Ruscus aculeatus L.

Last updated: 16 May 2016

Scientific Name

Ruscus aculeatus L.  

Synonyms

Oxymyrsine pungens Bubani, Ruscus flexuosus Mill., Ruscus laxus Sm., Ruscus parasiticus Gueldenst., Ruscus ponticus Woronow [1]

Vernacular Name

English Box-holly, butcher’s broom, knee holly [2]
Arab Khizana [2], aas barri, meurdjel, senesaq [3]
France bois pointu, fragon (piquant), fragon piquant (piquant), houx frêlon, petit houx [3]
Germany Dornmyrte, Stechender Mäusedorn [3]
Italy Bruscolo, pungi-topo, spruneggio [3]
Netherlands Muizedoorn [3].

Geographical Distributions

Ruscus aculeatus is wildly distributed in Azores, West Europe, and from Mediterranean region to Iran. It is now cultivated in various regions of the world for various uses. [3]

Botanical Description

R. aculeatus is a member of the Asparagaceae family [3]. It is a perennial evergreen subshrub that can grow from 20 cm to 80 cm high. It has heavy branches and erect stem. The leaves are small, scalelike, brown-membranous, and the phylloclades are spread in the form of acuminate and leathery leaves. The flowers are small, greeish white, dioecious, and borne at the middle of the phylloclades. The fruit is a scarlet berry [4].

Cultivation

No documentation.

Chemical Constituent

R. aculeatus has been reported to contain spirostanol saponins, furostanol saponins, flavonoids, sitosterol, sigmasterol, campesterol, tyramine, coumarins, glycolic acid, euparone, triterpenes. [5][6][7][8][9] 

Plant Part Used

Roots and rhizomes. [4]

Traditional Use

R. aculeatus has been used in traditional medicine as vasoprotective and diuretic. [4]

Preclinical Data

Pharmacology

Cardiac activity

Numerous animal and laboratory models have investigated the mechanism by which this herb is effective in treating venous disorders [10]. In a laboratory analysis using canine cutaneous veins, researchers found that temperature directly affects the constriction of the veins in response to R. aculeatus extract in an opposite manner than that of sympathetic nerve activation and that it is likely due to the indication that the extract causes contractions via alpha adrenergic activation [11]. An in vivo study followed up on earlier findings that ruscogenin extracted from this herb exhibits anti-inflammatory and anti-thrombic activities. The results indicate that ruscogenin suppressed leukocyte migration in a dose dependent manner [12].

R. aculeatus extract has been found to inhibit the activation of endothelial cells by hypoxia and to inhibit the macromolecular permeability effects of histamine. [13][14]

The investigations into the mechanism by which Ruscus extract acts has been examined in two studies using vein segments taken from patients for medical reasons and compared the varicose veins with controls. The varicose veins showed greater levels of cyclic guanosine monophosphate and these levels were altered by use of the Ruscus extract [15]. In a similar analysis, using varicose veins and control veins from patients, researchers compared the effects of Ruscus extract and norepinephrine. Both applications demonstrated contractions in the veins examined. Contractions in response to the Ruscus extract were reduced by alpha2-adrenergic blockade in varicose veins but were not reduced in controls indicating a different distribution of the alpha adrenergic receptors in those with varicose disease [16].

Toxicity

No documentation.

Clinical Data

Clinical findings

R. aculeatus is a primary ingredient in several well studied drugs designed to treat venous insufficiency.  Typically these drugs use combinations of Ruscus extract, hesperidin and ascorbic acid in varying amounts.  Clinical studies have examined the efficacy of these preparations in a wide range of patients suffering from venous insufficiency and all have proven to be effective in both relieving symptoms and in improving measured parameters while being well tolerated. [17][18][19][20][21]

Clinical research on Ruscus extract as a single ingredient preparation has demonstrated similar positive results.  In a double-blind, placebo controlled study of 148 patients with venous insufficiency, examination at 8 and 12 weeks showed improvements in symptoms and measured parameters in the Ruscus group over the placebo group. [22]

Precautions

No documentation.

Side effects

R. aculeatus is considered to be safe if used as directed and under the guidance of a trained professional.  Occasional gastric upset and nausea may occur. [23]

Pregnancy/Breast Feeding

No documentation.

Age limitation

No documentation.

Adverse reaction

No documentation.

Interaction & Depletion

No documentation.

Interaction with drug

Anticoagulant and antiplatelet medications

Based on pharmacology, avoid using R. aculeatus in combination with anticoagulant and antiplatelet medications as the coumarin content of the herb may potentiate the effects of these drugs. [24]

MAO inhibitors

Based on pharmacology, avoid concurrent use with MAO inhibitors as R. aculeatus contains tyramine. [24]

Interaction with other Herbs

No documentation.

Contraindications

No documentation.

Dosage

No documentation.

Poisonous Management

No documentation.

Line drawing

No documentation.

