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Clematis

Scientific Name(s): Clematis species
Common Name(s): Clematis, Devil's-darning-needle, Old-man's beard, Traveler's-joy, Umdlonzo (Zulu), Vine bower, Virgin's bower, Woodbine

Medically reviewed by Drugs.com. Last updated on Jul 6, 2022.

Clinical Overview

Use

Clematis has been evaluated for its anti-inflammatory, cytotoxic, and antimicrobial effects.

Dosing

No clinical evidence supports dosage recommendations for clematis.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

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

Interactions

None well documented.

Adverse Reactions

Skin irritation, hypo- or hyperpigmentation of the skin, profuse salivation, blistering, inflamed eyes, abdominal cramping, vomiting of blood, weakness, bloody diarrhea, and painful, excessive or bloody urine have been reported.

Toxicology

Poisoning symptoms may include dizziness, confusion, possible fainting, and convulsions.

Scientific Family

  • Ranunculaceae

Botany

Clematis is a genus of mostly climbing perennial shrubs in the buttercup family with approximately 355 species worldwide, mainly in North America and Asia. Over 70 species are used in Chinese traditional medicine(Ding 2009) and several species are cultivated in North America for their beautiful flowers. Common species include woodbine (Clematis virginiana), virgin's bower (Clematis cirrhosa), old-man's beard (Clematis vitalba), and vine bower (Clematis viticella).

C. virginiana is a trailing vine that can grow up to 15 m higher than other botanicals, often resulting in a bower or shaded shelter. The long, feathery, beard-like tail on the fruit led to the common name "old-man's beard." This species is a North American native plant that was once included in a continental pharmacopeia as a medicine.

Clematis grows in thickets, roadsides, woods, and stream banks. It can be found in Manitoba and Quebec, as far south as Alabama and Louisiana, and west to Kansas. The vine has leaves divided into 3 oval and toothed leaflets, each on long, tendril-like stalks that aid in its climbing habit. From July to September, it displays creamy white flowers that bloom into large clusters that become fruit heads with long plume-like tails.(Readers Digest 1986, Duke 1985)

Other species in the genus include: Clematis dioica from tropical areas of Central and South America,(Lewis 1977) Clematis recta (Clematis erecta) of Southern Europe, C. vitalba of Eurasian and North African origin,(NBII ISSG 2022) Clematis chinensis Osbeck (Wei Ling Xian) of Chinese origin,(Ody 1993) and Clematis thunbergii from Senegal.(Lewis 1977)

History

The popular use of C. virginiana for skin disorders (sores, cuts), itching, and venereal eruptions in North American pioneer medicine was probably learned from American Indians.(Readers Digest 1986) Throughout history, the leaf of the plant was used in folk remedies for treating cancers and tumors, as well as for itching, fever, renosis, nephrosis, ulcers, and scrofula.(Duke 1985) Past uses also indicate diuretic, poisonous, rubefacient, sudorific, purgative, and vesicant properties. The Chinese have traditionally used the roots and rhizomes of C. chinensis, Clematis mandschurica Rupr., and Clematis hexapetala Pall., referred to as "weilingxian" in Chinese, for their analgesic, abirritative, antibacterial, antiphlogistic, anticancer, and diuretic effects.(Ding 2009) Clematis armandii and Clematis montana, referred to as "mu tong," have been used in China to decrease fever in order to induce urination, stimulate menstrual discharge, and promote lactation.(Peng 2009) In Anatolia, Turkey, ground leaves or aerial parts are applied to inflamed joint(s) for 15 to 30 minutes to provide pain relief. The irritation causes a gap to open on the skin, which causes drainage of edema. Sometimes, the wound is plugged by a grape dreg to promote continuous drainage. To treat an open wound, Plantago major is applied. Additionally, C. vitalba branches have been used to alleviate tooth pain by smoking the branch like a cigarette.(Yesilada 2007) Clematis has long been cultivated as a woody climbing or trailing vine for growing over a fence or wherever dense foliage is desired. Other reports have mentioned using the fuzzy seed mass for smoking as well as utilizing the young shoots of the Eurasian variety (Clematis taurica) in cooking.

Chemistry

Early literature reports on the extraction of alkaloid, glycoside, and saponin fractions from certain species.(Kingsbury 1964) Members of Ranunculaceae family contain protoanemonin, an irritant compound found mostly in the fresh leaves and sap that are derived from a precursor glycoside known as ranunculin.(Turner 1991) Compound such as anemonin, caulosaponin, caulosapogenin, stigmasterol glycoside, ceryl alcohol, myricylalcohol, beta-siterosterol, trimethylamine, n-triacontane, n-nonacosane, ginnone, ginnol, and campesterol, as well as beheinc-, caffeic-, chlorogenic-, and melissic-acid have also been reported from C. vitalba.(Duke 1985) The dried seeds contain approximately 15% protein and 14% fat.

