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Scientific Name(s): Pueraria lobata (Willd) Ohwi., Pueraria montana (Lour.) Merr., Pueraria thunbergiana (Siebold & Zucc.) Benth., Pueraria tuberosa (Indian kudzu)
Common Name(s): Ge Gen, Japanese arrowroot, Kakka, Kakkon, Kakkonto, Kudzu, Kudzu vine, XJL (NPI-028)
Clinical Overview
Use
Kudzu is being investigated for its potential use as a therapy for alcoholism; however, sufficient and consistent clinical trials are lacking. The estrogenic activity of kudzu and the cardioprotective effects of its constituent puerarin are also under investigation, but clinical trials are limited.
Dosing
Alcohol abuse: 3 g daily of kudzu extract (25% isoflavone content) has been studied in adults diagnosed with alcohol abuse/dependence. In another study, 2.4 g of kudzu root was given daily. Unstable angina: Intravenous (IV) puerarin has been used in studies of unstable angina at dosages of 200 to 500 mg daily for up to 28 days.
Contraindications
Contraindications have not been identified.
Pregnancy/Lactation
Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.
Interactions
None well documented. Because kudzu may decrease blood glucose, additive effects are possible with use of antihyperglycemic agents.
Adverse Reactions
A few case reports of hypersensitivity reactions (ie, maculopapular drug eruption, Stevens-Johnson syndrome–type reaction) exist.
Toxicology
No data.
Scientific Family
- Fabaceae (pea)
Botany
Kudzu is a fast-growing vine native to the subtropical regions of China and Japan, as well as some other Pacific islands.1, 2 The plant consists of leaves (containing 3 broad oval leaflets), purple flowers, and curling tendril spikes.3, 4 Because the stem grows up to 20 m in length and due to its extensive root system, kudzu has been used to control soil erosion. Since its introduction to the United States, kudzu has become well established and proliferates in moist southern regions, where it is now considered an invasive plant.
History
Kudzu was introduced to the United States in the late 1800s to control soil erosion.5 Although it is widely recognized as a ground cover and fodder crop in the Western world, kudzu also has a history of medicinal use in Asian cultures. Beginning in the sixth century BC, Chinese herbalists used the plant to prevent intoxication, reduce muscular pain, and treat measles.4, 6
Chemistry
Numerous reports have identified chemical constituents in various plant parts of kudzu.7, 8, 9 Flavonoid, isoflavonoid, and isoflavone content (including puerarin) has been identified in kudzu roots and flowers.10, 11, 12, 13, 14, 15, 16, 17, 18, 19 Kudzu contains a high total isoflavone content compared with other isoflavone-containing herbs, with the dry root containing as much as 5.32 mg/g.20, 21
Oleanene triterpene glycosides, also known as kudzu saponins, have been isolated from the plant.22, 23 Analysis of isoflavonoid aglycones and their glycosides has been performed.24 Robinin in kudzu leaf has also been reported.25 Other constituents evaluated include daidzin, daidzein, genistein, genestin,26 tectoridin,27 kakkalide,28 formononetin, biochanin A, and plant sterols.2, 4, 29, 30, 31 In addition, morphological and anatomical identification studies of kudzu have been performed.32
Uses and Pharmacology
Alcohol abuse
Animal data
Available animal studies of the effects of kudzu on alcohol dependence have been reviewed.6, 33, 34 The isoflavones daidzin, daidzein, and puerarin may be responsible for the suppression of ethanol intake; although the mechanism of action is not certain, inhibition of alcohol dehydrogenase is thought to be a major factor in kudzu’s antidipsotropic activity.30, 34, 35, 36, 37, 38
Clinical data
Few clinical trials evaluating the effects of kudzu on alcohol consumption have been conducted, with conflicting results.39 In a study of 38 military veterans, kudzu extract administered for 1 month had no effect on alcohol consumption patterns or cravings.40 Another small study (N=14) conducted over a period of several weeks demonstrated a reduction in the number of beers and total volume consumed by heavy drinkers.5, 41 The amount of isoflavone present in the extracts used in these 2 trials likely differed, which may account for the inconsistent results.5
More recent clinical studies available in the literature were all conducted by the same pool of researchers, with all demonstrating favorable effects of kudzu on moderate to heavy alcohol consumption.5, 42, 43, 44, 45, 46
Cancer
In vitro data
A kudzu ethanolic extract has been evaluated for antiproliferative activity against breast, ovarian, and cervical cancer cell lines, with some components demonstrating cytotoxic activity.47
Cardiovascular effects
Animal and in vitro data
Kudzu has been examined for its effects on vascular smooth muscle tissue48; for its potential effects in arrhythmia, ischemia, and angina pectoris49, 50, 51; and for its antioxidant activity.52, 53
Clinical data
A meta-analysis examined patients with unstable angina pectoris who received puerarin as an adjunct to conventional therapy. Most of the 41 included studies (N=2,953) were conducted among Chinese populations and were of small sample size. The meta-analysis reported improvements in the incidence of angina pectoris, electrocardiogram findings, nitroglycerin consumption, and plasma endothelin levels.54
