Scientific Name(s): Smilax aristolochiifolia Mill. (Mexican sarsaparilla), Smilax china, Smilax febrifuga Kunth (Ecuadorian sarsaparilla), Smilax officinalis Kunth (Honduras sarsaparilla), Smilax ornata Lem., Smilax regelii Killip et Morton (Honduras, Jamaican sarsaparilla), Smilax
Common Name(s): Ba Qia catbrier, Greenbrier, Jin Gang Teng, Khao yen, Rhizoma Smilacis Glabrae, Sarsa, Sarsaparilla, Smilace, Smilax, Zarzaparilla
Extracts of the roots may be effective in treating gout and metabolic syndrome; however, evidence is based largely on animal studies and clinical trials are limited. Sarsaparilla has been traditionally used for treating syphilis, leprosy, and psoriasis; however, evidence to support these uses is lacking. Evidence is also lacking for purported ergogenic/adaptogenic effects. Interest in cytotoxic potential in treating cancer exists.
Clinical trials are lacking to provide guidance on therapeutic dosages. Typical sarsaparilla doses for a variety of uses range from 0.3 to 2 g/day of the powdered root.
Contraindications have not yet been identified.
Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking. Estrogenic and antiestrogenic activities have been described for extracts of at least one of the species.
None well documented.
GI irritation and increased diuresis have been reported. Clinical studies are lacking to provide evidence (or lack of evidence) of harm.
Information regarding toxicology with the use of sarsaparilla is limited.
Many Smilax species are very similar in appearance, regardless of origin. Sarsaparilla is a woody, trailing vine that can grow to 50 m in length. The nectar-rich flowers are used in honey production, and the root is used for medicinal purposes. The root has a pleasant fragrance and spicy sweet taste and is used as a natural flavoring agent in medicines, foods, and nonalcoholic beverages; however, the sarsaparilla root should not be confused with the sassafras tree, which is the source of the distinctive flavoring of American root beer.1, 2, 3
The Spanish physician Nicolás Monardes described using sarsaparilla to treat syphilis in 1574. In 1812, Portuguese soldiers suffering from syphilis recovered faster if sarsaparilla was taken to treat the disease versus mercury, the standard treatment at the time.4 Sarsaparilla has been used by many cultures for other ailments as well, including skin disorders, arthritis, fever, digestive disorders, leprosy, and cancer.1, 4 Late 15th century accounts of the identification and first descriptions of American drugs include sarsaparilla.5 Sarsaparilla was used as a medicinal plant in American and European remedies in the 16th century as well.6 Sarsaparilla has been used for treating syphilis and other sexually transmitted diseases throughout the world and was documented as an adjuvant for leprosy treatment in 1959.7 S. china (Ba Qia or Jin Gang Teng) was included in the 2010 Chinese Pharmacopoeia.8
The rhizomes and roots of the genus are of primary interest. Due to the diversity of the species, standardization of preparations is difficult.9
Smilax species contain a number of steroidal saponins, including sarsaponin, smilasaponin (smilacin), sarsaparilloside and its aglycones sarsasaponin (parillin), sarsasapogenin (parigenin), and smilagenin.1, 4, 10, 11 Other saponins include diosgenin, furostanol, tigogenin, and asperagenin,1, 10 as well as the phytosterols sitosterol, stigmasterol, and pollinastanol.1, 2 At least 50 phenolic compounds and flavonoids have been described.12, 13, 14, 15, 16, 17, 18 Flavonol glycosides, such as isoastilbin, isoengetitin, and astilbin, have been identified.19 Other constituents in sarsaparilla include starch (50%), resin, cetyl alcohol, volatile oil, caffeoylshikimic acid, shikimic acid, ferulic acid, sarsapic acid, kaempferol, and quercetin. Minerals reported in the genus include aluminum, chromium, iron, magnesium, selenium, calcium, zinc, and others.1, 2, 20, 21, 22
The berries contain large amounts of carotenoids (up to 375 mcg/g fresh weight), including lycopene, beta-carotene, cryptoxanthin,23 while the leaves contain phenolic and flavonoid compounds.24
Uses and Pharmacology
In vitro studies report effects on inflammatory markers.22, 25, 26
Extracts of Smilax species have been shown to inhibit induced paw inflammation in rats26, 27 and antiproliferative activity in mice models of psoriasis.28
There are no clinical data regarding the use of sarsaparilla for anti-inflammatory effects.
