Volume 156, 28 October 2014, Pages 135-146
Xysmalobium undulatum (uzara) - Review of an antidiarrhoeal traditional medicine (Review)
Department of Pharmaceutical Sciences, Faculty
of Science, Tshwane University of Technology, Private Bag X680,
Pretoria, South Africa
Abstract
Ethnopharmacological
relevance: Xysmalobium undulatum, commonly known as uzara, is
traditionally used as an antidiarrhoeal and to treat stomach cramps,
dysmenorrhoea and afterbirth cramps. In addition, it was reportedly used
to treat anxiety and other conditions relating to mental health. Aim of
the review: To unite the botanical aspects, ethnopharmacology,
phytochemistry, biological activity, pharmacokinetic and pharmacodynamic
data, toxicity and commercial aspects of the scientific literature
available on uzara. Method: An extensive review of the literature
covering 1917-2014 was carried out. Electronic databases including
Scopus®, Pubmed®, Google Scholar® and Google® were used to assemble the
data. All abstracts, full-text articles and books written in English and
German were examined and
included. Results: The phytochemistry of uzara has been comprehensively
investigated and at least 18 compounds have been isolated and
characterised. Uzara contains mainly cardenolide glycosides such as
uzarin and xysmalorin and cardenolide aglycones such as uzarigenin and
xysmalogenin. Limited scientific studies on the biological activity of
uzara have been done. In vitro antisecretory antidiarrhoeal action was
confirmed. Central nervous system activity was conflicting, in vitro and
in vivo (animals) studies were inconclusive and no clinical studies
have been performed. No antimutagenic effects have been reported and no
toxicity up to date has been associated with uzara consumption.
Significant cross-reactivity of uzara compounds with commercial digoxin
and digitoxin assays may interfere with therapeutic drug monitoring.
Conclusions: The key traditional uses associated with uzara have been
investigated in vitro and in vivo (animal), but clinical trial data is
lacking. © 2014 Elsevier Ireland Ltd. All rights reserved.
Author keywords
Central nervous system; Diarrhoea; Digitoxin; Digoxin; Uzara; Xysmalobium undulatum
Indexed keywords
EMTREE drug terms: aglycone; antidepressant agent;
antidiarrheal agent; cardenolide; cardiac glycoside; citalopram;
desipramine; digitoxin; digoxin; glycoside; herbaceous agent;
imipramine; monoamine oxidase A inhibitor; monoamine oxidase B
inhibitor; plant extract;
serotonin uptake inhibitor; unclassified drug; uzarigenin; uzarin;
xysmalogenin; xysmalorin; antidiarrheal agent; antiinfective agent;
cardiac glycoside; central nervous system agents; glycoside; plant medicinal product
EMTREE medical terms: abdominal cramp; Alzheimer
disease; antidepressant activity; antidiarrheal activity; antifungal
activity; antioxidant activity; antiprotozoal activity; anxiety
disorder; Apocynaceae; biological activity; biosynthesis; carbon nuclear
magnetic resonance; central nervous system; chirality; depression;
diarrhea; drug cross reactivity; drug monitoring; dysmenorrhea;
ethnopharmacology; geographic distribution; habitat; herb; herbal
medicine; high performance liquid chromatography; human; mass
spectrometry; medicinal plant; mutagenicity; nonhuman; Parkinson disease; phase 3 clinical trial (topic); phytochemistry; plant
root; proton nuclear magnetic resonance; Review; single drug dose;
South Africa; stereochemistry; structure activity relation; systematic
review; traditional medicine; uzara; wound healing; Xysmalobium
undulatum; chemistry; drug effects; phytotherapy; traditional medicine
MeSH: Anti-Infective Agents; Antidiarrheals;
Apocynaceae; Cardiac Glycosides; Central Nervous System Agents;
Glycosides; Humans; Medicine, Traditional; Phytotherapy; Plant Preparations; Plant Roots; Structure-Activity Relationship; Wound Healing
Medline is the source for the MeSH terms of this document.
Medline is the source for the MeSH terms of this document.
Chemicals and CAS Registry Numbers: cardenolide,
29565-36-4; citalopram, 59729-33-8; desipramine, 50-47-5, 58-28-6;
digitoxin, 71-63-6; digoxin, 20830-75-5, 57285-89-9; imipramine,
113-52-0, 50-49-7;Anti-Infective Agents; Antidiarrheals; Cardiac
Glycosides; Central Nervous System Agents; Glycosides; Plant
Preparations
Drug tradename: lanicor,uzara.