Calotropis procera (Aiton) Dryand.

Last updated: 18 Apr 2016

Scientific Name

Calotropis procera (Aiton) Dryand.

Synonyms

Apocynum syriacum Garsault [Invalid], Asclepias gigantea Willd. [Illegitimate], Asclepias patula Decne., Asclepias procera Aiton, Calotropis busseana K.Schum., Calotropis gigantea var. procera (Aiton) P.T.Li, Calotropis heterophylla Wall. ex Wight, Calotropis inflexa Chiov., Calotropis persica Gand., Calotropis syriaca Woodson, Calotropis wallichii Wight, Madorius procerus (Aiton) Kuntze. [1]

Vernacular Name

Malaysia Lembega, rembega [2]
English Apple of Sodom [2][3], cotton leaf, dead sea apple, dead sea fruit, English cotton, French cotton, giant milkweed, milkweed, mudar plant, Sodom apple, swallow wort [2]
China Bai hua niu jiao gua [2]
India Aak, aakdo, aakra, aush, bhanu, bili yekkada gida, bimbora, dudla, erikku, ganarupaka, jilledu, kashthila, kharak, mandara, nallajilledu, nano akdo, pashkand, pratapa, rajarka, ravi, sadapushpa, shaker al lighal, tapana, uruko, vara, vasukha, vellerukku, yakkeda gida, yerra jilledu [2]
Nepal Aank [2]
Pakistan Ak, arrigh, karak, kark. [2]
Laos Dok hak, dok kap, kok may [2][3]
Tibet A rga I rtsa ba, a rgai rtsa ba [2]
Vietnam Bong-bong, b[oof]ng b[oof]ng, bong qui, l[as] nh[or] [2][3]
Saudi Arabia Axhur, ashkar, baranbakh, eshar, kerenka, koruga, krenka, ngeyi, ochar, oshur, rhalga, torcha, tourza, turja [2]
East Africa Ararat, bohr, etethero, kihuta, mpamba mwitu, mpumbula, mufuthu, okwotpu; etetheru (Turkana); labechi (Samburu); muvuthu (Kamba) [2]
Gambia Bawane, faftan, kupampan [2]
Guinea mpompomogolo, nguyo [2]
Ivory Coast Furo fugo, ganganpi, niapi djara, nopiada, togo fogo, tumo tigi [2]
Kenya Etesuro [2]
Mali Bamanbé, bandambi, bauane, bawane, komitigi, korunka, ngoyo, nyenyi, pobu, tezera, tomitigi, toreha, turdja, tursha [2]
Nigeria Bauane, koruga, ochar, tezera, kayou, kupa, papawea [2]
Senegal Achur, babadi, bupumba pumb, bawam bawam, mbontal [2]
Ghana A-gbo-loba, owula kofi ba, polipoli, unablapong, wolaporhu, walapugo, wutsoe-wutsoe [2]
Tanzania Mpamba mwitu [2]
Togo Inawokodu, kudjohe, tambutiji, tschofu, tshawou [2].

Geographical Distributions

Calotropis procera can be found from tropical and subtropical Africa, through Saudi-Arabia and the Middle East to the Indian subcontinent, Indo-China and Thailand, and introduced in drier areas of Australia, Central and South America and the Mascarene Islands. Probably also introduced or spread to South-East Asia. [3]

Botanical Description

C. pulcherrima is a member of the Fabaceae family. It is a shrub or a small tree with glabrous branches that are armed with thorns. [4]

The leaves are 5-9 pinnate and 1-3 cm long; leaflets in 5-12 pears, oblong, rounded and mucronate at the apex, glabrous, 1-2 cm long and 5-8 mm broad. [4]

The inflorescence is in terminal or upper axilla racemes. [4]

The flowers are yellow, red or orange. The bracts are linear-lanceolate, small and deciduous. The pedicels are slender with 4-8 cm long and glabrous. The receptacle is broadly campanulate, 3 mm long. The sepals are unequal, the inferior larger, and 1.5 cm long, cucullate in the bud, the 4 others are about 1 cm long. The petals are unguiculate, about 2 cm long, superior with longer claw and narrower lamen. The filaments elongated, about 6 cm long. The ovary shortly stipitate and glabrous. [4]

The pod linear-oblong, shortly stipitate, acuminate, 8-12 cm long and 2 cm broad, with partitions between the seeds. [4]

The seeds are 6-8 ovate and compressed. [4]

Cultivation

No documentation

Chemical Constituent

Ethanol extract of C. procera root bark has been reported to contain mudarol isovalerate, mudrol, mudaric acid, akundarol isovalerate, akundrol, akundaric acid, and silver salt. [5]

