Pasiflora

Passiflora incarnata L.,
Passifloraceae

engl. passionflower, maypop; fr. passiflore, fleur de la passion; njem. Passionsblumenkraut, fleischfarbige Passionsblume

BOTANIČKI PODACI

Pasiflora je zeljasta puzavica, gole, tanke, slabo izbrazdane stabljike duge do 9 metara, s izmjenično poredanim listovima. Listovi su duboko dlanasto razdijeljeni, liske su jajasto suličaste, na vrhu sitno pilaste. Na dugim lisnim peteljkama se nalaze po dvije nektarijske žlijezde. Cvjetovi su pojedinačni, u promjeru 3-8 cm, latice su blijedoljubičaste, a iz njihove baze izrasta niz nitastih ružičastih do purpurnih članova krunice, tako da se prividno čini da su latice dvovrsne. Pasiflora je samonikla u istočnim i južnim dijelovima Sjeverne Amerike, a kao ukrasna biljka sadi se u cijelom svijetu. Upotrebljava se cijeli nadzemni dio biljke. Pasifloru ne treba brkati s voćem passionfruit, vrstom Passiflora edulis Sims. čiji se listovi katkad koriste za patvorenje droge.

OFICINALNI DIJELOVI BILJKE

Zelen biljke (passiflorae herba). Droga mora odgovarati propisima Ph.eur. i Ph.fr.

Falsifikacija je česta. Ispitati mikroskopski - karakteristične dlake lista i stabljike, uglavnom zakrivljene i zašiljenog terminusa. Mezofil lista sadrži oksalatne kristale veličine 15 μm, izolirane ili grupirane duž nervature lista.

KEMIJSKI SASTAV (AKTIVNE TVARI)

Flavonoidi (2,5% u suhoj masi biljke): izo-viteksin-2''-glukozid, shaftozid, izo-shatozid, izo-orientin-2''-β-D-glukozid, vicenin-2. Šećeri: saharoza, fruktoza, glukoza. Polisaharidi: arabinoglukan. Eterično ulje (u tragovima): limonen, α-pinen, zizaen, zizanen, kumen. Cijanogenetski heterozidi (tragovi): ginokardin. Alkaloidi (tragovi): harmin, harmol, hamalol.

INDIKACIJE/DJELOVANJE

Komisija E: stanja nervoze.

ESCOP: Napetost, nemir, iritabilnost, nesanica.

Druge upotrebe: anksiozinost, predoperativna anksioznost, depresija (lakša do srednja), ADHD, terapija ovisnosti (marihuana/kanabinoidi, kokain, nikotin, alkohol), erektilna disfunkcija, tinitus.

TIPOVI EKSTRAKATA

Infuz, tinktura, SIPF, suhi standardizirani ekstrakti.

POSOLOGIJA

Komisija E: 4-8g droge dnevno kao infuz ili ekvivalentni pripravci.

ESCOP: 1,5-8g droge dnevno u obliku infuza. 1-4mL tinkture (1:8 50vol% etanol w/v) 3-4x dnevno. Djeca 3-12 godina: korekcija doze ekvivalentna težini (odrasla osoba 60kg).

KONTRAINDIKACIJE

Bez kontraindikacija (ESCOP, komisija E).

INTERAKCIJE S LIJEKOVIMA

Bez interakcija (Komisija E, ESCOP).

Suspektne: benzodiazepini.

osobna iskustvena praksa

Premda sam zaslužan za uvođenje pasiflore u hrvatsku fitoterapijsku praksu (prije moje knjige nije bilo monoterapijskih pripravaka na tržištu), bio sam neko vrijeme skeptičan prema punom potencijalu ove biljke. Vremenom sam samog sebe opovrgnuo, što je uvijek lijep osjećaj. Moji francuski učitelji govorili su mi da je pasiflora postala popularna nakon prvog svjetskog rata, kao jedan od lijekova kod PTSP-a u vojnika. Ona je vremenom postala puno više od toga.

