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.
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 pereirahas 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).