446 Rev. Fac. Med. 2020 Vol. 68 No. 3: 446-52 REVIEW ARTICLE DOI: http://dx.doi.org/10.15446/revfacmed.v68n3.75184 Received: 20/10/2018 Accepted: 21/03/2019 Revista de la Facultad de Medicina Cnidoscolus aconitifolius: therapeutic use and phytochemical properties. Literature review Cnidoscolus aconitifolius: usos terapéuticos y propiedades fitoquímicas. Revisión de la literatura Verónica Bautista-Robles1, Gabriel Guerrero-Reyes1, Gabriel Isaac Sánchez-Torres1, Felipe de Jesús Parada-Luna1, Juan José Barrios-Gutiérrez1, Dehuí Vázquez-Cerero1, Gudelia Martínez-Sala1, José Isaías Siliceo-Murrieta1, Ruth Ana María González-Villoria1, Hady Keita1 . 1 Universidad de la Sierra Sur - Postgraduate Studies Division - Master’s in Public Health - Miahuatlán de Porfirio Díaz - Oaxaca - México. Corresponding autor: Hady Keita. Maestría en Salud Pública, División de Estudios de Postgrado, Universidad de la Sierra Sur. Guillermo Rojas Mijangos S/N Esquina Avenida Universidad, Col. Ciudad Universitaria, División de Estudios de Postgrado, oficina de la Maestría en Salud Pública. Telephone number: +52 1 5513658712. Miahuatlán de Porfirio Díaz, Oaxaca. México. Email: [email protected]. Abstract Introduction: Medicinal plants have been traditionally used to cure or alleviate infectious Bautista-Robles V, Guerrero-Reyes G, and non-infectious diseases. They are widely accepted due to their low cost and low toxicity Sánchez-Torres GI, Parada-Luna FJ, Barrios-Gutiérrez JJ, Vázquez-Cerero indexes. These plants are frequently used in cases involving skin irritation, superficial wounds, D, et al. Cnidoscolus aconitifolius: the- insect bites, and snake bites. rapeutic use and phytochemical pro- Objective: To compile available evidence on the main therapeutic uses and phytochemical perties. Literature review. Rev. Fac. Med. 2020;68(3):446-52. English. doi: components of Cnidoscolus aconitifolius (popularly known as chaya), a plant that grows in http://dx.doi.org/10.15446/revfacmed. tropical regions of Mexico and Central America. v68n3.75184. Materials and methods: A literature review of studies on C. aconitifolius published until 2017 was conducted in the BIREME, PubMed/Medline, Elsevier and SciELO databases. De- scriptors “Cnidoscolus” and “aconitifolius” were used for the literature search, and no language restrictions were applied. Results: 82 articles were retrieved after completing the initial search. Once the studies were filtered by title (descriptors in the title) and duplicates were removed, 18 articles were reviewed. Based on the information found, it was possible to confirm that this plant has mul- tiple health benefits. Conclusions: The traditional therapeutic use of Cnidoscolus aconitifolius is backed by scientific evidence. Therefore, further research aimed at identifying new phytochemical properties of this plant should be conducted to establish alternative therapies for treating different conditions. Keywords: Plants, Medicinal; Phytochemicals; Therapeutic Uses (MeSH). Resumen Introducción. El uso tradicional de plantas medicinales para tratar diferentes enfermedades, Bautista-Robles V, Guerrero-Reyes G, ya sean infecciosas o no, es ampliamente aceptado debido a su bajo costo y sus bajos índices Sánchez-Torres GI, Parada-Luna FJ, Ba- rrios-Gutiérrez JJ, Vázquez-Cerero D, de toxicidad. Estas plantas son frecuentemente usadas en casos que involucran irritaciones et al. [Cnidoscolus aconitifolius: usos de la piel, heridas superficiales, picaduras de insectos y mordeduras de víboras. terapéuticos y propiedades fitoquími- Objetivo. Recopilar la información disponible sobre los principales usos terapéuticos y los cas. Revisión de la literatura]. Rev. Fac. Med. 2020;68(3):446-52. English. doi: componentes fitoquímicos deCnidoscolus aconitifolius, una planta conocida popularmente http://dx.doi.org/10.15446/revfac- como chaya y que crece en regiones tropicales de México y Centroamérica. med.v68n3.75184. Materiales y métodos. Se realizó una revisión de la literatura sobre C. aconitifolius publicada hasta 2017 en las bases de datos BIREME, PubMed/Medline, Elsevier y SciELO. Para la búsqueda se emplearon los descriptores “Cnidoscolus” y “aconitifolius”, y no se aplicaron filtros de idioma. Resultados. Se identificaron 82 artículos luego de completar la búsqueda inicial. Después de filtrar los estudios por título (presencia de descriptores de búsqueda en el título) y remover duplicados, se incluyeron 18 artículos en la revisión. De acuerdo a la información encontra- da, fue posible confirmar que esta planta ofrece diversos beneficios para la salud. Conclusiones. El uso terapéutico tradicional de la chaya está sustentado por evidencia científica, por lo que se sugiere realizar más investigaciones centradas en la identificación de nuevas propiedades fitoquímicas de esta planta y, así, establecer alternativas terapéuti- cas para distintas afecciones. Palabras clave: Plantas medicinales; Fitoquímicos; Usos terapéuticos (DeCS). 