Herbal Antibiotics: Natural Alternatives for Treating Drug-Resistant Bacteria (16 page)

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Cryptolepis possesses little antifungal activity, though again, some studies have found it effective against candida while others have not. Again, a review of the studies, in my opinion, indicates that it is effective against candida and that preparation problems are the source of the discrepancy.

Use to Treat

Systemic infections, especially malaria, MRSA, streptococcus, babesia, campylobacter, urinary tract infections, tuberculosis, wound sepsis. It is very good for several Gram-negative bacterial infections: klebsiella, salmonella, shigella,
E. coli
, enterobacter, gonorrhea, and most likely pseudomonas

Other Uses

The root has long been used as a brilliant yellow dye in the regions in which it grows; hence its common name, yellow dye root. The dye is usually used for dying leather, generally goat skins. The roots are gathered, dried, then ground in a wooden mortar. The powdered root is blended with hot water in a large vessel. The goat skin is coated with groundnut oil and then dipped in the dye bath. The extract is hand-rubbed into the leather during soaking. Then a tamarind fruit paste is added and rubbed in. The skin is exposed to air for a few minutes, then reimmersed in the bath and rubbed once more. The fruit paste purifies the color.

Though the roots are the primary part of the plant used (both for dye and medicine), the leaves are used as a vegetable in Burkina Faso.

Finding Cryptolepis

The herb is somewhat difficult to obtain in the United States. The only tincture I currently know of is available from Woodland Essence.
Cryptolepis buchanani
may (I repeat,
may
) be a decent substitute for
C. sanguinolenta
, and it is somewhat easier to find. Raksa Thai Herbs is a good source.

Habitat and Appearance

Cryptolepis sanguinolenta
is a slender, thin-stemmed climbing shrub whose stem produces a blood-red to deep orange juice when cut (
sanguinolenta
means “tinged or mixed with blood; bloody”). Essentially it's a tropical plant that likes it hottish and a bit humid. It is common from sea level to 2,500 feet (800 m) in altitude in savanna, dry forest, and gallery forest—that is, the riparian forests that develop along rivers and wetlands.

Cultivation and Collection

From reports, though it is usually wildcrafted, cryptolepis seems fairly easy to cultivate from seed and root cuttings. The seeds can be broadcast if desired. Due to its climbing nature, the plant needs a trellis to do well. Because of the growing international interest in the plant, commercial planting in Africa is on the increase.

The seeds are collected when semi-ripe and red/black in color. Normally they are then planted in raised mounds to facilitate harvesting of the roots. The seeds lose viability fairly quickly; they have a 90 percent to 100 percent germination rate for 4 weeks after harvesting and then begin to decline.

Roots can be collected after the plant is 1 year old, at any time of year. The side of the mounds are dug into and the root harvested. Up to one-third of the root from an individual plant can be taken without damaging the plant or its growth.

Cryptolepis would probably grow well in the American South, the northwest Olympic Peninsula, and parts of the West, or in any climate similar to its natural home. Given its importance, it should be cultivated wherever and whenever it can grow.

Plant Chemistry

There is some confusion in the naming of some of the more potent alkaloids in
C. sanguinolenta
, as researchers in different parts of the world named them with different names at about the same time. It still isn't sorted out. However, the primary ones are cryptolepine, neocryptolepine
(a.k.a. cryptotackieniene, quinindoline), several other forms of neocryptolepine, hydroxycryptolepine, cryptolepine hydrochloride, isocryptoline (a.k.a. cryptosanguinolentine), quindoline, cryptoheptine, biscryptolepine, cryptoquindoline, cryptospirolepine, and cryptomisrine.

Most cryptolepis species contain phenolic compounds but
C. sanguinolenta
does not. Screening has found alkaloids (numerous), polyuronoides, and reducing sugars but little else. Polyphenols, saponins, flavonoids, and cyanogenic glycosides have been reported in at least one study. Cryptolepine is considered to be the strongest constituent (see the sida monograph,
page 102
, especially the “Scientific Research” section), though many of the others are nearly as potent.