Experiments report antioxidant activity for extracts of this genus.24, 29, 30, 31 Protective effects against oxidative stress and induced hepatotoxicity have been demonstrated.32, 33
There are no quality clinical data regarding the use of sarsaparilla for antioxidant activity.
Antimycotic activity has been described in a screening study.34 In vitro antimicrobial activity has been described for Smilax glabra rhizome extracts and Smilax campestris, including activity against Candida albicans.12, 35 Butanol extracts of S. china showed activity against HIV in vitro.36
There are no quality clinical data regarding the use of sarsaparilla for antimicrobial activity.
Studies with extracts for individual Smilax species have investigated cytotoxic activity against human cell lines (including cervical, hepatic, breast, gastric, and colon cancer), and induced tumors in mice.11, 37, 38, 39, 40, 41 In castrated mice with induced benign prostatic hyperplasia, extracts from S. china reduced dihydrotestosterone levels and histopathological examination reveals possible protective effect against prostate enlargement.8
Research reveals no clinical data regarding the use of sarsaparilla in cancer.
In vitro studies suggest modulatory effects on endothelial dysfunction.42
Hypoglycemic effects have been demonstrated in mice, possibly via effects on inflammatory aspects of metabolic syndrome.43, 44 Astilbin protected against induced reperfusion injury in rats, possibly via modulation of proinflammatory markers.19 Astilbin and smitilbin from S. glabra, however, did not stimulate insulin secretion.45
In saline-challenged mice, Smilax canariensis (Canary Islands) increased diuresis similarly to hydrochlorothiazide and furosemide.46 S. glabra flavonoids inhibited induced intracellular calcium ion release in cardiomyoblast cells.47
There are no clinical data regarding the use of sarsaparilla in cardiovascular-related conditions.
A study in mice with induced seizures reported an antiepileptic effect (increased seizure latency) for extracts of the rhizome of S. china.48
There are no clinical data regarding the use of sarsaparilla in CNS-related conditions.
Several studies in hyperuricemic and hyperuricosuric rats have been conducted with positive findings. 49, 50, 51, 52, 53, 54, 55
Rhizoma Smilacis Glabrae, in combination with ash bark, has been studied in patients with gout. The “Rebixiao” preparation was effective in reducing serum uric acid levels56; however, the study had methodological limitations.57
Sarsaparilla may bind to endotoxins; however, clinical studies are lacking.4 An older study conducted in the 1940s suggested sarsaponin improved psoriasis.58 The fact that the saponin sarsasapogenin can be synthetically transformed into testosterone bears no relevance in vivo. A review of more than 600 commercially available supplements determined that no research validated purported ergogenic claims.59, 60
Clinical trials are lacking to provide guidance on therapeutic dosages. Typical sarsaparilla doses for a variety of uses range from 0.3 to 2 g/day of the powdered root.61, 62
Pregnancy / Lactation
Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking. Estrogenic and antiestrogenic activities have been described for extracts of Smilax corbularia (Thai sarsaparilla).41
Case reports are lacking. Hepatic induction of cytochrome P450 2A6 has been described for extracts of S. china species.63 An increased absorption of digitalis and elimination of hypnotics may be expected.64 An additive effect with diuretics and allopurinol might also be anticipated, based on animal studies.46, 53
Clinical studies are lacking to provide evidence (or lack of evidence) of harm; however, traditional use of sarsaparilla, eaten raw or in soups and used in Chinese medicine, suggests safety at usual dosages.2, 38 GI irritation and increased diuresis have been reported.2, 60 Occupational asthma caused by sarsaparilla root dust has been reported.64
Information regarding toxicology with the use of sarsaparilla is limited.
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