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Dichroa Root

Scientific Name(s): Dichroa febrifuga Lour
Common Name(s): Basak, Big golden sword, British Indian, Ch'ang shan, Chi-fen ts'ao, Chi-ku ch'ang-shan, Chi-ku feng, Chicken-bone alum root, Chicken-droppings grass, Chinese quinine, Dichroa root, Huang ch'ang-shan, Native alum root, Pai ch'ang-shan, T'u ch'ang-shan, Ta chin-tao, Thuong son, White alum root, Yellow alum root

Medically reviewed by Drugs.com. Last updated on Dec 11, 2023.

Clinical Overview

Use

Dichroa root has been used to treat malaria for centuries in China; however, there are no recent clinical trials to support this use.

Dosing

There are no recent clinical studies of dichroa root to provide dosing recommendations.

Contraindications

Contraindications have not yet been identified.

Pregnancy/Lactation

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

Interactions

None well documented.

Adverse Reactions

Possible adverse effects include nausea, vomiting, and diarrhea. Hepatotoxicity is also a concern.

Toxicology

Limited information concerning toxicity of dichroa root is available.

Scientific Family

Botany

Dichroa root comes from a deciduous shrub that prefers damp areas such as wooded valleys or stream edges. The roots and leaves are used medicinally. The plant bears light-blue flowers and blue-colored berries.Doctor's Manual 1977

History

rIn China, dichroa root has been used to treat malaria for many centuries.Hocking 1977, Takaya 1999 One of the earliest records of plants used as medicine includes dichroa root.Taylor 1981 In his book Flora Cochinchinensis (published in 1790), Portuguese Jesuit João de Loureiro described the febrifugal (ie, mitigating fever) and emetic properties of ch’ang shan and provided the scientific name Dichroa febrifuga.Burns 2008 Chinese scholar/emperor Shen Nung (circa 2735 BC) recorded the plant's effectiveness in treating fever caused by malaria parasites.Burger 1999

Chemistry

Alkaloid febrifugine and its isomer isofebrifugine were isolated during World War II in order to study their effects against malaria.(Hocking 1977, Takaya 1999) Febrifugine is the main alkaloidal constituent present.(Murata 1999) Halofuginone (an alkaloid originally isolated from D. febrifuga) and haloguinol are synthetic derivatives of dichroa root. Halofuginone, along with other febrifugine analogues, was developed in the 1960s for antimalarial evaluation.(Du 2020, McLaughlin 2014)

Uses and Pharmacology

Anti-inflammatory effects

Animal and in vitro data

In a study using rat liver, an aqueous extract of D. febrifuga root regulated inflammation-related proteins, suggesting a potential role in the management of inflammation.(Choi 2003) Similarly, in another study in lipopolysaccharide-stimulated macrophages, the aqueous extract exerted anti-inflammatory effects via inhibition of interleukin (IL)-1beta and IL-6 production in a dose-dependent manner without affecting cell viability.(Park 2009) In vivo and in vitro experiments have documented a synergestic effect between halofuginone and dexamethasone in reducing inflammation in acute lung injury more than either agent alone. The mechanism involved suppression of the NF-kappaB pathway and decreased proinflammatory cytokines (ie, tumor necrosis factor-alpha, IL-1beta, IL-23).(Du 2020)

Antimalarial activity

With drug resistance from medications such as chloroquine and quinine becoming prevalent, researchers have sought other antimalarial sources. Isolates of D. febrifuga, febrifugine and isofebrifugine, were found to be the active components against malaria; however, chemists could not separate adverse effects (eg, nausea, vomiting, diarrhea) from their beneficial actions.(Burger 1999, Zeng 1982, Zhao 1986, Zhu 2012) Febrifugine exerts its antimalarial effects by impairing the haemazoin formation needed for parasite maturation at the trophozoite stage. Various analogues have been synthesized in an effort to minimize adverse effects and enhance bioavailability; some of these compounds have therapeutic indices greater than 10 times that of chloroquine.(McLaughlin 2014, Zhu 2009) One study suggested that increased lipophilicity of the analogues was associated with improved antimalarial activity.(Doctor's Manual 1977, Zhu 2012)

Animal and in vitro data

Febrifugine and isofebrifugine in certain preparations (eg, acetone extract) demonstrated high antimalarial activity against Plasmodium falciparum and Plasmodiumberghei.(Takaya 1999) In a study evaluating the effects of an aqueous extract of D. febrifuga against P. berghei in mice, a reduction in infection rate and an increase in mean survival time were observed.(Gopal 1982).Two reports suggest that dichroa extracts alter nitric oxide (NO) concentrations. In mice infected with P. berghei, febrifugine 1 mg/kg/day orally reduced mortality and parasitemia, and increased NO production and plasma concentration, thus contributing to host defense against malaria infection.(Murata 1999) In an in vivo study, febrifugine significantly enhanced NO production in mouse peritoneal macrophages, with dose-dependent activations.(Murata 1998) However, another study investigating the effects of an aqueous extract of D. febrifuga root demonstrated a decrease in NO production as well as tumor necrosis factor, which plays a role in endotoxin-mediated shock and inflammation. In mouse macrophages, NO synthase and NO serum levels were decreased, suggesting suppression of inflammatory response and possible use as an anti-inflammatory.(Kim 2000)

Other uses

Changrolin, a Chinese antiarrhythmic drug derived from dichroa, has been studied for its antiarrhythmic effects in small mammal cardiac cells.(Chen 2010, Lu 1995)

In a study testing synthetic febrifugine analogues, cytotoxic effects against cancer cells lines (KB, MCF7, LU1, and HepG2) were observed.(Mai 2014) In vitro testing demonstrated potential tumoricidal properties associated with dichroa root.(Mazzio 2009)

In one study, febrifugine analogues exerted activity against Leishmania donovani parasites,(Pandey 2017) while anti-Schistomsoma activity was documented with febrifugine in which both egg production and adult worms were eliminated in vitro.(Mitsui 2020)

Antifibrotic properties of halofuginone have also been described(Du 2020) with in vitro and in vivo studies demonstrating protection against intestinal fibrosis,(Duan 2020), osteoarthritis,(Mu 2018) excessive fibrocartilage development in chondrocytes,(Li 2017) and intervertebral disc degeneration.(Luo 2018)

Dosing

There are no recent clinical studies of dichroa root to provide dosing recommendations.

Pregnancy / Lactation

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

Interactions

None well documented.

Adverse Reactions

Nausea, vomiting, and diarrhea have been reported.Burger 1999 Dichroa root may cause hepatotoxicity.Mojab 2012, Zhu 2012, Zhu 2009

Toxicology

Information regarding toxicity with use of dichroa root is lacking.

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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