An analysis of the leaves has found many of the same alkaloids that are present in the root, including cryptolepine. Aqueous and ethanolic extracts of the leaves are highly active against malaria (and presumably other microorganisms), giving a 90 percent inhibition of multidrug-resistant malarial strains in vitro. The leaves contain at least two novel alkaloids not present in the roots: cryptolepinoic acid and methyl cryptolepinoate, as well as the usual cryptolepine, hydroxycryptolepine, and quindoline.

C. buchanani
,
C. hypoglauca
, and
C. triangularis
have all been listed as containing similar alkaloids as
C. sanguinolenta
. The research is thinner than I would like and
triangularis
may be a synonym of
sanguinolenta
.
Buchanani
has been studied in the most depth. It's a traditional herb in Ayurvedic practice (see that description,
page 98
). Several sources list it as containing cryptolepine and quindoline as well as sarmentogenin, sarmentocymarin, nicotinoyl glucoside, glucopyranose, buchananine, buchanin, n-triacontanol, n-triacontanoic acid, alpha-amyrin, beta-sitosterol glucoside, cryptosin, cryptanoside A-D, germinocol, cryptolepain, sarverogenin, and isosaverogenin. These latter two compounds appear to have potent antibacterial and antiparasitic properties. Given its traditional uses in India, it appears that
C. buchanani
may in fact be a good substitute for
sanguinolenta
.

C. obtusa
contains some novel steroidal alkaloids, but not much work has been done on this plant—and on the rest of the family even less.

Traditional Uses of Cryptolepis

Cryptolepis has been successfully used for centuries by traditional African healers in the treatment of malaria, fevers, and diarrhea, as shown in the chart below.

AYURVEDA

Cryptolepis buchanani
has been used in traditional Ayurvedic practice for millennia. It is widely distributed throughout Pakistan, India, Nepal, Bhutan, Myanmar, China, Thailand, and Sri Lanka. It is considered an invasive weed in many areas (a useful sign of medicinal importance). There are a multitude of local names for the plant in those regions, 60 that I have identified so far.
Maranta
is a common one. It's been used as an antidiarrheal, antibacterial, anti-inflammatory, antiulcerative, blood purifier, demulcent, diaphoretic, and diuretic, and for treating paralysis and rickets and as a general tonic for overall health. It is commonly used for urinary tract infections, for coughs as an expectorant, as a febrifuge (antipyretic), and for abdominal disorders such as dysentery.

In Thailand alcohol extracts of the plant have been used as a primary anti-inflammatory in the treatment of arthritis, muscle and joint pain, and rheumatism.

Scientific studies of
C. buchanani
conducted in India and based on traditional use have found it is strongly antibacterial, effective against
Staphylococcus aureus
,
E. coli
,
Salmonella typhimurium
,
Klebsiella pneumoniae
,
Proteus vulgaris
, and
Bacillus subtilis
. Research has found it to possess immunopotentiating properties (useful in immunodeficiency), to act as a cardiotonic and cardio-protector, to be hepatoprotective, and to be strongly anti-inflammatory. It has shown some hypotensive actions and is considered to be, in one study, antiamphetaminic (a truly strange category—I gave him the amphetamines but they didn't work because …).

A Clinical Trial

Parameters:
44 outpatients with uncomplicated malaria were given a strong tea (steeped for 5 to 10 minutes) three times daily for 5 days, with posttreatment follow-up for 28 days.

Results:
More than half cleared the malarial parasite from their blood within 72 hours (mean clearance time was 82.3 hours). Fever clearance time was 25.2 hours compared with chloroquine's clearance time of 48 hours. Chills, vomiting, and nausea were cleared in all patients in 72 hours. There were two instances of late recrudescence (return of the disease), but the researchers are unsure whether this resulted from reinfection or relapse; no genetic testing was done on the initial infection. Overall the cure rate was 93.5 percent. Nii-Ayi Ankrah, of the Department of Clinical Pathology at the University of Ghana, remarked (in a separate article), “The present result is indeed welcome news since it advances the vision to incorporate plant medicine into the health care delivery system in Ghana.”
1
How different than in the United States.

