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Soursop

Scientific Name(s): Annona muricata L.
Common Name(s): Araticum-grande, Araticum-manso, Cachiman épineux, Coração-de-rainha, Corossol épineux, Graviola, Guanábana, Guanábano, Jaca-de-pobre, Jaca-do-Pará, Sauersack, Stachelannone

Clinical Overview

Use

The seeds, fruit, and leaves have been used traditionally for stomach complaints and fever, and as a sedative. Clinical trials are lacking to support these uses.

Dosing

Information is lacking.

Contraindications

Information is lacking. Patients with established Parkinson disease should avoid consumption of the fruit or decoctions made from the leaves (see Toxicology).

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking. Avoid use (see Toxicology).

Interactions

None well documented.

Adverse Reactions

Information is lacking.

Toxicology

A relationship between consumption of A. muricata and atypical parkinsonism has been suggested based on epidemiological observations and animal experiments.

Botany

A. muricata (Soursop) is an evergreen tree native to the warm, humid climates of Brazil, Mexico, the Caribbean region, and Central America. The long prickly fruit measures 20 to 30 cm and weighs up to 2 kg. The fruit is composed of fibrous membranes and a white pulp with many large seeds dispersed throughout, making it difficult to eat without processing.PLANTS 2008, Damico 2003, Rieser 1996, Moghadamtousi 2015 A synonym is Annona macrocarpa Wercklé.

History

Because of its characteristic flavor, A. muricata is grown commercially for its fruit crop, which is used to make juice, candy, sorbet, and ice cream. Soursop has been used traditionally in the management of diarrheal and diabetes-related diseases, as well as for sedative, antimicrobial, and insecticidal properties.Damico 2003, Luna 2006, Lutchmedial 2004

Chemistry

The fruit is high in carbohydrates, especially fructose, and contains vitamins C, B1, and B2 in large amounts. Calcium, magnesium, zinc, potassium, and phosphorous have also been identified.Lutchmedial 2004

Annonaceous acetogenins, fatty acid derivatives, are the most-studied chemical constituents of the plant parts, with estimates of 40 or more distinct compounds.Rieser 1996, Chang 2001, Li 2001, Gleye 2000, 9, Champy 2005, Kim 1998, Zeng 1996, Wu 1995, Wu 1995, Wu 1995, Wu 1995, Kim 1998 Annonacin is the predominant acetogenin.Champy 2005 The alkaloids reticuline and coreximine have also been identified.Kotake 2004

A glycoprotein lectin has been identified in the seeds of the ripe fruits of A. muricataDamico 2003 and N-fatty acyl tryptamines in the seeds have been described.Li 2001

Reviews of the phytochemistry of the plant have been published.Moghadamtousi 2015

Uses and Pharmacology

Clinical trials are lacking,Cercato 2015 but are not likely to be forthcoming due to the toxicity of annonacin.

Antidiabetic

The ethanolic bark extract has been shown to possess antidiabetic and hypolipidemic effects in rats.Cercato 2015

Antimicrobial/Molluscicidal

Activity against both a standard strain and a clinical isolate of herpes simplex virus was demonstrated by an ethanolic extract of A. muricata stem bark.Padma 1998 In a clinical trial, acetogenins extracted from the fruit pericarp were responsible for antileishmanial activity demonstrated in an in vitro experiment.Lannuzel 2006 Another study demonstrated in vitro activity of the leaf extract against some Leishmania species and Trypanosomia cruzi.Osorio 2007

Ethanolic leaf extracts of A. muricata showed molluscicidal activity thought to be, at least in part, due to the annonacin acetogenins.Luna 2006, Moghadamtousi 2015

Cancer

Studies identifying the specific acetogenin compounds in the seeds, leaves, root, and stem bark have explored the potent cytotoxicity of these compounds. Activity against certain human cancer cell lines has been demonstrated in vitro.Rieser 1996, Chang 2001, Liaw 2002, Kim 1998, Zeng 1996, Kim 1998, Tundis 2017

Dosing

Information is lacking. One report estimates that the amount of annonacin ingested by an adult eating one fruit daily for a year is comparable with the intravenous dose used to induce brain lesions in rats. One fruit contains approximately annonacin 15 mg, and a can of commercial nectar contains 36 mg.Champy 2005

Pregnancy / Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking. Toxic neurological effects have been demonstrated in ratsLannuzel 2006 as well as in vitro cytotoxicity.Rieser 1996, Chang 2001, Liaw 2002, Kim 1998, Zeng 1996, Kim 1998 Annonacin crosses the blood-brain barrier.Lannuzel 2006

Interactions

None well documented.

