Pao pereira

• How It Works

  Animal studies suggest that pao pereira has antimalarial and anticancer effects. Human studies have not been conducted.

  Pao pereira is a tree native to the northern part of South America. Preparations made from the stem bark are used in folk medicine to treat malaria, digestive disorders, constipation, fever, liver pain, and cancer, and as sexual stimulants. Laboratory and animal studies show that the bark extracts have antimalarial and pain-relieving properties, may help improve cognition, and may also have anticancer effects.

  Pao pereira is marketed in supplemental form as an alternative anticancer treatment. However, its safety and effectiveness has not been determined in humans.

• Purported Uses
  • Malaria
    Lab experiments and animal studies have shown that Pao pereira has antimalarial activity.
  • Fever
    Although used for this purpose in folk medicine, scientific evidence is lacking.
  • Liver pain
    Pao pereira extracts appeared to relieve pain in animal models. Studies in humans are lacking.
  • Stomach disorders
    Although used for this purpose in folk medicine, scientific research has not been conducted.
  • Cancer treatment
    Pao pereira showed anticancer activity in lab and animal studies, but these extracts have not been studied in humans.
• Do Not Take If

  As studies have not been conducted in humans, there are no reports of drug interactions with pao pereira.

• Side Effects

  Studies in humans are lacking.

• Scientific Name

  Geissospermum vellosii Fr., Geissospermum leave, Tabernaemontana laevis

• Clinical Summary

  Pao pereira is a tree native to northern part of South America and belongs to the family Apocyanaceae. Both aqueous and alcoholic decoctions prepared from the stem bark are used in folk medicine to treat a variety of ailments including malaria, digestive disorders, constipation, fever, liver pain and cancer, and as sexual stimulants.

  Studies done in vitro and in animal models using the bark extracts indicate antimalarial ⁽¹⁾, antinociceptive ^(2) (11), and anti-inflammatory ⁽¹¹⁾ effects, as well as anticholinesterase activity resulting in reversal of cognitive defects ⁽³⁾. This property is being explored as a potential treatment for Alzheimer’s disease ⁽⁴⁾. Flavopereirine derived from pao pereira demonstrated activity against leishmaniasis in vitro ⁽¹³⁾.

  The anticancer potential of pao pereira has also been investigated. In preclinical studies, the bark extracts demonstrated antitumor activity and enhanced carboplatin effects in ovarian cancer cells ⁽⁵⁾. It also suppressed the growth of prostate cancer ^(6) (7) and pancreatic cancer cells along with potentiating gemcitabine effects ⁽⁸⁾, and inhibited pancreatic cancer stem-like cells ⁽¹²⁾. Clinical trials have not yet been conducted.

  Pao pereira is marketed in supplemental form as an alternative anticancer treatment, but safety and efficacy has not been determined.

• Purported Uses
  • Malaria
  • Fever
  • Liver Pain
  • Stomach disorders
  • Cancer treatment
• Mechanism of Action

  Bioactive compounds in pao pereira known as indole alkaloids showed antiplasmodial activity against a chloroquine-sensitive strain of Plasmodium falciparum, the causative agent of malaria. Of five alkaloids tested, geissolosimine demonstrated the highest activity ⁽¹⁾, although the mechanism of action is yet to be determined. In a murine model, the crude extract and the dichloromethane fraction of pao pereira exerted antinociceptive effects against acetic acid and formalin-induced-nociception via stimulation of the 5-HT 1A receptor, which is involved in neuromodulation by binding serotonin ⁽²⁾. In another study, geissospermine, the most abundant alkaloid, inhibited acetylcholinesterase, resulting in increased levels of acetylcholine, and reduced amnesia induced by scopolamine in mice in a dose-dependent manner ⁽³⁾.