Other studies, in mice, have found that the intake of a cryptolepis tea prior to inoculation with the malarial parasite does confer some degree of protection against infection. Taking it daily as a preventive as so many in Africa do seems to work well.

TRADITIONAL CHINESE MEDICINE

Given the plant's presence in China and nearby countries, it is certain that it is used in TCM, but none of my sources, though rather extensive in places, give a listing for the plant.

WESTERN BOTANIC PRACTICE

Until recently, this plant was not known to Western practice.

Scientific Research

Cryptolepis was discovered by the West because of the resurgence of pharmaceutically resistant plasmodial parasites. In an attempt to find new treatments for malaria, researchers began looking at traditional treatments. Initial studies revealed both
Cryptolepis sanguinolenta
and
Artemisia annua
(see monograph,
page 140
) to be powerfully active against resistant strains. Artemisia was the first to be developed into a drug (with the same predictable problems ensuing). Cryptolepis lagged behind, but in the past 15 years a tremendous amount of research has been conducted on the plant. Initially, most of it was concerned with malaria.

Cryptolepis is potently active against the malarial parasite,
Plasmodium falciparum
. (It is also active against other members of the genus:
P. berghei berghei
,
P. berghei yoelii
, and
P. vinckei petteri
.) Scores of studies have found it to be effective against the malarial parasite
no matter the degree of its resistance to pharmaceuticals.
Five of the plant's constituents—cryptolepine, cryptolepine hydrochloride, hydroxycryptolepine, cryptoheptine, and neocryptolepine—have been found to be exceptionally active against the parasite, and one other, quindoline, is also active, though not as strong. Studies looking solely at inhibition of beta-haematin formation, which is one of the primary ways that antimalarials deal with malarial infection of blood cells, have found that seven compounds in cryptolepis are active in that respect.

The herb has been remarkably potent against malaria in human clinical trials. One such trial compared the effectiveness of cryptolepis (a hot water infusion of the powdered root) with chloroquine, the usual synthetic drug for malaria treatment, in comparative patient populations at the outpatient clinic of the Centre for Scientific Research into Plant Medicine at Mampong-Akuapem in Ghana, West Africa. Clinical symptoms were relieved in 36 hours with cryptolepis, and 48 hours with chloroquine. Parasitic clearance time was 3.3 days in the cryptolepis group, and 2.3 days in the chloroquine group—a remarkably comparable time period. Forty percent of the patients using chloroquine reported unpleasant side effects necessitating other medications, whereas those using cryptolepis reported
no
side effects.

Because many of the antimalarial compounds in cryptolepis are water
soluble, and water-soluble extracts have worked well in clinical trials, a local company in Ghana hopes that a premade tea of cryptolepis will work well against malaria. Using 2.5 grams of powdered root per tea bag, the preparation is called Phyto-Laria and can be purchased over the counter in Ghana. (Similar products, Malaherb and Herbaquine, are also available in Ghana, and one called Malarial is sold in Mali.)

Pharmaceutical companies have created a number of cryptolepine analogues in an attempt to generate a patented drug they can control. Side effects from these analogues are unknown (isolated cryptolepine, unlike the plant it comes from, has shown a number of serious side effects during in vitro and in vivo studies), and like artemisinin and artesenuate (constituents isolated from
Artemisia annua
; see monograph,
page 140
), these analogues are likely to prove futile in the long run since the malarial parasite does develop immunity to single chemical compounds with regularity. Even though the analogues are molecularly close to cryptolepine, studies have found their mode of action to be different from cryptolepine's—the researchers really don't know what they do in the body or the likely long-term impacts. Because the herb itself is so tremendously safe and effective, I would not recommend the use of analogues if they do in fact ever come on the market.

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