Adverse Reactions

Information is lacking. A single study evaluated the hemagglutination effect of lectin isolated from the seeds.Damico 2003 The clinical importance of this finding is unclear.

Toxicology

Based on an epidemiological observation of higher parkinsonism rates among populations regularly consuming the fruits and traditional medicines of the Annonaceae family, especially graviola, a group of researchers has investigated the plausibility of a causal relationship.Lannuzel 2006, Lannuzel 2007 Among people presenting with atypical parkinsonism on the Caribbean island of Guadeloupe, the majority were levodopa unresponsive, with 1 in 2 patients reporting a high consumption of fruit and decoctions of A. muricata leaves.Lannuzel 2006, Lannuzel 2007 Patients younger than 65 years of age had some resolution of symptoms (eg, gait disorders, bradykinesia, rigidity) when consumption was stopped.Lannuzel 2007, Lannuzel 2002 Annonacin and the alkaloids reticuline and coreximine have been evaluated for toxic effect on rat dopaminergic neurons in vitro. The mechanisms of action remain unclear but are suspected to involve the inhibition of dopamine uptake, as well as effects on neuronal energy production and mitochondrial respiration.Kotake 2004, Lannuzel 2006, Lannuzel 2007 Nigral and striatal degeneration in rats has been demonstratedChampy 2005, Champy 2004 and alkaloid-induced cell death was also observed.Lannuzel 2007, 2002

Ethanolic extracts from Annona muricata seeds were highly active in brine shrimp lethality testing. The fruit seeds are considered toxic and unsuitable for use as animal fodder.Rieser 1996