Glavni razlog zbog koje ju propisujem je nesanica. Gledajući objektivnim očima, pasiflora se pokazala superiornom u odnosu na odolen (valerijanu), vjerojatno najpoznatiju "biljku za živce". Prema meta analizama kliničkih studija odoljena, te kliničkim studijama pasiflore, upravo je pasiflora prvi biljni odabir kod insomnije. No koristim ju i kod:

• nervoze
• anksioznosti
• ADHD-a
• lake i srednje teške depresije

Kod nesanica obično sugeriram dozu od 5-10mL SIPF pripravka, uzetog navečer prije spavanja. U težim slučajevima ju kombiniram s tinkturom odoljena, ali i matičnjaka i lavande, u istoj dozi. Na isti način se može koristiti i kod anksioznosti i nervoze, ali u razdijeljenim dozama (5mL 2x dnevno). Ukoliko se kombinira s odoljenom, treba imati na umu sedativni i hipotenzivni učinak.

Komisija E striktno navodi pedijatrijsku upotrebu pasiflore, stoga se koristi kod ADHD-a. Korekcija doze nije linearna s tjelesnom težinom, stoga djeca od 20kg bez problema mogu uzimati i 3mL pasiflore 2x dnevno. No, početnicima u fitoterapijskim protokolima uvijek se mudro konzultirati oko korekcije doze. Pristup ADHD-u je složen  i individualan te ne uključuje samo farmakološke tvari, ali se statistički najčešće kombinira s pycnogenolom, te DHA (omega-3).

Kod lake i srednje teške depresije, pasiflora ima ključnu prednost pred planetarno poznatim pripravcima gospine trave. Ona nije PXR agonist, ne djeluje na CYP3A4 enzim, te time ne iskazuje neugodne interakcije s lijekovima. Pogodna je i kao monoterapije, imajući stalno na umu individualan pristup ovoj bolesti heterogenih uzroka i simptoma.

REFERENCE

KLINIČKA ISPITIVANJA

A Double-blind, Placebo-controlled Investigation of the Effects of Passiflora incarnata (Passionflower) Herbal Tea on Subjective Sleep Quality. Ngan A, Conduit R. Phytother Res. 2011 Feb 3. doi: 10.1002/ptr.3400. [Epub ahead of print]

[Medicinal plants for the treatment of generalized anxiety disorder: a review of controlled clinical studies.] Faustino TT, Almeida RB, Andreatini R. Rev Bras Psiquiatr. 2010 Oct 15. pii: S1516-44462010005000026. [Epub ahead of print] Portuguese.

Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Lakhan SE, Vieira KF. Nutr J. 2010 Oct 7;9:42. Review.

Natural remedies for anxiety disorders: potential use and clinical applications. Kinrys G, Coleman E, Rothstein E. Depress Anxiety. 2009;26(3):259-65. Review.

Preoperative oral Passiflora incarnata reduces anxiety in ambulatory surgery patients: a double-blind, placebo-controlled study. Movafegh A, Alizadeh R, Hajimohamadi F, Esfehani F, Nejatfar M. Anesth Analg. 2008 Jun;106(6):1728-32.

Herbal medicines in the treatment of psychiatric disorders: a systematic review. Sarris J. Phytother Res. 2007 Aug;21(8):703-16. Review.

[Botanical sedatives]. Unger M. Pharm Unserer Zeit. 2007;36(3):206-12. Review. German.

Passiflora for anxiety disorder. Miyasaka LS, Atallah AN, Soares BG. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD004518. Review.

Herbal remedies for anxiety - a systematic review of controlled clinical trials. Ernst E. Phytomedicine. 2006 Feb;13(3):205-8. Epub 2005 Aug 15. Review.

Medicinal plants for insomnia: a review of their pharmacology, efficacy and tolerability. Wheatley D. J Psychopharmacol. 2005 Jul;19(4):414-21. Review.

