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Chinese Cucumber

Scientific Name(s): Trichosanthes cucumerina, Trichosanthes kirilowii Maxim., Trichosanthes pericarpium
Common Name(s): Chinese cucumber, Chinese snake gourd, Compound Q, Gua-lou, Gualoupi, Radix trichosanthis, Snake gourd, Tian-hua-fen, Tolidostena japonica, Trichosanthis Fructus

Medically reviewed by Drugs.com. Last updated on Oct 22, 2021.

Clinical Overview

Use

Chinese cucumber has been studied, primarily in animal and in vitro studies, for its cardiovascular, immune system, antioxidant, antidiabetic, expectorant, and gastroprotective effects. 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 for any indication.

Dosing

Clinical studies are lacking to provide dosing guidance. In traditional Chinese medicine, Chinese cucumber has most commonly been administered as part of a polyherbal preparation. Seeds of the plant have been used as a dietary source of conjugated linolenic acid (20.8 g of seed kernels per day for 28 days).

Contraindications

Use is contraindicated in pregnancy.

Pregnancy/Lactation

Use is contraindicated. Extracts of the root possess abortifacient activity and are toxic to the fetus.

Interactions

None well documented.

Adverse Reactions

Available published clinical studies are limited. However, one trial in HIV subjects reported myalgia, fever, elevated liver function tests, and mild to moderate anaphylactic reactions.

Toxicology

Extracts of Chinese cucumber are extremely toxic (death has occurred), particularly if administered parenterally.

Scientific Family

  • Cucurbitaceae (cucumber)

Botany

Chinese cucumber is one of more than 40 recognized species of the genus Trichosanthes, which includes snake gourd or serpent gourd (T. cucumerina). Chinese cucumber is a member of the gourd family, and the root, fruit, seeds, stems, and peel have traditionally been used. T. kirilowii plant is most often referred to in Chinese Materia Medica.Duke 2002, USDA 2019

History

T. kirilowii has historically been used in traditional Chinese medicine 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.Duke 2002, Fan 2012

Chemistry

The most studied component of T. kirilowii is the ribosome-activating protein trichosanthin (sometimes referred to as "compound Q"), which is found in the root of the plant.de Virgilio 2010 A highly purified form of trichosanthin has been investigated under the name GLQ-223. Trichosanthins possess abortifacient activity and are toxic to the fetus. The plant seeds contain hydroxylated sterols, fatty acids, and lignans.Fan 2012, Yu 2018 Some studies have shown that cucurbitacin D can be extracted from T. kirilowii, as well as multiple other plants of the Cucurbitaceae family.Ding 2017 Phenolic and flavonoid constituents of the aerial plant parts of T. cucumerina have been described.Liyanage 2016 Reviews of the phytochemistry of Trichosanthis Fructus, the ripened fruits of T. kirilowii, have been published.Fan 2012, USDA 2016, Yu 2018

Uses and Pharmacology

Antioxidant activity

Animal data

Antioxidant activity has been demonstrated in vitro and in vivo in rodents.Chen 2014, Sathesh Kumar 2009, Seo 2015, Shah 2012, Zhang 2017

Antiviral activity

Animal and in vitro data

Studies in rats and guinea pigs demonstrated antiviral activity of trichosanthin.Shaw 2005 In vitro studies to determine potential applications have been reported.Fang 2011 In vitro studies have demonstrated activity against herpes simplex virus, HIV, and hepatitis B.He 2012, Wong 2014

Clinical data

Trichosanthin reportedly blocks HIV replication and destroys HIV-infected macrophages. In an older phase 2 clinical trial in 93 patients with HIV in whom antiretroviral agents (including zidovudine) had failed, addition of trichosanthin to antiviral agents, usually zidovudine, resulted in a median gain of 1.1 CD4+ cells/mm3.Byers 1994 Despite positive effects, more recent, improved, and larger studies are needed.

