arrest and mitochondria-dependent apoptosis in human breast cancer cells (Bcap37). Cancer Lett
18. Duangmano S, Sae-Lim P, Suksamrarn A, Domann FE, Patmasiriwat P. Cucurbitacin B inhibits human breast cancer cell proliferation through disruption of microtubule polymerization and nucleophosmin/B23 translocation. BMC Complement Altern Med
19. Duangmano S, Dakeng S, Jiratchariyakul W, Suksamrarn A, Smith DR, Patmasiriwat P. Antiproliferative effects of cucurbitacin B in breast cancer cells: down-regulation of the c-Myc/hTERT/telomerase pathway and obstruction of the cell cycle. Int J Mol Sci
20. Dakeng S, Duangmano S, Jiratchariyakul W, U-Pratya Y, Bögler O, Patmasiriwat P. Inhibition of Wnt signaling by cucurbitacin B in breast cancer cells: Reduction of Wnt-associated proteins and reduced translocation of galectin-3-mediated β-catenin to the nucleus. J Cell Biochem
21. Promkan M, Dakeng S, Chakrabarty S, Bögler O, Patmasiriwat P. The effectiveness of cucurbitacin B in BRCA1 defective breast cancer cells. PLoS One
22. Kim SR, Seo HS, Choi HS, et al. Trichosanthes kirilowii
ethanol extract and cucurbitacin D inhibit cell growth and induce apoptosis through inhibition of STAT3 activity in breast cancer cells. Evid Based Complement Alternat Med
23. Shin JW, Son JY, Kang JK, Han SH, Cho CK, Son CG. Trichosanthes kirilowii
tuber extract induces G2/M phase arrest via inhibition of tubulin polymerization in HepG2 cells. J Ethnopharmacol
24. Takahashi N, Yoshida Y, Sugiura T, Matsuno K, Fujino A, Yamashita U. Cucurbitacin D isolated from Trichosanthes kirilowii
induces apoptosis in human hepatocellular carcinoma cells in vitro. Int Immunopharmacol
25. Cai Y, Xiong S, Zheng Y, Luo F, Jiang P, Chu Y. Trichosanthin enhances anti-tumor immune response in a murine Lewis lung cancer model by boosting the interaction between TSLC1 and CRTAM. Cell Mol Immunol
26. Li M, Li X, Li JC. Possible mechanisms of trichosanthin-induced apoptosis of tumor cells. Anat Rec (Hoboken)
27. Liu F, Wang B, Wang Z, Yu S. Trichosanthin down-regulates notch signaling and inhibits proliferation of the nasopharyngeal carcinoma cell line CNE2 in vitro. Fitoterapia
28. Kabir SR, Islam MF, Alom MJ, Abu Zubair M, Absar N. Purification, characterizations of a snake guard seeds lectin with antitumor activity against Ehrlich ascites carcinoma cells in vivo in mice. Protein Pept Lett
29. Sha O, Niu J, Ng TB, Cho EY, Fu X, Jiang W. Anti-tumor action of trichosanthin, a type 1 ribosome-inactivating protein, employed in traditional Chinese medicine: a mini review. Cancer Chemother Pharmacol
30. Wang BL, Su H, Chen Y, Wang J, Xu GL. A role for trichosanthin in the expansion of CD4CD25 regulatory T cells. Scand J Immunol
31. Zhou X, Yang N, Lu L, et al. Up-regulation of IL-10 expression in dendritic cells is involved in trichosanthin-induced immunosuppression. Immunol Lett
32. Song Y, Ding N, Kanazawa T, Yamashita U, Yoshida Y. Cucurbitacin D is a new inflammasome activator in macrophages. Int Immunopharmacol
33. Arawwawala M, Thabrew I, Arambewela L, Handunnetti S. Anti-inflammatory activity of Trichosanthes cucumerina
Linn. in rats. J Ethnopharmacol
34. Sathesh Kumar S, Ravi Kumar B, Krishna Mohan G. Hepatoprotective effect of Trichosanthes cucumerina
Var cucumerina L. on carbon tetrachloride induced liver damage in rats. J Ethnopharmacol
35. Chen Y, Miao Y, Huang L, et al. Antioxidant activities of saponins extracted from Radix Trichosanthis: an in vivo and in vitro evaluation. BMC Complement Altern Med
36. Seo CS, Kim TW, Kim YJ, et al. Trichosanthes kirilowii
ameliorates cisplatin-induced nephrotoxicity in both in vitro and in vivo [published online September 4, 2014]. Nat Prod Res
37. Shah SL, Mali VR, Zambare GN, Bodhankar SL. Cardioprotective activity of methanol extract of fruit of Trichosanthes cucumerina
on doxorubicin-induced cardiotoxicity in Wistar rats. Toxicol Int
38. Kirana H, Srinivasan BP. Trichosanthes cucumerina
Linn. improves glucose tolerance and tissue glycogen in non insulin dependent diabetes mellitus induced rats. Indian J Pharmacol
39. Saha SS, Chakraborty A, Ghosh S, Ghosh M. Comparative study of hypocholesterolemic and hypolipidemic effects of conjugated linolenic acid isomers against induced biochemical perturbations and aberration in erythrocyte membrane fluidity. Eur J Nutr
40. Yuan GF, Yuan JQ, Li D. Punicic acid from Trichosanthes kirilowii
seed oil is rapidly metabolized to conjugated linoleic acid in rats. J Med Food
41. Yuan G, Sinclair AJ, Xu C, Li D. Incorporation and metabolism of punicic acid in healthy young humans. Mol Nutr Food Res
42. Arawwawala LD, Thabrew MI, Arambewela LS. Gastroprotective activity of Trichosanthes cucumerina
in rats. J Ethnopharmacol
43. Xiang DJ, Chen LM, Gu JS, Stone P, Chen Q. Trichosanthin, a Chinese medicine for the medical treatment of ectopic pregnancy with high levels of β-hCG. Reprod Sci
44. Lu PX, Jin YC. Ectopic pregnancy treated with trichosanthin. Clinical analysis of 71 patients. Chin Med J (Engl)
. 1989;102(5):365-367. 2509159
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