997

12(2): Medicinal and poisonous plants 2

Cissus L.

Sp. pl. 1: 117 (1753), Gen. pl. ed. 5: 53 (1754).

VITACEAE

x = 12; Cissus adnata: 2n = 48, Cissus javana: 2n = 24, Cissus quadrangularis: 2n = 24, (45), Cissus repens: 2n = 96, Cissus verticillata: 2n = 48

Major species Cissus quadrangularis L.

Cissus occurs throughout the tropical and warm regions of the world and consists of about 350 species.

In South-East Asia, several Cissus species are used as an anti-inflammatory, antidiarrhoeal and against headache.
In Java, Thailand, India and southern Africa, the leaves of Cissus quadrangularis are applied on boils, burns and wounds while the crushed leaves or the juice from the stem, which has a pungent smell and taste when crushed, are applied for rheumatism and to ease the pain of broken bones and hasten recovery. In India, the powdered root is also used in the treatment of fractured bones, as well as for indigestion, and the juice of the plant is applied for scurvy, asthma, ear problems or nosebleed, and used as an alterative for amenorrhoea. An infusion of the plant is considered purgative. In Thailand, the fresh stem is used in the treatment of haemorrhoids, by swallowing thin slices, covered in banana pulp, without chewing, to prevent irritation in the mouth. In southern Africa, the juice from the stem is dripped into the ear for earache, and a decoction of the root is used for swellings and muscle pain.
In Java, a cold infusion of the pounded root of Cissus adnata is taken for cough, and the juice from the stem is taken for cough and diarrhoea. Externally, the leaves are applied for maturation of boils, cuts and fractures, just like those of Cissus compressa Backer (synonym Vitis compressa Blume). A poultice of the roots of Cissus diffusa (Miq.) Amshoff (synonym Vitis diffusa Miq.) from Borneo, Peninsular Malaysia and Sulawesi, is applied for headache. A paste of the fresh leaves of Cissus nodosa Blume is spread over the abdomen for intestinal problems. The fruits cause inflammation in the mouth when eaten, but externally they are applied for skin ailments. The roots of Cissus rostrata (Miq.) Planch. (synonym Vitis furcata Lawson) are boiled to make a poultice for rheumatism. In Indonesia, the leaves of Cissus javana DC. (synonym Cissus discolor Blume) are taken for stomach-ache, and the leaves and shoots of Cissus repens Lamk are poulticed on swellings and for fever. In Peninsular Malaysia, the pounded leaves of Cissus hastata are used to poultice boils, or are boiled and put on the abdomen for ague.
The fruits of Cissus modeccoides Planch. (synonym Cissus triloba Merr.) from China and Indo-China, are widely used for arthritis and rheumatism and the roots are applied for headache. In China, Cissus assamica (Laws.) Craib is used to treat snakebites. In West Africa, a decoction of the stem of Cissus populnea Guill. & Perr. is applied to sores of cattle suffering from foot-and-mouth disease. In Nigeria, a gum, 'Okoho gum', which is extracted from the root can serve as a binder in lactose-based tablets, or may be useful in prolonged release tablet formulations.
The young shoots and leaves of several Cissus species, e.g. Cissus javana, Cissus quadrangularis and Cissus repens, are pleasantly acid in taste and eaten as a vegetable, often mixed with other vegetables.
The stems of Cissus are often used for making strong ropes; others are cultivated as ornamentals, and also as pot plants in the temperate regions.

Cissus is used on a local scale only.