A small 12-week study (N=15) reported decreased blood pressure and enhanced plasma fibrinolytic activity with daily consumption of Indian kudzu (P. tuberosa).55
Diabetes
Animal and in vitro data
Isoflavones in P. lobata have demonstrated alpha-glucosidase inhibitory effects in vitro, while other constituents (eg, puerarin) have resulted in increased glucose utilization in rat models.56, 57
In a study of mice with streptozotocin-induced diabetes, improvements in memory and cognitive function, as well as changes in acetylcholinesterase activity, were observed.58
Estrogenic activity
Animal and in vitro data
The high isoflavone content of kudzu has prompted investigation of the potential estrogenic activity of kudzu extracts. In vitro experiments suggest that daidzein is more potent than daidzin or puerarin.27 Studies comparing kudzu with red clover, soybean, mung, and alfalfa sprouts found kudzu to be the most potent19, while another study suggested the ethanol extract of P. lobata is less effective than Pueraria mirifica or Mucana collettii.21
Clinical data
In one trial of 25 menopausal women, a decrease in the number of hot flushes per day occurred when a multiple-ingredient preparation containing kudzu extract was used.59 However, in a larger trial, a P. lobata extract did not demonstrate positive effects on symptoms of menopause.60 In another study, P. lobata root given to postmenopausal women for 60 days prior to hysterectomy resulted in increased collagen and elastin content and less blood loss during surgery.61
Hepatoprotective effects
Animal and in vitro data
A few experimental studies in mice and human cells that investigated the hepatoprotective effects of puerarin and saponins demonstrated some antihepatotoxic activity.20, 62, 63
Obesity
In vitro data
In an in vitro experiment, biochanin A demonstrated potential hypolipidemic activity via activation of peroxisome proliferator–activated receptors.64
Clinical data
The effects of kudzu flower (as Pueraria thomsonii extract) on obesity have been evaluated in a clinical trial (N=81). Reduced body mass index and visceral (but not subcutaneous) fat was demonstrated over 12 weeks.65
Osteogenic activity
In vitro data
In an in vitro study of a Radix puerariae (kudzu root) extract, an increase in the synthesis of alkaline phosphatase in human osteoblast cells was observed.66
Dosing
Based on pharmacokinetic studies in healthy adults, a 3-times-daily dosing schedule is recommended. In one study, the isoflavone puerarin was rapidly absorbed after oral administration, reaching peak levels in 2 hours.18 Isoflavone content varies widely among commercial kudzu preparations, with most containing less than 1%.5
Alcohol abuse
3 g daily of kudzu extract (25% isoflavone content) has been studied in adults with a diagnosis of alcohol abuse/dependence.5 In another study, 2.4 g of kudzu root of unknown isoflavone content was given daily.40
Unstable angina
IV puerarin has been used in studies of unstable angina at dosages of 200 to 500 mg daily for up to 28 days.54
Pregnancy / Lactation
Information regarding safety and efficacy in pregnancy and lactation is lacking.
Briggs Book Link
- Kudzu
Interactions
None well documented. Several in vitro and animal studies indicate glucose-lowering effects; therefore, additive effects are possible with use of antihyperglycemic agents.56, 57 Puerarin and other compounds from Radix puerariae (kudzu root) affect cytochrome P450 (CYP-450) isoenzymes; study results demonstrate contradictory effects (ie, a complex pattern of CYP modulation was observed, including both induction and inactivation).67
Adverse Reactions
Kudzu has historically been used for medicinal purposes, with few reported adverse reactions.30 There are a few case reports of hypersensitivity reactions (ie, maculopapular drug eruption, Stevens-Johnson syndrome–type reaction) to the kudzu-containing Kakkonto decoction.68
Toxicology
Although data regarding use in traditional Chinese medicine indicate a lack of toxicity, the safety profile of kudzu and its extracts has not been determined by systematic pharmacologic screens.49 Acute toxicity of 4 Pueraria species has been studied comparatively.51
Index Terms
- Pueraria thomsonii
- Radix puerariae
- Kudzu flower
- Kudzu root
References
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Consumption of Pueraria flower extract reduces body mass index via a decrease in the visceral fat area in obese humans. Biosci Biotechnol Biochem. 2012;76(8):1511-1517.2287819566. Huh JE, Yang HR, Park DS, et al. Puerariae radix promotes differentiation and mineralization in human osteoblast-like SaOS-2 cells. J Ethnopharmacol. 2006;104(3):345-350.1645521667. Guerra MC, Speroni E, Broccoli M, et al. Comparison between Chinese medical herb Pueraria lobata crude extract and its main isoflavone puerarin antioxidant properties and effects on rat liver CYP-catalysed drug metabolism. Life Sci. 2000;67(24):2997-3006.1113301268. Akita H, Sowa J, Makiura M, Akamatsu H, Matsunaga K. Maculopapular drug eruption due to the Japanese herbal medicine Kakkonto (kudzu or arrowroot decoction). Contact Dermatitis. 2003;48(6):348-349.14531887
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