  Anticancer effects are attributed to various mechanisms. One study showed that pao pereira induces apoptosis in pancreatic cells in vitro and in vivo via cleavage of caspases 3 and 8 and PARP, associated with DNA damage and cell cycle inhibition ⁽⁸⁾. In the prostate cancer cell line LNCaP, reduced tumor cell growth and induced apoptosis by pao pereira extract may occur via beta-carboline alkaloids that upregulate DNA repair response genes as well as genes involved in the apoptotic pathway ⁽⁶⁾. Another study suggests the extract induces cell growth arrest and apoptosis in LNCaP cells partially via inhibition of nuclear factor kappa B (NFκB) activation, which is responsible for cell survival ⁽⁷⁾.

• Contraindications

  None known.

• Adverse Reactions
  • Studies in humans are lacking.
• Herb-Drug Interactions

  None known.

• Herb Lab Interactions

  None known.

• References

  1. Mbeunkui F, Grace MH, Lategan C, et al. In vitro antiplasmodial activity of indole alkaloids from the stem bark of Geissospermum vellosii. J Ethnopharmacol. Jan 31 2012;139(2):471-477.

  2. Werner JA, Oliveira SM, Martins DF, et al. Evidence for a role of 5-HT(1A) receptor on antinociceptive action from Geissospermum vellosii. J Ethnopharmacol. Aug 17 2009;125(1):163-169.

  3. Lima JA, Costa RS, Epifanio RA, et al. Geissospermum vellosii stembark: anticholinesterase activity and improvement of scopolamine-induced memory deficits. Pharmacol Biochem Behav. May 2009;92(3):508-513.

  4. Araujo JQ, Lima JA, Pinto Ada C, de Alencastro RB, Albuquerque MG. Docking of the alkaloid geissospermine into acetylcholinesterase: a natural scaffold targeting the treatment of Alzheimer’s disease. J Mol Model. Jun 2011;17(6):1401-1412.

  5. Yu J, Chen Q. The plant extract of Pao pereira potentiates carboplatin effects against ovarian cancer. Pharm Biol. Jan 2014;52(1):36-43.

  6. Bemis DL, Capodice JL, Desai M, Katz AE, Buttyan R. beta-carboline alkaloid-enriched extract from the amazonian rain forest tree pao pereira suppresses prostate cancer cells. J Soc Integr Oncol. Spring 2009;7(2):59-65.

  7. Chang C, Zhao W, Xie B, et al. Pao Pereira Extract Suppresses Castration-Resistant Prostate Cancer Cell Growth, Survival, and Invasion Through Inhibition of NFkappaB Signaling. Integr Cancer Ther. Nov 27 2013;13(3):249-258.

  8. Yu J, Drisko J, Chen Q. Inhibition of pancreatic cancer and potentiation of gemcitabine effects by the extract of Pao Pereira. Oncol Rep. Jul 2013;30(1):149-156.

  9. Mbeunkui F, Grace MH, Lila MA. Isolation and structural elucidation of indole alkaloids from Geissospermum vellosii by mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. Feb 15 2012;885-886:83-89.

  10. Hughes NA, Rapaport H. Flavopereirine, an Alkaloid from Geissospevrnurn oellosii. JACS. 1957;80:1604-1609.

  11. Lima JA, Costa TW, Silva LL, et al. Antinociceptive and anti-inflammatory effects of a Geissospermum vellosii stem bark fraction. An Acad Bras Cienc. Mar 2016;88(1):237-248.

  12. Dong R, Chen P, Chen Q. Extract of the Medicinal Plant Pao Pereira Inhibits Pancreatic Cancer Stem-Like Cell In Vitro and In Vivo. Integr Cancer Ther. Dec 2018;17(4):1204-1215.

  13. da Silva ESJV, Cordovil Brigido HP, Oliveira de Albuquerque KC, et al. Flavopereirine-An Alkaloid Derived from Geissospermum vellosii-Presents Leishmanicidal Activity In Vitro. Molecules. Feb 21 2019;24(4).