Phytochemical analysis of several parts ofCissus quadrangularishas revealed the presence of a variety of compounds. The aerial parts contain tartaric acid and calcium oxalate in the form of crystals. Especially the latter may be held responsible for the irritating action on the skin and in the mouth. Furthermore, the triterpenoids / steroids onocer-7-ene-3'ALFA',21'BETA'-diol and onocer-7-ene-3'BETA',21'ALFA'-diol were isolated from the stems, as well as 'BETA'-sitosterol, 'DELTA'-amyrin and 'DELTA'-amyrone, resveratrol, piceatannol, pallidol, parthenocissine A, taraxeryl acetate, friedelan-3-one, taraxerol and an asymmetrical tetracyclic triterpenoid, 7-oxoonocer-8-ene-3'BETA',21'ALFA'-diol. In addition, extraction was performed on the aerial parts using ethanol followed by hexane and other solvents. From the hexane fraction the following alkanes were isolated: 4-hydroxy-2-methyl-tricos-2-en-22-one, 9-methyl-octadec-9-ene, heptadecyl octadecanoate, icosanyl icosanoate, 31-methyltritriacontan-1-ol, 7-hydroxy-20-oxo-docosanyl cyclohexane, 31-methyltritriacontanoic acid and iso-pentacosanoic acid. Stilbene derivatives from Cissus quadrangularis mentioned in the literature include quadrangularins A, B, and C. Quercitin, quercetrin and isoquercetrin were isolated from the stem of Cissus quadrangularis, while cyanidin, delphinidin, kaempferol, myricetin were found in the leaves of Cissus hastata.
In an in vitro assay, an ethanol extract of the aerial parts acted upon the isolated intestines and the uterus of rabbits and albino rats and on the tracheal and intestinal muscles of the dog in a manner comparable to that of acetylcholine. The overall LD₅₀ of this extract was found to be 15.5 mg/kg in guinea-pigs. Furthermore, in dogs a fraction containing glycosides produced a dose-dependent hypotension. The negative chronotropic effects on the myocardium could be overcome by applying calcium, which is thought to inhibit the passage through the cell membrane. Intramuscular administration of an extract to rats and local use as an ointment in dogs showed a reduction of the convalescence time of experimental cortisone-treated fractures by 33%. Cortisone has an anti-anabolic action and thus delays consolidation.
In another test, the effects of a methanolic extract of the stems of Cissus quadrangularis (CQ) on the healing process of experimentally fractured radius-ulna of the dog was evaluated. Radiological and histopathological examination revealed faster initiation of the healing process in CQ treated animals than the control animals. The treated group also revealed a greater decrease in serum calcium level than the control group. Healing was almost complete 3 weeks after fracturing in the treated animals and remained incomplete in the control animals, and no significant alteration of serum calcium level was observed. Cissus quadrangularis was also screened for its genotoxic effects on Swiss mice. Salted, sun-dried and oil fried stems induced moderate mutagenic effects including chromosomal aberrations, sperm head abnormalities and micronuclei production, which were comparable to the effect of 20-methylcholanthrene.
Furthermore, the consumption of Cissus quadrangularis is suspected of causing significant loss of livestock in the Sudan. Nubian goats, 3—6 months old, and desert sheep, 6—9 months old, were given dried stems finely ground in a water suspension at 0, 0.25, 0.5, 1, 5 or 10 g/kg body weight daily by stomach tube until death or slaughter. Signs of poisoning included decreased appetite, staggering, dyspnoea, diarrhoea and loss of condition. Pathological changes included haemorrhaging in kidney, lung, heart and intestine, focal catarrhal enteritis and atrophy of cardiac fat, hydroperitoneum and hydropericardium.
In India, a stem extract of Cissus quadrangularis was found to inhibit rice tungro virus infection when dilute macerates were sprayed on rice seedlings before inoculation by means of viruliferous Nephotettix virescens. In another test, a 5% aqueous leaf extract was sprayed on chillies 30 days after transplanting, which caused a reduction of the yellow mite (Polyphagotarsonemus latus) populations, at 5 and 10 days after treatment.
From the fruits of the South American Cissus verticillata (L.) Nicolson & C.E. Jarvis (synonym Cissus sicyoides L.), which is naturalized in Java, delphinidin-3-rhamnoside, delphinidin-3-rutinoside and cyanidin-3-rhamnosyl-arabinoside, were extracted. The anthocyanin content of the fruit juice was about 120 mg/100 ml. The effect of the aqueous extract of Cissus verticillata on isolated guinea-pig aortic rings was studied in vitro. The extract was found to contract the smooth muscle of the aorta in a dose-responsive relation. The extract also potentiated the norepinephrine-induced contraction in normal calcium and in solutions without calcium. Lanthanum ions were found to inhibit the contraction induced by the extract. Also, the vasoconstrictor effect of the extract was increased in solutions without calcium or with low calcium, thus showing an inverse calcium-dependent contraction. Prolonged exposure to calcium-free solution did not abolish the induced contraction. Caffeine reduced contractile response induced by the extract in normal calcium, as well as in solutions without calcium. These results support the idea that the aqueous extract of Cissus verticillata acts at the membrane level, increasing the calcium entry through the membrane as well as acting on the internal calcium deposits, possibly on the sarcoplasmic reticulum.
Anti-inflammatory effects of aqueous extracts from Cissus verticillata have been investigated in vivo, by using the carrageenan-induced rat paw oedema (systemic model) and the mice ear oedema test (topical model) using tetradecanoylphorbol acetate as inflammatory agent. Dry extracts from a stem decoction were administered in oral doses of 500 mg/kg in the systemic model, and in doses of 3 and 5 mg/mouse ear in the topical model. In the systemic anti-inflammation assay, the oral administration produced a significant anti-inflammatory effect. In the topical model, the administration produced similar inhibitions of the oedema, with a reduction of approximately 50% in comparison with the control group. In homogenated tissue samples from the inflamed areas, a distinct decrease in the level of myeloperoxidase enzyme was noted. Furthermore, it was reported that LD₅₀ values after intraperitoneal administration were quite high.
In another in vitro screening assay, a Cissus verticillata extract showed a moderate cytostatic activity against HEp-2 cells.
Powdered root of Cissus populnea is used in parts of Eastern Nigeria as seasoning, added to soup, and mean daily intake is around 3—15 g/person. In an in vivo model, Sprague-Dawley rats were given diets with and without Cissus populnea during 10 days. Results suggest a goitrogenic effect, resembling a mild effect of thiocyanate. Slight dietary deficiency and the goitrogens in unfermented smoked cassava and in Cissus populnea may act together to cause the goitre that is endemic to some parts of Eastern Nigeria.