References

  1. The Plant List. Ver1.1. Ruscus aculeatus L. [homepage on the Internet]. c2013 [updated 2012 Mar 23; cited 2016 May 11]. Available from: http://www.theplantlist.org/tpl1.1/record/kew-286704
  2. Quattrocchi U. CRC world dictionary of medicinal and poisonous plants: Common names, scientific names, eponyms, synonyms, and etymology. Volume V R-Z. Boca Raton, Florida: CRC Press, 2012; p. 110.
  3. Mansfeld's World Database of Agricultural and Horticultural Crops. Ruscus aculeatus L. [homepage on the Internet]. No date [cited 2016 May 16] Available from: http://mansfeld.ipk-gatersleben.de/apex/f?p=185:46:13872684074686::NO::module,mf_use,source,akzanz,rehm,akzname,taxid:mf,,botnam,0,,Ruscus%20aculeatus,7343
  4.  Burlando B, Verotta L, Cornara L, Bottini-Massa E. Herbal principles in cosmetics: Properties and mechanisms of action. Boca Raton, Florida: CRC Press, 2010; p. 105
  5. ElSohly M, Knapp JE, Slatkin KF, Schiff PL Jr, Doorenbos NJ, Quimby MW. Constituents of Ruscus aculeatus. Lloydia. 1975;38(2):106-108.
  6. Nikolov S, Joneidi M, Panova D. Quantitative determination of ruscogenin in Ruscus species by densitometric thin-layer chromatography. Pharmazie. 1976;31(9):611-612.
  7. Dunouau C, Bellé R, Oulad-Ali A, Anton R, David B. Triterpenes and sterols from Ruscus aculeatus. Planta Med. 1996;62(2):189-190.
  8. Mimaki Y, Kuroda M, Kameyama A, Yokosuka A, Sashida Y. Steroidal saponins from the underground parts of Ruscus aculeatus and their cytostatic activity on HL-60 cells. Phytochemistry. 1998;48(3):485-493.
  9. Mimaki Y, Kuroda M, Yokosuka A, Sashida Y. A spirostanol saponin from the underground parts of Ruscus aculeatus. Phytochemistry. 1999;51(5):689-692.
  10. Bouskela E, Cyrino FZ, Marcelon G. Effects of Ruscus extract on the internal diameter of arterioles and venules of the hamster cheek pouch microcirculation. J Cardiovasc Pharmacol. 1993;22(2):221-224.
  11. Rubanyi G, Marcelon G, Vanhoutte PM. Effect of temperature on the responsiveness of cutaneous veins to the extract of Ruscus aculeatus. Gen Pharmacol. 1984;15(5):431-434.
  12. Huang YL, Kou JP, Ma L, Song JX, Yu BY. Possible mechanism of the anti-inflammatory activity of ruscogenin: role of intercellular adhesion molecule-1 and nuclear factor-kappaB. J Pharmacol Sci. 2008;108(2):198-205.
  13. Bouaziz N, Michiels C, Janssens D, et al. Effect of Ruscus extract and hesperidin methylchalcone on hypoxia-induced activation of endothelial cells. Int Angiol. Dec 1999;18(4):306-312.
  14. Bouskela E, Cyrino FZ, Marcelon G. Possible mechanisms for the inhibitory effect of Ruscus extract on increased microvascular permeability induced by histamine in hamster cheek pouch. J Cardiovasc Pharmacol. 1994;24(2):281-285.
  15. Nemcova S, Gloviczki P, Rud KS, Miller VM. Cyclic nucleotides and production of prostanoids in human varicose veins. J Vasc Surg. 1999;30(5):876-883.
  16. Miller VM, Rud KS, Gloviczki P. Pharmacological assessment of adrenergic receptors in human varicose veins. Int Angiol. 2000;19(2):176-183.
  17. Cappelli R, Nicora M, Di Perri T. Use of extract of Ruscus aculeatus in venous disease in the lower limbs. Clinical – Venous insufficiency. Drugs Exp Clin Res. 1988;14(4):277-283.
  18. Weindorf N, Schultz-Ehrenburg U. Controlled study of increasing venous tone in primary varicose veins by oral administration of Ruscus aculeatus and trimethylhespiridinchalcone. Z Hautkr.1987;62(1):28-38.
  19. Beltramino R, Penenory A, Buceta AM. An open-label, randomized multicenter study comparing the efficacy and safety of Cyclo 3 Fort versus hydroxyethyl rutoside in chronic venous lymphatic insufficiency. Angiology. 2000;51(7):535-544.
  20. Guex JJ, Enriquez Vega DM, Avril L, Boussetta S, Taïeb C. Assessment of quality of life in Mexican patients suffering from chronic venous disorder - impact of oral Ruscus aculeatus-hesperidin-methyl-chalcone-ascorbic acid treatment - 'QUALITY Study'. Phlebology. 2009;24(4):157-165.
  21. Boyle P, Diehm C, Robertson C. Meta-analysis of clinical trials of Cyclo 3 Fort in the treatment of chronic venous insufficiency.Int Angiol. 2003;22(3):250-262.
  22. Vanscheidt W, Jost V, Wolna P, et al. Efficacy and safety of a Butcher's broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency. Arzneimittelforschung. 2002;52(4):243-250.
  23. Blumenthal M, Goldberg A, Brinkman J. Expanded commission E monographs. Austin, Texas: Theime Publishers; 2000.Casileth B, Lucareli C. Herb-drug interactions in oncology. Ontario: BC Decker, 2003; p. 63-64.
  24. Casileth B, Lucareli C. Herb-drug interactions in oncology. Ontario: BC Decker, 2003; p. 63-64.