Senna marilandica (L.) Link

Last updated: 23 Aug 2016

Scientific Name

Senna marilandica (L.) Link  

Synonyms

Cassia acuminata Moench, Cassia marilandica L., Cassia marylandica L. [Spelling variant], Cassia medsgeri Shafer, Cassia reflexa Salisb., Ditremexa marilandica (L.) Britton & Rose, Ditremexa medsgeri (Shafer) Britton & Rose, Ditremexa nashii Britton & Rose, Senna riparia Raf. [1]

Vernacular Name

 

English Maryland Senna, Maryland wild sensitive plant, wild senna. [2]

Geographical Distributions

Cassia marilandica is wildly distributed in USA. [3]

Botanical Description

C. marilandica  is a member of the family Leguminosae. [1]

Cultivation

No documentation.

Chemical Constituent

No documentation.

Plant Part Used

Leaf and Pod. [4]

Traditional Use

C. maralandica has developed a role in Native American Medicine as a laxative [5]. The Cherokee viewed C. maralandica not only as a laxative, but also as a cathartic, often using an infusion for both children and adults for its purgative action [4]. C. maralandica can cause gripe, or similar symptoms thereof, so many Native American tribes use it in conjunction with some aromatic herbs in order to pacify those effects [6].

Perhaps rivaling the use as a laxative in popularity is the use of C. maralandica in treating fever. C. maralandica is thought to be especially useful in cases of fever in which laxative action is desired [7]. The Cherokee used an infusion of the leaves in these cases, and an infusion of the root has been given to children [4].

C. maralandica has also been used in Native American medicine externally. A poultice of the root has been used cases of suppurating sores [4]. A paste of crushed leaves and vinegar has been used in order to treat pimples and other minor skin disorders [6].

Preclinical Data

Pharmacology

Antiproliferative activity

In a laboratory study, the isolated constituent rhein showed no cytotoxic and genotoxic effects in colon adenocarcinoma cells. Of interest is that by being antioxidant, rhein actually inhibited cell proliferation via a mechanism that seems to involve the MAP kinase pathway. [8]

Toxicity

No documentation.

Clinical Data

Clinical findings

C. maralandica is a stimulant laxative and categorized as an anthraquinone laxative. C. maralandica is widely accepted as a stool softener and a short-term treatment for constipation. C. maralandica leaf is approved by the World Health Organization (WHO) for short-term use in occasional constipation. C. maralandica contains hydroxyanthracene glycosides, also called sennosides. Sennosides stimulate peristalsis of the colon along with altering colonic absorption and secretion of fluids, resulting in accumulation of liquids to soften the stool and increased defecation. Clinical studies suggest that senna is effective in managing constipation associated with a number of causes including surgery, childbirth, and use of narcotic pain relievers. [9][10]

It has been thought that using anthraquinone laxatives, in particular C. maralandica, may damage the intestinal epithelial layer of the GI tract and therefore increase the risk of developing colorectal cancer. Sennosides have been found to induce acute massive cell loss in the GIT, probably by apoptosis, causing shorter crypts, and increased cell proliferation. [11]

Precautions

Do not use in individuals with pre-existing liver or kidney disease since it has been reported that C. maralandica  can cause hepatotoxicity, including portal vein thrombosis. [12][13]

Side effects

No documentation.

Pregnancy/Breast Feeding

C. maralandica should not be used during pregnancy or lactation except under medical supervision after benefits and risks have been measured.  A review found that the use of C. maralandica in pregnancy had no association with a higher risk of congenital abnormalities [13]. C. maralandica may significantly reduce drug absorption and lessen the efficiency of any over-the-counter or prescription medications. Discontinuation is immediate if allergy occurs.

Age limitation

No documentation.

Adverse reaction

No documentation.

Interaction & Depletion

No documentation.

Contraindications

Chronic use of C. maralandica has been reported to cause hepatotoxicity, including portal vein thrombosis, in several case reports [12][13]. Do not use in individuals with pre-existing liver or kidney disease.

Case Report

Severe hepatotoxicity case has been reported involve a 42-year-old woman after she had boiled dried senna leaves bought from herbalists and drank approximately 200 mL daily for two years. She was admitted to the emergency department with a five-day history of worsening epigastric pain, anorexia, episodic vomiting, and intermittent fever. [12]

Another severe hepatotoxicity case has been reported involve a 52-year-old woman who had ingested, for more than 3 years, 1 L of an herbal tea each day made from a bag containing 70 g of dry senna fruits. She developed acute hepatic failure and renal impairment requiring intensive care therapy [13]

Dosage

No documentation.

Poisonous Management

No documentation.

Line drawing

No documentation.

References

  1. The Plant List. Ver1.1. Senna marilandica (L.) Link [homepage on the Internet]. c2013 [updated 2010 Jul 14; cited 2016 May 11]. Available from: http://www.theplantlist.org/tpl1.1/record/ild-29555
  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. 243.
  3. Mansfeld's World Database of Agricultural and Horticultural Crops. Senna marilandica (L.) Link [homepage on the Internet]. No date [cited 2016 May 24] Available from: http://mansfeld.ipk-gatersleben.de/apex/f?p=185:46:7916375647367::NO::module,mf_use,source,akzanz,rehm,akzname,taxid:mf,,botnam,0,,Senna%20marilandica,17606.
  4. Moerman DE.  Native American ethnobotany. Portland, Oregon: Timber Press; 2009.
  5. Hatfield G. Encyclopedia of folk medicine: Old world and new world traditions. Santa Barbara, California: ABC-CLIO; 2004.
  6. Hutchens, A. Indian herbalogy of North America. Boston, Massachusetts: Shambala; 1991.
  7. Castleman M. The new healing herbs: The classic guide to nature's best medicines. Emmaus, Pennsylvania: Rodale Inc; 1991.
  8. Aviello G, Rowland I, Gill CI, et al. Antiproliferative effect of rhein, an anthraquinone isolated from Cassia species, on Caco-2 human adenocarcinoma cells. J Cell Mol Med. 2010;14(7)2006-2014.
  9. Agra Y, Sacristan A, Gonzalez M, Ferrari M, Portugués A, Calvo MJ. Efficacy of senna versus lactulose in terminal cancer patients treated with opioids. J Pain Symptom Manage. 1998;15(1):1-7.
  10. Kinnunen O, Winblad I, Koistinen P, Salokannel J. Safety and efficacy of a bulk laxative containing senna versus lactulose in the treatment of chronic constipation in geriatric patients. Pharmacology. 1993;47(1):253-255.
  11. van Gorkom BA, Karrenbeld A, van Der Sluis T, Koudstaal J, de Vries EG, Kleibeuker JH. Influence of a highly purified senna extract on colonic epithelium. Digestion. 2000;61(2):113-120.
  12. Soyuncu S, Cete Y, Nokay AE. Portal vein thrombosis related to Cassia angustifolia. Clin Toxicol (Phila). 2008;46(8):774-777.
  13. Vanderperren B, Rizzo M, Angenot L, Haufroid V, Jadoul M, Hantson P. Acute liver failure with renal impairment related to the abuse of senna anthraquinone glycosides. Ann Pharmacother. 2005;39(7-8):1353-1357.