Perennial, evergreen or deciduous, climbing or scrambling lianas, variably hairy, hairs uni- or multicellular, then often uniseriate, climbing by leaf-opposed tendrils, branched or unbranched, branches subtended by a bract; roots sometimes tuberous. Leaves alternate, simple or pinnate, 3—5(—7)-foliolate, margins entire or indented, sometimes with domatia; petiole present; stipules 2, caducous. Inflorescence leaf-opposed, pedunculate, multi-flowered in umbellate cymes, or paniculate with terminal umbels, often loose; peduncle and pedicel subtended by bracts. Flowers bisexual, small, usually 4-merous; calyx cup-shaped, entire or shallowly lobed; corolla with 4 lobes, free, cohering in bud by the interlocked epidermis cells, cucullate at apex, reflexed after anthesis, soon caducous; stamens 4, inserted on the receptacle at the base of the disk, opposite the petals, filaments erect, often flattened, anthers dorsifixed, opening by longitudinal slits, introrse; disk adnate to and entirely surrounding the ovary, margins sometimes slightly lobed; ovary superior, 2-locular, 2 ovules per locule; style cylindrical or conical, stigma minute, accrescent. Fruit a fleshy berry, with 1(—4) seeds. Seed ovoid, pyriform or rarely elongate, shape depending on number of seeds in berry, flattened, with 1—2 furrows or pits on the ventral surface; albumen on transverse section ruminate, not U- or T-shaped. Seedling with epigeal germination; cotyledons similar or dissimilar.

Many Cissus start flowering at the beginning of the rainy period, and fruiting at the beginning of the dry season; others can be found flowering and fruiting throughout the year. Cissus is pollinated by insects. Cissus quadrangularis shows Crassulacean Acid Metabolism (CAM), a physiological adaptation to drought typical of many succulent plants, in which CO₂ is fixed in the dark.