C. procera has been reported to contain madaralbum, madarfluavil, caoutchouc, mudarine, and calotropin. [6]

C. procera has been reported to contain pekilocerin A, uscharidin, uzarigenin, uzarigenin 3-O [β-D-glucopyranosyl-(1->2)-β-D-glucopyranoside], and voruscharin. [7][8]

Plant Part Used

Bark, leaf, flower, root. [9]

Traditional Use

Powdered root of C. procera had been used as a remedy for dysentery but traditional practitioners warn of the prevailing side effects which are very much similar to those of ipecacuanha i.e. vomiting and depression with bilious stools. Some advocate the use of tinctures of the roots, however, it seems that the powdered root is superior in its effects. In Gambia, the young leaves boiled in water and mixed with cook rice seem to be the remedy for dysentery. The root bark is regarded as an excellent medication for colic and stomach problems in some African countries; in Sudan it is used for jaundice. For intestinal worm infestation, the Kusasi of Ghana make a salve from root and leaf ash with shea butter that is rubbed into scarifications on the abdomen of children. Unani medicine advocate the use of the roots to treat haemorrhoids, tape worms and the root decoction is used to treat ancylostomiasis (worm disease). [6][10][11]

Asthma is treated by using either the flowers or the roots in a decoction. A decoction of the leaves is given to relieve cough. For whooping cough the leaves are boiled with Momordica charantia and the decoction is drank a glassful each time. The root is also good for asthma and cough according to Unani medicine. In Egypt the dried leaves are smoked in pipes for relieving cough. [10][11]

C. procera is popularly used to treat leprosy in Africa. Various methods had been employed for this. In Bamako, the patient is bathed with an 8-day macerate, and in Senegal the patient is given a diluted decoction of the roots. The Gambians uses the juice of the boiled leaves as a remedy for leprosy. There are others who advocate the writing of Quranic verses on the leaves before boiling. The root is also used in the treatment of venereal diseases like gonorrhea and syphilis. In these cases the root or root bark is fermented in honey and given to the patient to drink. [10]

A remedy for snake bite is to take the root with black pepper in the dose of 5 to 10 grains. For women with hypermenorrhoea the dried leaves are used to control the bleeding while in cases of amenorrhoea a decoction of the leaves mixed with shea butter is given. In cases of dystochia a little of the powdered roots mixed in water is prescribed to be given 15 minutes after delivery. In Sudan the latex is used to procure abortion. The stem bark is considered an aphrodisiac while the dried flowers is a remedy for impotency. The Nubians made use of the latex to cure toothache and to loosen the tooth to facilitate extraction; the Pathans on the other hand used fresh roots as toothbrush to prevent and cure toothache. Circulatory and cardiac problems are treated with diluted extract of the root bark. An infusion of one leaf in one glass of water is drunk against arterial hypertension. [6][10]

Preclinical Data

Pharmacology

Anti-inflammatory activity

The flowers, the roots and the latex of C. procera all have anti-inflammatory activities. This fact had been proven a few studies [11][12]. A study concluded that the anti-inflammatory effects of dried latex of C. procera were due to its ability to inhibit histamine and bradykinin and partially inhibiting prostaglandin E2 [13]. Another study identified the active anti-inflammatory compound to be protein in nature. They found that the protein was able to inhibit neutrophil migration induced by carrageenin. On the basis of this they suggested that in inhibitory effect of the latex is likely to be cell-mediated. Reports concurred with this finding and suggested that this effect is mediated through NO production [14].

Antipyretic, analgesic and neuromuscular blocking activity

A single oral dose of dry latex (DL) of C. procera ranging from 165 to 830 mg/kg produced a significant dose dependent analgesic effects against acetic acid induced writhing. The effects of DL at a dose of 415 mg/kg were more pronounced as compared to a 100 mg/kg oral of aspirin. The 830 mg/kg oral dose of DL does not produce toxic effects in mice. [15]

Antiulcerogenic activity

The chloroform fraction of C. procera root extract showed significant anti-ulcer activity against aspirin, indomethacin, ethanol, indomethacin + ethanol and stress-induced ulceration. A study found that the extract not only inhibit gastric secretory volume and total acidity, it also inhibited arachidonic acid metabolism making the inhibition of 5-lipoxygenase as a probable mechanism for its anti-ulcer activity [16]. Another study found that the dried latex of C. procera has the therapeutic potential to relieve gastric hyperacidity and to prevent gastric ulceration induced by necrotizing agents [17].