Passiflora: a review update. Dhawan K, Dhawan S, Sharma A. J Ethnopharmacol. 2004 Sep;94(1):1-23. Review.

[Passion Flower (Passiflora incarnata L.)--a reliable herbal sedative]. Krenn L. Wien Med Wochenschr. 2002;152(15-16):404-6. Review. German.

Antitussive activity of the methanol extract of Passiflora incarnata leaves. Dhawan K, Sharma A. Fitoterapia. 2002 Aug;73(5):397-9.

Reversal of cannabinoids (delta9-THC) by the benzoflavone moiety from methanol extract of Passiflora incarnata Linneaus in mice: a possible therapy for cannabinoid addiction. Dhawan K, Kumar S, Sharma A. J Pharm Pharmacol. 2002 Jun;54(6):875-81.

Anti-anxiety studies on extracts of Passiflora incarnata Linneaus. Dhawan K, Kumar S, Sharma A. J Ethnopharmacol. 2001 Dec;78(2-3):165-70.

Passionflower in the treatment of opiates withdrawal: a double-blind randomized controlled trial. Akhondzadeh S, Kashani L, Mobaseri M, Hosseini SH, Nikzad S, Khani M. J Clin Pharm Ther. 2001 Oct;26(5):369-73.

Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. Akhondzadeh S, Naghavi HR, Vazirian M, Shayeganpour A, Rashidi H, Khani M. J Clin Pharm Ther. 2001 Oct;26(5):363-7.

[Phytochemicals as means to induce sleep]. Volz HP. Z Arztl Fortbild Qualitatssich. 2001 Jan;95(1):33-4. German.

A combination of plant extracts in the treatment of outpatients with adjustment disorder with anxious mood: controlled study versus placebo. Bourin M, Bougerol T, Guitton B, Broutin E. Fundam Clin Pharmacol. 1997;11(2):127-32.

Pharmacological trials of crude extract of Passiflora alata. Oga S, de Freitas PC, Gomes da Silva AC, Hanada S. Planta Med. 1984 Aug;50(4):303-6. No abstract available.

[On the use of Passiflora extract in tinnitus]. LORIIA AG. Vestn Otorinolaringol. 1962 May-Jun;24:91-2. Russian. No abstract available.

PREDKLINIČKA ISPITIVANJA

Pharmacological studies in an herbal drug combination of St. John's Wort (Hypericum perforatum) and passion flower (Passiflora incarnata): In vitro and in vivo evidence of synergy between Hypericum and Passiflora in antidepressant pharmacological models. Fiebich BL, Knörle R, Appel K, Kammler T, Weiss G. Fitoterapia. 2010 Dec 24. [Epub ahead of print]

Modulation of the γ-aminobutyric acid (GABA) system by Passiflora incarnata L. Appel K, Rose T, Fiebich B, Kammler T, Hoffmann C, Weiss G. Phytother Res. 2010 Nov 19. doi: 10.1002/ptr.3352. [Epub ahead of print]

Passiflora incarnata L. (Passionflower) extracts elicit GABA currents in hippocampal neurons in vitro, and show anxiogenic and anticonvulsant effects in vivo, varying with extraction method. Elsas SM, Rossi DJ, Raber J, White G, Seeley CA, Gregory WL, Mohr C, Pfankuch T, Soumyanath A. Phytomedicine. 2010 Oct;17(12):940-9. Epub 2010 Apr 10.

Apparently no sedative benzoflavone moiety in passiflorae herba. Holbik M, Krasteva S, Mayer N, Kählig H, Krenn L. Planta Med. 2010 May;76(7):662-4. Epub 2010 Mar 18.

Anxiolytic effects of a passion flower (Passiflora incarnata L.) extract in the elevated plus maze in mice. Grundmann O, Wähling C, Staiger C, Butterweck V. Pharmazie. 2009 Jan;64(1):63-4.