447 Therapeutic uses of chaya Introduction Is there sufficient scientific evidence on the therapeutic properties of chaya to treat human pathologies? About 80% of people living in developing countries prac- tice traditional medicine as an alternative therapy for Materials and methods their health care. Specifically, the use of medicinal plants in therapy (defined as any plant species that can be A literature review on C. aconitifolius was conducted used for therapeutic purposes due to its composition in the BIREME, PubMed/Medline, Elsevier and SciELO or whose active ingredients can serve as precursors for databases with the descriptors “Cnidoscolus” and “ac- the synthesis of new drugs), also known as phytother- onitifolius”. The search was limited to articles published apy, is quite widespread worldwide. It is worth noting until 2017; no articles were excluded because of lan- that around 67% of the species used in these types of guage restrictions or methodological reasons. therapies come from least developed and developing countries.1-6 Data search Traditional medicine is based on folk knowledge, which determines its efficacy through observable benefits. This The first step was to make a general query without restric- type of medication may pose challenges; for example, tions, and then a new search was made using the title as in popular phytotherapy, it is very difficult to control the a filter. The strategies presented in Table 1 were applied. dose and quality of the product, which can lead to risks and damage to health. This problem is mainly explained Table 1. Databases analyzed and search strategies used. by the fact that many traditional remedies are made Search strategy Search No. of Database from wild plants whose chemical components can vary (syntax) limits articles due to genetic or environmental reasons.7,8 It should be TITLE(Cnidoscolus noted that ethnobotany has no scientific validation.9-10 Elsevier Title 3 aconitifolius) The traditional use of medicinal plants to treat both (ti:(cnidoscolus)) AND infectious and non-infectious diseases has been wide- SciELO Titulo 1 ly accepted since ancient times due to their low cost, (ti:(aconitifolius)) accessibility, and low toxicity rates compared to syn- (ti:(Cnidoscolus BIREME Titulo 15 thetic products.11-13 Humans commonly resort to this aconitifolius)) therapeutic option in the presence of skin irritations, PubMed/ Cnidoscolus[Title] AND 14,15 Title 14 wounds, insect bites, and snake bites. Medline aconitifolius[Title] Currently, there is an exponential increase in the Source: Own elaboration. use of phytotherapy to maintain an adequate state of general health.16 In this regard, the World Health Orga- nization (WHO) states that more than two thirds of the Selection of articles world’s population use or have used at least one me- In the first search without restriction, 82 articles were dicinal plant to treat some condition.4 retrieved. During the subsequent search, after filtering Chronic non-communicable diseases are a new chal- the publications by title, 33 were obtained, of which 15 lenge in the fight to improve global health and are a were excluded because they were repeated. Finally, 18 public health concern despite the progress made by the articles were included in the research. The algorithm pharmaceutical industry. Moreover, it should be noted for selecting the articles of interest is shown in Figure 1. that some populations do not have easy access to med- icines and medicinal plants are their first, or even only, nitial search: M rticles ecluded or not treatment option. PubMed/Medline lsevier having the descriptors in In this context, a relevant example of the use of phy- and Sci (n the title (n9 totherapy is chaya (Cnidoscolus aconitifolius), a plant of the genus Cnidoscolus that belongs to the family Eu- legible (n Duplicate reoval (n1 phorbiacea, which has been attributed different benefits for the treatment and control of certain pathologies. The family Euphorbiacea comprises 50 species, of which 20 ncluded (n1 are considered endemic to Mexico and are distributed mainly in tropical and subtropical zones, Mesoameri- Figure 1. Flow chart used for selection of the articles of interest. ca being the area where they are most produced and Source: Own elaboration. where their domestication is most frequent.17-19 Hypoglycemic,20 antioxidant,21 analgesic and anti-in- Data collection flammatory effects22-24 are the main benefits attributed to chaya. It is commonly used to treat rheumatism, gas- The selected articles were reviewed to synthesize, an- trointestinal disorders25