Antidiarrhoeal activity

A single dose of dry latex of C. procera was able to significantly decrease the frequency of defaecation, the severity of diarrhoea and afforded protection from diarrhoea in 10% of rats treated with castor oil. This was achieved through reduction in intestinal transit and inhibition of castor oil induced intestinal fluid accumulation. [18]

Wound healing activity

A study on application of 20 μL of 1% sterile solution of the latex of C. procera on full thickness wound of rats twice daily for 7 days found that there was augmentation of healing process through marked increase in collagen, DNA and protein synthesis and epithelisation leading to reduction of wound area. [19]

Antifertility activity

The effect of ethanol and aqueous extracts of C. procera roots has been studied on oestrous cycle and on some parameters of oestrogenic functionality in rats. There was evidence of interruption in normal oestrous cycle by both extracts through prolongation of the dioestrous stage of the oestrous cycle with consequent temporary inhibition of ovulation [20]. Another study found their ethanol extract of the roots did not show any antioestrogenic activity, however, there was evidence of strong anti-implantation and uterotropic activity at dose level of 250 mg/kg [21].

Cardioprotective activity

A study found that by pre treating albino rats with 300 mg/kg of ethanol extract of latex of C. procera thrice daily for 30 days, there was significant reduction in the elevated marker enzyme levels in serum and heart homogenates in isoproterenol-induced myocardial infarction. Histopathological studies showed a marked protection by the extract against myocardial necrotic damage. [22]

Smooth muscle relaxant activity

A study reported earlier the ability of their ethanol extract to induce smooth muscle relaxation. Another study demonstrated similar activity with their ethanol extract of the plant. They believe this could be through direct relaxant action on the smooth muscle [23]. Studies found that the oral administration of dry latex decreased intestinal transit time and also decrease intestinal content. At lower doses there was a dose-dependent contraction of gastrointestinal smooth muscles that was followed by desensitization at higher doses [24].

Toxicity

No documentation.

Clinical Data

Clinical findings

No documentation.

Case Report

A 76 year old male has been reported to develop severe dermatological lesions of the skin and mucous membranes following ingestion of burnt leaves of C. procera for two weeks. The lesions appeared as flaccid blisters on non-inflammatory base over the back with eroded and crusted lesions ocvee the rest of the body. Nikolsky’s was positive. Lesion developed from the mouth spreading all over the body except the palms and soles; genital and conjuctival mucosae. [7]

C. procera induced keratitis was reported by a number of workers. The clinical picture of this keratitis includes painless dimness of vision with photophobia, conjunctival congestion and mild to severe corneal oedema. This could subsequently lead to epithelial defect, iridocyclitis and secondary glaucoma as complications. All workers agreed that this is reversible provided the latex did not penetrate the corneal stroma and induce permanent loss of endothelial cells. Treatment with local steroid drops seems to be the best way of handling this situation. Basak et al. advocate using anti-glaucoma agents, cycloplegics, hypertonic saline and tears supplement to address any prevailing complications. [25]

Dosage

No documentation

Poisonous Management

Toxic parts

No documentation

Toxin

The latex of C. procera contains several alkaloids (such as calotropin, catotoxin, calcilin, gigantin) which are caustic and considered poisonous in nature. [25]

Risk management

No documentation.

Poisonous clinical findings

A retrospective analysis of 29 patients who presented with accidental ocular contact or injury with the latex of C. procera was performed. To test the ocular morbidity of patients, examinations like best corrected visual acuity (BCVA) on presentation, slit-lamp findings, conjunctival injection, extent of corneal involvement including fluorescein staining and intraocular pressure by non-contact tonometer (NCT) were carried out. The results are that all patients are presented with sudden painless dimness of vision with photophobia. Twenty-five (86%) patients had initial visual acuity of less than 20/60. All eyes had conjunctival congestion and mild to severe corneal edema with Descemet's folds. Three (10%) eyes had an epithelial defect, nine (31%) had iridocyclitis, and seven (24%) had associated secondary glaucoma. After treatment with topical corticosteroids, antiglaucoma agents, cycloplegics, hypertonic saline and tears supplements, 27 (93%) eyes recovered completely within 3–14 days. [25]

Management

No documentation.

Line drawing

No documentation.