Antiradical activities of the extract of Passiflora incarnata. Masteikova R, Bernatoniene J, Bernatoniene R, Velziene S. Acta Pol Pharm. 2008 Sep-Oct;65(5):577-83.

Anxiolytic activity of a phytochemically characterized Passiflora incarnata extract is mediated via the GABAergic system. Grundmann O, Wang J, McGregor GP, Butterweck V. Planta Med. 2008 Dec;74(15):1769-73. Epub 2008 Nov 12.

Possible role of GABAA-benzodiazepine receptor in anticonvulsant effects of Pasipay in rats. Nassiri-Asl M, Zamansoltani F, Shariati-Rad S. Zhong Xi Yi Jie He Xue Bao. 2008 Nov;6(11):1170-3.

Chrysin induces hyperalgesia via the GABAA receptor in mice. Zhai K, Hu L, Chen J, Fu CY, Chen Q. Planta Med. 2008 Aug;74(10):1229-34. Epub 2008 Jul 8.

The effects of chrysin, a Passiflora incarnata extract, on natural killer cell activity in male Sprague-Dawley rats undergoing abdominal surgery. Beaumont DM, Mark TM Jr, Hills R, Dixon P, Veit B, Garrett N. AANA J. 2008 Apr;76(2):113-7.

Evaluation of the anxiolytic effects of chrysin, a Passiflora incarnata extract, in the laboratory rat. Brown E, Hurd NS, McCall S, Ceremuga TE. AANA J. 2007 Oct;75(5):333-7.

Anticonvulsant effects of aerial parts of Passiflora incarnata extract in mice: involvement of benzodiazepine and opioid receptors. Nassiri-Asl M, Shariati-Rad S, Zamansoltani F. BMC Complement Altern Med. 2007 Aug 8;7:26.

In vitro susceptibility of Helicobacter pylori to botanical extracts used traditionally for the treatment of gastrointestinal disorders. Mahady GB, Pendland SL, Stoia A, Hamill FA, Fabricant D, Dietz BM, Chadwick LR. Phytother Res. 2005 Nov;19(11):988-91.

Hypnotic activities of chamomile and passiflora extracts in sleep-disturbed rats. Shinomiya K, Inoue T, Utsu Y, Tokunaga S, Masuoka T, Ohmori A, Kamei C. Biol Pharm Bull. 2005 May;28(5):808-10.

Pharmacological studies on the sedative and hypnotic effect of Kava kava and Passiflora extracts combination. Capasso A, Sorrentino L. Phytomedicine. 2005 Jan;12(1-2):39-45.

Drug/substance reversal effects of a novel tri-substituted benzoflavone moiety (BZF) isolated from Passiflora incarnata Linn.--a brief perspective. Dhawan K. Addict Biol. 2003 Dec;8(4):379-86. Review.

Nicotine reversal effects of the benzoflavone moiety from Passiflora incarnata Linneaus in mice. Dhawan K, Kumar S, Sharma A. Addict Biol. 2002 Oct;7(4):435-41.

Attenuation of benzodiazepine dependence in mice by a tri-substituted benzoflavone moiety of Passiflora incarnata Linneaus: a non-habit forming anxiolytic. Dhawan K, Dhawan S, Chhabra S. J Pharm Pharm Sci. 2003 May-Aug;6(2):215-22.

Antiasthmatic activity of the methanol extract of leaves of Passiflora incarnata. Dhawan K, Kumar S, Sharma A. Phytother Res. 2003 Aug;17(7):821-2.

Aphrodisiac activity of methanol extract of leaves of Passiflora incarnata Linn in mice. Dhawan K, Kumar S, Sharma A. Phytother Res. 2003 Apr;17(4):401-3.

Restoration of chronic-Delta 9-THC-induced decline in sexuality in male rats by a novel benzoflavone moiety from Passiflora incarnata Linn. Dhawan K, Sharma A. Br J Pharmacol. 2003 Jan;138(1):117-20.