Reports have identified anemonin (the dilactone of cyclobutane-1,2-diol-1,2 diacrylic acid derived from the cyclodimerization of protoanemonin) in Clematis hirsutissima,(Kern 1983) an oleanic saponin named clemontanoside B from C. montana leaves,(Jangwan 1990) 2 saponins named hushangoside and hederagenin glycoside from the stems of C. montana,(Bahuguna 1990) other saponins from Clematis species,(Fujita 1974) clemontanoside F from the roots of C. montana,(Thapliyal 1993) and 2 triterpenoid saponins named clematichineno-side A and B from the roots of C. chinensis.(Shao 1995) The major components of the essential oil of C. hexapetala are palmitic acid and 3-hydroxy-4-methoxyl benzaldehyde.(Jiang 1990)

Uses and Pharmacology

Anti-inflammatory effects

Clematis species have been traditionally used in several cultures for their anti-inflammatory effects. Although not fully understood, these effects may be due to the inhibition of proinflammatory cytokines and inhibition of cyclooxygenase (COX) enzymes. Specifically, the ethanolic extracts of 3 Clematis species (ie, Clematis pickeringii, Clematis microphyllia, and Clematis glycinoides) were found, albeit at differing degrees, to inhibit COX-1, COX-2, and 5-lipoxygenase, with the exception that stem and leaf extracts of C. microphyllia did not inhibit COX-2. The highest inhibition was noted with C. pickeringii.(Li 2006)

Animal data

In a murine model, the compound vitalboside was isolated from C. vitalba and studied for its anti-inflammatory effects. Vitalboside exerted a potent and dose-dependent, anti-inflammatory effect on carrageenan-induced paw edema. Additionally, antipyretic and antinociceptive effects were noted with vitalboside.(Yesilada 2007)

Similarly, Clematis brachiata exerted anti-inflammatory effects at doses of 100, 200, and 400 mg/kg on carrageenan-induced paw edema in rats. The 400 mg/kg dose was the most potent. Antipyretic and antinociceptive effects were also noted with treatment. Specifically, at a dose of 400 mg/kg, C. brachiata was found to lower body temperature in rats more so than indomethacin.(Mostafa 2010)

The triterpene saponin, AR-6, has been isolated from C. chinensis and evaluated for its anti-inflammatory effects. In rats with adjuvant-induced arthritis, the oral administration of AR-6 was associated with a reduction in the severity of clinical symptoms, absence of hyperplasia in the synovial membranes, and decreases in prostaglandin E2 (PGE2), tumor necrosis factor (TNF)-alpha, and nitric oxide levels.(Sun 2010)

A study was conducted to assess the anti-inflammatory effects of C. mandshurica on adjuvant arthritis in rats. Subcutaneous administration of C. mandshurica reduced swelling similarly as with rats receiving dexamethasone as a control. Specifically, when clematis was given on the same day or 5 days prior to the inflammatory insult, a reduction in inflammation was noted compared with the control rats. Clematis administration was also associated with a reduction in TNF-alpha and IL-1 production, with an increase in the production of IL-10, a cytokine that suppresses TNF-alpha production.(Suh 2006)

The in vitro and in vivo anti-inflammatory activities of triterpene saponins from Clematis florida significantly improved the symptoms of arthritis, such as paw swelling, arthritic index, and histological condition in rats. C. florida also reduced the levels of interleukin (IL)-1beta, TNF-alpha, and IL-6. Further studies also showed that triterpene saponins from C. florida induced anti-inflammatory activity and inhibited inflammatory mediators by blocking JAK-STAT signalling pathways in lipopolysaccaride-treated macrophages.(Yang 2021)

Antifungal and antiviral effects

In vitro data

A mannose-binding lectin isolated from C. montana exerted antiviral effects against HIV. Anti-HIV activity occurred at medium effective concentration values of 11±3.9 mcg/mL and 71±41 mcg/mL for HIV-1 and HIV-2, respectively. Antiviral activity was also noted against influenza A H1N1 subtype, H3N2 subtype, influenza B, parainfluenza-3, and virus reovirus-1.(Peng 2009)

Two compounds, beta-magnoflorine and alpha-magnoflorine, were isolated from Clematis parviolba and assessed for their antifungal effects. Both compounds exerted anti-inflammatory effects against Penicillium avellaneum UC-4376.(Chen 2009)