References

  1. The Plant List. Ver1.1. Calotropis procera (Aiton) Dryand. [homepage on the Internet]. c2013 [updated 2012 Mar 23; cited 2016 Apr 18]. Available from: http://www.theplantlist.org/tpl1.1/record/kew-2693668.
  2. Quattrocchi U. CRC world dictionary of medicinal and poisonous plants: Common names, scientific names, eponyms, synonyms, and etymology. Volume II C-D. Boca Raton, Florida: CRC Press, 2012; p. 45-46.
  3. Kiew R. Calotropis procera (Aiton) Aiton f. In: van Valkenburg JLCH, Bunyapraphatsara N, editors. Plant resources of South-East Asia No. 12(2): Medicinal and poisonous plants 2. Leiden, Netherlands: Backhuys Publishers, 2001; p. 137-138.
  4. Lanjouw J, Stoffers AL, editors. Flora of Suriname. Volume 2. Leiden, Netherlands: E.J. Brill. Foundation Van Eedenfonds, 1976; p. 86.
  5. Panda H. Medicinal plants cultivation & their uses. New Delhi: Asia Pacific Business Press, 2000; p. 231-234.
  6. Botanical: A modern herbal. [homepage on the Internet]. No date [cited 2016 Apr 18]. Available from: http://www.botanical.com/botanical/mgmh/c/calotr09.html.
  7. Behl PN, Luthra A. Bullous eruption with Calotropis procera - A medicinal plant used in India. Indian J Dermatol Venereol Leprol. 2002;68(3):150-151.
  8. Ahmad VU, Basha E, editors. Spectroscopic data of steroid glycoside. Volume 4. New York: Springer, 2006; p. 2337-2717.
  9. Herbal Medicine Research Centre, Institute for Medical Research. Compendium of medicinal plants used in Malaysia. Volume 1. Kuala Lumpur: HMRC IMR, 2002; p. 138.
  10. Neuwinger HD. African ethnobotany. Poisons and drugs. Chemistry, pharmacology, toxicology. Weinheim, Germany: Chapman & Hall, 1994; p. 224.
  11. Mascolo N, Sharma R, Jain SC, Capasso F. Ethnopharmacology of Calotropis procera flowers. J Ethnopharmacol. 1988;22(2):211-221.
  12. Kumar VL, Basu N. Anti-inflammatory activity of the latex of Calotropis procera. J Ethnopharmacol. 1994; 44(2):123-125.
  13. Arya S, Kumar VL. Antiinflammatory efficacy of extracts of latex of Calotropis procera against different mediators of inflammation. Mediators Inflamm. 2005;2005(4):228-232.
  14. Alencar NM, Figueiredo IS, Vale MR, et al. Anti-inflammatory effect of the latex from Calotropis procera in three different experimental models: peritonitis, paw edema and hemorrhagic cystitis. Planta Med. 2004;70(12):1144-1149.
  15. Dewan S, Sangraula H, Kumar VL. Preliminary studies on the analgesic activity of latex of Calotropris procera. J Ethnopharmacol. 2000;73(1):307-311.
  16. Sen T, Basu A, Chaudhuri AK. Studies on the possible mechanism of the gastric mucosal protection by Calotropis procera-involvement of 5-lipoxygenase pathway. Fundam Clin Pharmacol. 1998;12(1):82-87.
  17. Bharti S, Wahane VD, Kumar VL. Protective effect of Calotropis procera latex extracts on experimentally induced gastric ulcers in rat. J Ethnopharmacol. 2010;127(2):440-444.
  18. Kumar S, Dewan S, Sangraula H, Kumar VL. Anti-diarrhoeal activity of the latex of Calotropis procera. J Ethnopharmacol. 2001;76(1):115-118.
  19. Rasik AM, Raghubir R, Gupta A, Shukla A, Dubey MP, Srivastava S, Jain HK, Kulshrestha DK. Healing potential of Calotropis procera on dermal wounds in Guinea pigs. J Ethnopharmacol. 1999;68(1-3):261-266.
  20. Circosta C, Sanogo R, Occhiuto F. Effects of Calotropis procera on oestrous cycle and on oestrogenic functionality in rats. Farmaco. 2001;56(5-7):373-378.
  21. Kamath JV, Rana AC. Preliminary study on antifertility activity of Calotropis procera roots in female rats. Fitoterapia. 2002;73(2):111-115.
  22. Ahmed KK, Rana AC, Dixit VK. Effect of Calotropis procera latex on isoproterenol induced myocardial infarction in albino rats. Phytomedicine. 2004;11(4):327-330.
  23. Iwalewa EO, Elujoba AA, Bankole OA. In vitro spasmolytic effect of aqueous extract of Calotropis procera on guinea-pig trachea smooth muscle chain. Fitoterapia. 2005;76(2):250-253.
  24. Kumar VL, Shivkar YM. In vivo and in vitro effect of latex of Calotropis procera on gastrointestinal smooth muscles. J Ethnopharmacol. 2004;93(2-3):377-379.
  25. Basak SK, Bhaumik A, Mohanta A, Singhal P. Ocular toxicity by latex of Calotropis procera (Sodom apple). Indian J Ophthalmol. 2009;57(3):232.