Beneficial effects of chrysin and benzoflavone on virility in 2-year-old male rats. Dhawan K, Kumar S, Sharma A. J Med Food. 2002 Spring;5(1):43-8.

Prevention of chronic alcohol and nicotine-induced azospermia, sterility and decreased libido, by a novel tri-substituted benzoflavone moiety from Passiflora incarnata Linneaus in healthy male rats. Dhawan K, Sharma A. Life Sci. 2002 Nov 15;71(26):3059-69.

Suppression of alcohol-cessation-oriented hyper-anxiety by the benzoflavone moiety of Passiflora incarnata Linneaus in mice. Dhawan K, Kumar S, Sharma A. J Ethnopharmacol. 2002 Jul;81(2):239-44.

Anxiolytic activity of aerial and underground parts of Passiflora incarnata. Dhawan K, Kumar S, Sharma A. Fitoterapia. 2001 Dec;72(8):922-6.

Comparative biological activity study on Passiflora incarnata and P. edulis. Dhawan K, Kumar S, Sharma A. Fitoterapia. 2001 Aug;72(6):698-702.

Comparative evaluation of Melissa officinalis L., Tilia europaea L., Passiflora edulis Sims. and Hypericum perforatum L. in the elevated plus maze anxiety test. Coleta M, Campos MG, Cotrim MD, Sença da Cunha A. Pharmacopsychiatry. 2001 Jul;34 Suppl 1:S20Pro-1.

Behavioral characterisation of the flavonoids apigenin and chrysin. Zanoli P, Avallone R, Baraldi M. Fitoterapia. 2000 Aug;71 Suppl 1:S117-23.

Behavioural effects of Passiflora incarnata L. and its indole alkaloid and flavonoid derivatives and maltol in the mouse. Soulimani R, Younos C, Jarmouni S, Bousta D, Misslin R, Mortier F. J Ethnopharmacol. 1997 Jun;57(1):11-20.

Possible anxiolytic effects of chrysin, a central benzodiazepine receptor ligand isolated from Passiflora coerulea. Wolfman C, Viola H, Paladini A, Dajas F, Medina JH. Pharmacol Biochem Behav. 1994 Jan;47(1):1-4.

Chrysin (5,7-di-OH-flavone), a naturally-occurring ligand for benzodiazepine receptors, with anticonvulsant properties. Medina JH, Paladini AC, Wolfman C, Levi de Stein M, Calvo D, Diaz LE, Peña C. Biochem Pharmacol. 1990 Nov 15;40(10):2227-31.

Neuropharmacological activity of extracts from Passiflora incarnata. Speroni E, Minghetti A. Planta Med. 1988 Dec;54(6):488-91. No abstract available.

[Evaluation of the activity on the mouse CNS of several plant extracts and a combination of them]. Della Loggia R, Tubaro A, Redaelli C. Riv Neurol. 1981 Sep-Oct;51(5):297-310. Review. Italian

TOKSIČNOST I INTERAKCIJE

Interactions of Valeriana officinalis L. and Passiflora incarnata L. in a patient treated with lorazepam. Carrasco MC, Vallejo JR, Pardo-de-Santayana M, Peral D, Martín MA, Altimiras J. Phytother Res. 2009 Dec;23(12):1795-6.

Preclinical toxicological assessment of a phytotherapeutic product--CPV (based on dry extracts of Crataegus oxyacantha L., Passiflora incarnata L., and Valeriana officinalis L.). Tabach R, Rodrigues E, Carlini EA. Phytother Res. 2009 Jan;23(1):33-40.

Toxicity of Passiflora incarnata L. Fisher AA, Purcell P, Le Couteur DG. J Toxicol Clin Toxicol. 2000;38(1):63-6.

Vasculitis associated with herbal preparation containing Passiflora extract. Smith GW, Chalmers TM, Nuki G. Br J Rheumatol. 1993 Jan;32(1):87-8. No abstract available.