Antimicrobial effects

In vitro and in vivo data

The antimycotic activity of C. vitalba was assessed using the agar diffusion well bioassay method. The compound exerted antimycotic activity against a broad range of pathogenic yeast and yeast-like microorganisms, with minimal inhibitory concentrations ranging from 1.4 to 12.3 mcg/mL. This activity was determined to occur only in methanol fractions of the compound.(Buzzini 2003)

Antibacterial activity was reported with 4 new 8‑O-4′ neolignans identified from the whole plant of Clematis lasiandra in vitro.(Hao 2020)

Antioxidant and drug protectant effects

In vitro and in vivo data

In vitro tests have established the antioxidant potential of phenolic and flavonoid rich fractions of Clematis orientalis and Clematis ispahanica.(Karimi 2018)

In vivo data from rats suggests that Clematis triterpenoid saponins could ameliorate arthritis-associated gut microbial dysbiosis and may be potential adjuvant drugs that could provide relief from the GI damage caused as a side effect of commonly used drugs.(Guo 2019)

In vivo rat tests have demonstrated the protective effects of ethanolic extract of Clematis terniflora against corticosterone-induced neuronal damage via the AKTand ERK1/2 pathways.(Noh 2018)

Cytotoxic effects

Animal data and in vitro data

Four triterpene glycosides were isolated from the aboveground part of Clematis ganpiniana. Three of these compounds demonstrated cytotoxic activities against estrogen-independent human breast cancer cells (MDA-MB-231) and estrogen-dependent human breast cancer cells (MCF-7). The compound alpha-hederin showed the strongest anticancer activity with the highest apoptosis rates.(Ding 2009)

Clematis hederagenin saponin induced apoptosis in breast cancer cells through regulation of the mitochondrial apoptosis pathway. The results suggest that the hederagenin saponin extracted from Clematis ganpiniana offers potential as a novel breast cancer treatment.(Cheng 2018)

Reports related to Clematis flammula and its major component, boehmenan, confirm that this compound is able to induce lung cancer cell apoptosis by regulating epidermal growth factor-dependent pathways.(Sun 2021)

Clematis inhibited the growth of mouse tumors in an in vivo model with inhibitory rates of 40.3% (0.25 g/kg), 55.1% (0.5 g/kg), and 53% (1 g/kg). However, mouse survival time was not affected by clematis.(Qiu 2009)

Diuretic effects

Animal data

The diuretic effects of Clematis montevidensis were investigated in rats administered isotonic saline solution. Infusions of the root and aerial part of the plant demonstrated moderate diuretic activity believed to be due to oleanolic acid isolated from the plant.(Alvarez 2003)

Insecticidal effects

Experimental data

Antifeedant, insecticidal, and insect growth inhibitory activities of the triterpenoid saponins from Clematis aethusifolia Turcz against Plutella xylostella (L.) have been published.(Tian 2020)

Dosing

No clinical evidence supports dosage recommendations for clematis.

Pregnancy / Lactation

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

Interactions

None well documented.

Adverse Reactions

When the plants are handled or eaten, protoanemonin irritates and blisters the skin. A case report describes a man 34 years of age who developed hypo- and hyperpigmented areas on his skin following application of fresh C. chinensis to his wrist for pain relief. He used the product for 13 months and reported pruritic erythema with each twice weekly application. Subsequent examination by a physician confirmed the finding, and he tested positive on a patch test with both alcoholic and aqueous extracts of C. chinensis. Other adverse effects that may occur after contact with fresh C. chinensis include erythema, bullae, palpitations, and dyspnea.Tan 2008 Intense inflammation and burning of the digestive tract and around the mouth. Other adverse effects associated with oral intake include profuse salivation, blistering, inflamed eyes, abdominal cramping, vomiting of blood, weakness, and bloody diarrhea.Turner 1991 Kidneys may also be irritated, resulting in painful and excessive urination and bloody urine, ultimately leading to diminished urinary output.

Toxicology

A poisonous-plant reference focused on those buttercup species that contained protoanemonin in the fresh leaves and sap, including clematis. Poisoning symptoms may include dizziness, confusion, possible fainting, and convulsions. There is currently no report on the mechanism of toxicity.(Lin 2021)

Fatalities are not common, probably due to the rapid and intense acrid taste and irritation resulting from oral contact. If a large amount has been accidentally ingested, gastric lavage is recommended, followed by demulcents to soothe irritated membranes. Because protoanemonin is present mainly in fresh plant material, cooking or drying results in its decomposition.

Index Terms

  • Clematis chinensis
  • Clematis cirrhosa
  • Clematis dioica
  • Clematis erecta
  • Clematis recta
  • Clematis thunbergii
  • Clematis virginiana
  • Clematis vitalba
  • Clematis viticella

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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