Cancer

Animal and in vitro data

Multiple in vitro and animal studies have primarily investigated trichosanthin and cucurbitacin D using human cancer cell lines, with interest focused on breast and prostate cancers.Cai 2011, Dakeng 2012, Dat 2010, Ding 2017, Duangmano 2010, Duangmano 2012, Jeong 2017, Joo 2018, Kabir 2012, Kim 2013, Li 2010, Li 2010, Li 2016, Liu 2012, Mi 2005, Miao 2015, Minh 2015, Ni 2015, Promkan 2013, Sha 2013, Shin 2008, Song 2016, Takahashi 2009, Wei 2016, Yang 2007, Yin 2008

Protection against cisplatin-induced nephrotoxicity has been demonstrated,Seo 2015 while enhanced repair of ultraviolet B (UVB) radiation–induced DNA damage, which contributes to skin aging and carcinogenesis, has also been shown in vitro.Joo 2018

Clinical data

A combination product containing Astragalus membranaceus, Angelica gigas, and Trichosanthes kirilowii Maximowicz (SH003) has been studied in patients with solid cancers. Further clinical trials are needed.Cheon 2018

Cardiovascular effects

Animal data

A published review of animal and in vitro studies evaluating the cardiovascular and cerebrovascular effects of Trichosanthis Fructus describes calcium channel antagonism; protective effects on reperfusion injury and endothelial insult; and vasodilatory, angiogenic, and antiplatelet activity.Yu 2018 Antioxidant and anti-inflammatory properties have also been described, as well as positive effects in mice with methylthiouracil-induced hyperlipidemia.Yu 2018, Zhang 2016

In a study in rats, injection of Chinese snake gourd peel alleviated cardiac ischemic injury and inhibited cardiomyocyte apoptosis.Yang 2018 A review reports on hypotensive effects of gualoupi injection in dogs in the 1970s.Yu 2018

Clinical data

Despite reports of wide historical use of T. pericarpium (gualoupi) extract for cardiovascular disease in China,Fu 2018 quality clinical trials are lacking to provide evidence supporting a therapeutic role.

Diabetes

Animal data

The polysaccharide from snake gourd root has been used to produce a hydrogel that may have potential applications in novel drug delivery and treatment of diabetic ulcers.Yan 2019 Extracts from T. cucumerina demonstrated antidiabetic and hypolipidemic activity in rats.Kirana 2008, Saha 2012, Yu 2018 In a study of diabetic mice, a dose-dependent hypoglycemic effect was demonstrated with an aqueous extract of T. kirilowii.Lo 2017 A role in diabetic nephropathy has also been proposed based on rodent studies.Lu 2018

Dietary use

Animal data

In a study in rats, T. kirilowii seed oil served as a source of linolenic acid.Yuan 2009

Clinical data

In a clinical study of healthy young subjects, T. kirilowii seeds (20 g of seed kernels per day for 28 days) were consumed as a dietary source of conjugated linolenic acid.Yuan 2009

Expectorant effects

Animal data

In a study in mice, a decoction of gua-lou reportedly improved cough caused by ammonia.Yu 2018

Gastroprotective effects

Animal data

Fractions of the hot water extract of T. cucumerina aerial parts, particularly an ethyl acetate fraction, were gastroprotective in a study of rats with ethanol-induced gastric lesions.Karunakaran 2017

Immune system effects

Animal and in vitro data

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.Jiandong 2019, Song 2013, Wang 2010, Zhou 2007 In a study in mice, trichosanthin delayed allograft rejection.Song 2013 Anti-inflammatory effects of the related T. cucumerina against induced rat paw edema have also been demonstrated.Arawwawala 2010

Dosing

Clinical studies are lacking to provide dosing guidance. In traditional Chinese medicine, Chinese cucumber has most commonly been administered as part of a polyherbal preparation.

In a clinical study, T. kirilowii seeds (20.8 g of seed kernels per day for 28 days) were consumed as a dietary source of conjugated linolenic acid.Yuan 2009

Pregnancy / Lactation

Use is contraindicated. Extracts of the root possess abortifacient activity and are toxic to the fetus. Trichosanthin was evaluated in the management of ectopic pregnancy in a retrospective study of Chinese inpatients.Lu 1989, Xiang 2012

Interactions

None well documented. A 1988 study in rabbits suggests gualoupi injection can inhibit platelet aggregation; however, case reports of any interactions with anticoagulants or antiplatelet agents are lacking.Yu 2018

Adverse Reactions

Available published clinical studies are limited. However, one trial reported myalgia, fever, elevated liver function tests, and mild to moderate anaphylactic reactions.Byers 1994 Allergy and anaphylaxis with trichosanthin and gualoupi injection have been reported.Duke 2002, Yu 2018

Toxicology

Extracts of Chinese cucumber are extremely toxic, particularly if administered parenterally. Acute pulmonary edema, cerebral edema and hemorrhage, myocardosis, and death have been reported.Duke 2002 Extracts of the root are toxic to the fetus.Xiang 2012 Studies in rats have shown changes in heart, liver, and kidney morphology, but in older reports these changes were not apparent in dogs administered gualoupi injection.Yu 2018

References

Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

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