Cissus may be distinguished from the closely related Cayratia by its usually leaf-opposed umbellate cymes and its usually simple leaves. If the leaves are compound though, they are palmately 3—5—7-foliolate and the petiolules are absent, or, if present then the central petiolule is less than twice as long as the lateral, rarely longer, and if so the fruit is 1-seeded with 2 ventral furrows.
In Cissus, leaf-size and degree of pubescence vary considerably intraspecifically, as in Cayratia, but shape and relative size of leaves, nature and position of hairs, nature of tendrils, nature of stipules and seed characteristics are useful diagnostic characters.
Cissus adnata, Cissus assamica (Laws.) Craib and the not locally used Cissus aristata Blume are distinct and easily recognized by the nature and distribution of their trichomes although they have been frequently confused in the literature with respect to their circumscription and synonymy. Cissus adnata, from India to Australia, has both multicellular, uniseriate and unicellular 2-armed trichomes on the abaxial leaf surface, glabrous stipules and a pubescent ovary; Cissus assamica, from India to New Guinea, has unicellar, 2-armed hairs, sparsely distributed, glabrous stipules and ovary; Cissus aristata extending, from Burma (Myanmar)to Papua New Guinea, has scattered unicellar, 2-armed hairs, pubescent stipules and a glabrous ovary.

Cissus occurs in thickets, open forest, along forest borders and on river banks, at low and medium altitudes.

Cissus is propagated by seed, although some species can be multiplied by stem cuttings.

Larvae of the grape vine Sphinx (Hippotion celerio), a minor pest of grape vine (Vitis vinifera L.), also feed on Cissus quadrangularis in India.

Cissus stems and roots can be harvested throughout the year. As some species are deciduous, leaves can only be harvested in the season.

The parts of Cissus harvested are often used fresh. Roots are mainly dried and powdered for future use.

The Cissus species treated here have a large area of distribution, either naturally or as a result of cultivation, and do not seem to be at risk of genetic erosion. There are no known breeding programmes of Cissus.

Several pharmacological effects of fractions of a number of Cissus species, e.g. in the fields of anti-spasmodics and anti-inflammatories, may be of interest for future developments. On the other hand, Cissus species are also suspected to have adverse effects, for instance causing significant loss of livestock, or causing goitre. Therefore, more research will be needed to fully evaluate their possibilities.

Barakat, S.E.M., Adam, S.E.I., Maglad, M.A. & Wasfi, I.A., 1985. Effects of Cissus quadrangularis on goats and sheep in Sudan. Revue d'Elevage et de Médecine Vétérinaire des Pays Tropicaux 38(2): 185—194.
Burkill, I.H., 1966. A dictionary of the economic products of the Malay Peninsula. Revised reprint. Vol. 2. Ministry of Agriculture and Co-operatives, Kuala Lumpur, Malaysia. pp. 2282—2291.
Das, P.K. & Sanyal, A.K., 1964. Studies on Cissus quadrangularis L. Acetylcholine-like action of the total extract. Indian Journal of Medical Research 52: 63—66.
Deka, D.K., Lahon, L.C., Saikia, J. & Mukit, A., 1994. Effect of Cissus quadrangularis in accelerating healing process of experimentally fracture radius-ulna of dog: A preliminary study. Indian Journal of Pharmacology 26(1): 44—45.
Jackes, B.R., 1988. Revision of the Australian Vitaceae, 3. Cissus L. Austrobaileya 2(5): 481—505.
Perry, L.M., 1980. Medicinal plants of East and Southeast Asia. Attributed properties and uses. MIT Press, Cambridge, Massachusetts, United States & London, United Kingdom. p. 434.

N.O. Aguilar

Cissus adnata
Cissus hastata
Cissus quadrangularis

Aguilar, N.O., 2001. Cissus L.. In: van Valkenburg, J.L.C.H. and Bunyapraphatsara, N. (Editors): Plant Resources of South-East Asia No 12(2): Medicinal and poisonous plants 2. PROSEA Foundation, Bogor, Indonesia. Database record: prota4u.org/prosea

The following species in this genus are important in this commodity group and are treated separatedly in this database:
Cissus adnata
Cissus hastata
Cissus quadrangularis