ReviewsThis document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.Bryophyllum (see below) [4]. While these reviews describe various compounds and bioactivities, none of them addresses the pharmacological and clinical data that support the therapeutic use of Bryophyllum preparations in European countries. The present review focuses on B. pinnatum, but the few data available on Bryophyllum daigremontianum, Bryophyllum delagoense, and the hybrid Bryophyllum daigremontianum x tubiflorum have also been included. The German homeopathic pharmacopeia (HAB) 2014 [5] lists the two species B. pinnatum and B. daigremontianum as officinal in its monography "Bryophyllum Rh", and both have been used in AM. B. delagoense was introduced in the 1980s as an anthroposophic medicinal product in Germany, primarily for sedative purposes (Personal communication, Dr. med. Siegward-M. Elsas, see Acknowledgments).
Botany
Bryophyllum pinnatum is a succulent perennial plant native to Madagascar which is used in anthroposophical medicine to treat psychiatric disorders and as a tocolytic agent to prevent premature labour. We performed a metabolite profiling study in order to obtain a comprehensive picture of the constituents in B. pinnatum leaves and to identify chromatographic markers for quality control and safety assessment of medicinal preparations. Preliminary HPLC-PDA-ESIMS analyses revealed that flavonoid glycosides were the main UV-absorbing constituents in the MeOH extract of B. pinnatum. Two phenolic glucosides, syringic acid -D-glucopyranosyl ester (1) and 4'-O--D-glucopyranosyl-cis-p-coumaric acid (2), as well as nine flavonoids (3-11) including kaempferol, quercetin, myricetin, acacetin, and diosmetin glycosides were unambiguously identified by 1H and 2D NMR analysis after isolation from a MeOH extract. The flavonol glycosides quercetin 3-O--L-arabinopyranosyl-(1 → 2)--L-rhamnopyranoside 7-O--D-glucopyranoside (3) and myricetin 3-O--L-arabinopyranosyl-(1 → 2)--L-rhamnopyranoside (4) were new natural products. With the aid of HPLC-PDA-APCIMS and authentic references isolated from the related species B. daigremontianum, the presence of four bufadienolides, bersaldegenin-1-acetate (12), bryophyllin A (13), bersaldegenin-3-acetate (14), and bersaldegenin-1,3,5-orthoacetate (15)
AbstractBryophyllum pinnatum is a succulent perennial plant native to Madagascar which is used in anthroposophical medicine to treat psychiatric disorders, and as a tocolytic agent to prevent premature labour. We performed a metabolite profiling study in order to obtain a comprehensive picture of the constituents in B. pinnatum leaves, and to identify chromatographic markers for quality control and safety
A quantitative assay for determination of the main bufadienolides bersaldegenin-1-acetate (1), bersaldegenin-3-acetate (2), bryophyllin A (3), and bersaldegenin-1,3,5-orthoacetate (4) in Bryophyllum pinnatum leaves and manufactured products was developed and validated. The assay involved extraction by pressurised liquid extraction, followed by quantification by ultrahigh performance liquid chromatography-tandem mass spectroscopy. The ultrahigh performance liquid chromatography-tandem mass spectroscopy method was applied to various batches of leaves harvested on several dates from plants grown at two locations (Brazil and Germany). In addition, press juices prepared from plants cultivated in Germany and Brazil were analysed. The total bufadienolide content ranged from 16.28 to 40.50 mg/100 g dry weight in leaves from plants grown in Brazil. The total content of these four bufadienolides was significantly lower in plants cultivated in Germany (3.78-12.49 mg/100 g dry weight, resp.). The total amounts of bufadienolides were 0.091-0.163 mg/100 mL and 0.89-1.16 mg/100 mL in press juices obtained from plants cultivated in Germany and Brazil, respectively. When analysing single leaves from individual plants, the content of bufadienolides was markedly higher in young leaves. For comparative purposes, the content of these bufadienolides was also determined in Bryophyllum daigremontianum and Bryophyllum tubiflorum. Bersaldegenin-1,3,5-orthoacetate (4) was predominant in the leaves of B. daigremontianum and in the stems of B. tubiflorum, while the leaves of B. tubiflorum contained very low amounts of 1-4.
Hintergrund:Bryophyllum pinnatum wurde durch die anthroposophische Medizin in Europa eingeführt und wird heutzutage auch in der konventionellen Medizin breit angewendet. Ziel dieser Studie war es, die Verordnungen im Bereich Gynäkologie und Geburtshilfe in der Schweiz sowie das Wirkungspotenzial von B. pinnatum und mögliche unerwünschte Ereignisse zu erfassen. Patienten und Methoden: Arztpraxen und Kliniken für Geburtshilfe und Gynäkologie wurden gebeten, die Verordnungen von B. pinnatum bei ihren Patientinnen im Zeitraum von 31 Monaten mittels eines Online-Fragebogens zu dokumentieren. Ergebnisse: Am UniversitätsSpital Zürich, am Kantonsspital Winterthur sowie in 2 Arztpraxen wurden bei insgesamt 174 Frauen 208 Verordnungen mit B. pinnatum erfasst (mehrere Verordnungen pro Patientin möglich). Der überwiegende Anteil der Patientinnen war schwanger (87%). B. pinnatum wurde bei 83% aller Frauen bzw. bei 95% der Schwangeren als Tokolytikum bei Frühgeburtsbestrebungen verordnet und zeigte eine gute bis sehr gute Wirkung. Wegen innerer Unruhe erhielten 14% der Patientinnen B. pinnatum zur Sedation am Tag und 5% zur Sedation bei Schlafproblemen. Für diese beiden Indikationen konnte die Unruhe gemindert werden. 13% der Frauen litten an einer hyperaktiven Blase, deren Therapie mit B. pinnatum in zwei Drittel der Fälle als sehr wirksam eingestuft wurde. Für die Behandlung wurde in 92% der Fälle Kautabletten Bryophyllum 50% verschrieben. Schlussfolgerungen: Im Bereich der konventionellen Gynäkologie und Geburtshilfe wird B. pinnatum überwiegend bei schwangeren Patientinnen verordnet, dabei vor allem bei vorzeitigen Wehen, innerer Unruhe und hyperaktiver Blase. B. pinnatum zeigte eine gute Wirkung in der Behandlung dieser mit Hyperaktivität verbundenen Beschwerden.
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