References

Annona muricata L. USDA, NRCS. 2008. The PLANTS Database (http://plants.usda.gov, Nov, 2008). National Plant Data Center, Baton Rouge, LA 70874-4490 USA.
Cercato LM, White PA, Nampo FK, Santos MR, Camargo EA. A systematic review of medicinal plants used for weight loss in Brazil: Is there potential for obesity treatment? J Ethnopharmacol. 2015;176:286-296.26520790
Champy P, Höglinger GU, Féger J, et al. Annonacin, a lipophilic inhibitor of mitochondrial complex I, induces nigral and striatal neurodegeneration in rats: possible relevance for atypical parkinsonism in Guadeloupe. J Neurochem. 2004;88(1):63-69.14675150
Champy P, Melot A, Guérineau Eng V, et al. Quantification of acetogenins in Annona muricata linked to atypical parkinsonism in guadeloupe. Mov Disord. 2005;20(12):1629-1633.16078200
Chang FR, Wu YC. Novel cytotoxic annonaceous acetogenins from Annona muricata. J Nat Prod. 2001;64(7):925-931.11473425
Damico DC, Freire MG, Gomes VM, et al. Isolation and characterization of a lectin from Annona muricata seeds. J Protein Chem. 2003;22(7-8):655-661.14714732
Gleye C, Raynaud S, Fourneau C, et al. Cohibins C and D, two important metabolites in the biogenesis of acetogenins from Annona muricata and Annona nutans. J Nat Prod. 2000;63(9):1192-1196.11000017
Jaramillo MC, Arango GJ, González MC, Robledo SM, Velez ID. Cytotoxicity and antileishmanial activity of Annona muricata pericarp. Fitoterapia. 2000;71(2):183-186.10727816
Kim GS, Zeng L, Alali F, et al. Muricoreacin and murihexocin C, mono-tetrahydrofuran acetogenins, from the leaves of Annona muricata. Phytochemistry. 1998;49(2):565-571.9747542
Kim GS, Zeng L, Alali F, et al. Two new mono-tetrahydrofuran ring acetogenins, annomuricin E and muricapentocin, from the leaves of Annona muricata. J Nat Prod. 1998;61(4):432-436.9584396
Kotake Y, Okuda K, Kamizono M, et al. Detection and determination of reticuline and N-methylcoculaurine in the Annonaceae family using liquid chromatography-tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2004;806(1):75-78.15149614
Lannuzel A, Höglinger GU, Champy P, Michel PP, Hirsch EC, Ruberg M. Is atypical parkinsonism in the Caribbean caused by the consumption of Annonacae? J Neural Transm Suppl. 2006;(70):153-157.17017523
Lannuzel A, Höglinger GU, Verhaeghe S, et al. Atypical parkinsonism in Guadeloupe: a common risk factor for two closely related phenotypes? Brain. 2007;130(pt 3):816-827.17303592
Lannuzel A, Michel PP, Caparros-Lefebvre D, Abaul J, Hocquemiller R, Ruberg M. Toxicity of Annonaceae for dopaminergic neurons: potential role in atypical parkinsonism in Guadeloupe. Mov Disord. 2002;17(1):84-90.11835443
Lannuzel A, Michel PP, Höglinger GU, et al. The mitochondrial complex I inhibitor annonacin is toxic to mesencephalic dopaminergic neurons by impairment of energy metabolism. Neuroscience. 2003;121(2):287-296.14521988
Li DY, Yu JG, Zhu JX, et al. Annonaceous acetogenins of the seeds from Annona muricata. J Asian Nat Prod Res. 2001;3(4):267-276.11783580
Liaw CC, Chang FR, Lin CY, et al. New cytotoxic monotetrahydrofuran annonaceous acetogenins from Annona muricata. J Nat Prod. 2002;65(4):470-475.11975482
Luna Jde S, De Carvalho JM, De Lima MR, et al. Acetogenins in Annona muricata L. (annonaceae) leaves are potent molluscicides. Nat Prod Res. 2006;20(3):253-257.16401556
Lutchmedial M, Ramlal R, Badrie N, Chang-Yen I. Nutritional and sensory quality of stirred soursop (Annona muricata L.) yoghurt. Int J Food Sci Nutr. 2004;55(5):407-414.15545049
Moghadamtousi SZ, Fadaeinasab M, Nikzad S, Mohan G, Ali HM, Kadir HA. Annona muricata (Annonaceae): A review of Its traditional uses, isolated acetogenins and biological activities. Int J Mol Sci. 2015;16(7):15625-15658.26184167
Osorio E, Arango GJ, Jiménez N, et al. Antiprotozoal and cytotoxic activities in vitro of Colombian Annonaceae. J Ethnopharmacol. 2007;111(3):630-635.17296281
Padma P, Pramod NP, Thyagarajan SP, Khosa RL. Effect of the extract of Annona muricata and Petunia nyctaginiflora on Herpes simplex virus. J Ethnopharmacol. 1998;61(1):81-83.9687085
Rieser MJ, Gu ZM, Fang XP, Zeng L, Wood KV, McLaughlin JL. Five novel mono-tetrahydrofuran ring acetogenins from the seeds of Annona muricata. J Nat Prod. 1996;59(2):100-108.8991944
Tundis R, Xiao J, Loizzo MR. Annona species (Annonaceae): a rich source of potential antitumor agents? Ann N Y Acad Sci. 2017;1398(1):30-36.28415154
Wu FE, Gu ZM, Zeng L, et al. Two new cytotoxic monotetrahydrofuran Annonaceous acetogenins, annomuricins A and B, from the leaves of Annona muricata. J Nat Prod. 1995;58(6):830-836.7673926
Wu FE, Zeng L, Gu ZM, et al. Muricatocins A and B, two new bioactive monotetrahydrofuran Annonaceous acetogenins from the leaves of Annona muricata. J Nat Prod. 1995;58(6):902-908.7673935
Wu FE, Zeng L, Gu ZM, et al. New bioactive monotetrahydrofuran Annonaceous acetogenins, annomuricin C and muricatocin C, from the leaves of Annona muricata. J Nat Prod. 1995;58(6):909-915.7673936
Wu FE, Zhao GX, Zeng L, et al. Additional bioactive acetogenins, annomutacin and (2,4-trans and cis)-10R-annonacin-A-ones, from the leaves of Annona muricata. J Nat Prod. 1995;58(9):1430-1437.7494150
Zeng L, Wu FE, Oberlies NH, McLaughlin JL, Sastrodihadjo S. Five new monotetrahydrofuran ring acetogenins from the leaves of Annona muricata. J Nat Prod. 1996;59(11):1035-1042.8946744

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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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