Akuamma
GENERAL
Akuamma (Picralima nitida) is a tree about 4-35 meters high, which grows mostly in the undergrowth and belongs to the family of the Apocynaceae. The tree is widespread in high altitude deciduous forests of West-Central Africa, where Akuamma is also used for folk medicine. Its range extends from the Ivory Coast to western Cameroon and across the Congo Basin and Uganda.
The seeds, fruits, leaves, bark and roots of the plant are used ethnomedicinally. These parts of the plant are used in Africa as an aphrodisiac, for the treatment of malaria, as an antipyretic and against pneumonia. Furthermore, akuamma is used as a treatment for gastrointestinal complaints, for pain, as a vermifuge and for venereal diseases, and the juice of the leaves being dripped into the ears for ear infections (see Erharuyi et al. 2014: 1f).
IN FOLK MEDICINE
In Ghana, for example, the dried and powdered seeds are filled into capsules and sold under the name "Picap". It is assumed that the seeds have analgesic properties similar to those of morphine (Menzies et al. 1998: 101). In Nigeria, on the other hand, a syrup called "MAMA" is sold. MAMA Syrup is a mixture of Alstonia boonei bark extract and Picralima nitida seed extract, which is used to treat malaria (see Falodun et al. 2015: 113f).
Picralima nitida is also known as a medicine by the Yoruba. "Akuamma" is also called "Agege" or "Obere" among the Yoruba, and is used folk medicine against stomach complaints, pneumonia, worms, fever and against malaria (see Igboasoiyi et al. 2017: 40).
PHYTOCHEMISTRY
Alkaloids, tannins, saponins, flavonoids, terpenoids, steroids, polyphenols, and glycosides have been identified as constituents of Akuamma (see Erharuyi et al. 2014: 2).
Igboasoiyi et al. found alkaloids, tannins, saponins, glycosides, cardiac glycosides, triterpenes, anthraquinone glycosides, flavonoids, and carbohydrates in an alcoholic extract of the seeds. (see Igboasoiyi et al. 2017: 39).
Thomas Anderson Henry and Thomas Marvel Sharp were the first to isolate 4 alkaloids from Akuamma seeds in the 1920s. At that time, they were able to characterize only one alkaloid in more detail and named it akuammine. Akuammine is the alkaloid found mainly in the seeds (see Henry & Sharp 1927: 1951). Later Henry isolated 6 more alkaloids and characterized pseudo akuammigine and akuammiline (see Ramirez et al. 2003: 1891).
Among the first alkaloids isolated were acuammine, pseudo-acuammine, acuammidine, acuammicine, acuammigine, pseudo-acuammigine, acuammiline, and acuammenine. Later, picraphylline, picracin, picraline, picralicine, picratidine, picranitine, burnamine, pericalline, and pericine were also discovered. Most of the alkaloids are found in the seeds of Akuamma, with some of the aforementioned alkaloids exhibiting opioid analgesic activity (see Erharuyi et al. 2014: 2).
Akuammine can be said to be the main alkaloid found in the seeds. It is considered a potent analgesic and, according to Knowles (2016), binds mainly to kappa opioid receptors, but also weakly to mu opioid receptors. Substances that bind to the kappa opioid receptor are mostly known to induce dysphoria (= depressed mood) rather than euphoria. Other notable alkaloids that bind with low affinity to various opioid receptors are akuammidine, akuammicine, and pseudo-akuammigine (see Knowles 2016).
The phyto-opioid mitragynine contained in the well-known kratom tree (Mitragyna speciosa) shows structural similarity to the alkaloids contained in Akuamma (see Duwiejua et al. 2002: 77).
PHARMACOLOGY
According to Erharuyi et al. (2014), a study reported the opioid analgesic effects of 5 of the alkaloids present in Picralima nitida. These are reported to include akuammine, akuammidine, akuammicine, pseudo-akuammine, and akuammigine, although according to Knowles (2016), akuammigine has analgesic effects but does not bind at opioid receptors. In another study on Picralima nitida, a significant effect against malaria was demonstrated. Furthermore, an aqueous extract of Akuamma had effects against parasites such as Trypanosoma brucei. In addition, studies also confirmed an effect of an extract from the seeds of Akuamma against Leishmania parasites. In other studies, a larvicidal effect was confirmed. In addition, the antipyretic effect has also been confirmed, which is even said to be comparable to aspirin. Pseudo-akuammigine also showed activity against inflammation. Akuamma also appears to have anti-microbial activity against Escherichia coli, Staphylococcus aureus, Shigella dysenteriae, Proteus vulgaris, Enterobacter cloacae, Streptococcus faecalis, Pseudomonas aeruginosa, Proteus mirabilis, Salmonella typhi, Bacillus cereus and Candida albicans. In addition, a certain effect against gastric ulcers was also observed and in another study methanol and ethanol extracts showed an anti-diabetic effect. Furthermore, a cytotoxic effect was also found in an in vitro study of human breast cancer cells (see Erharuyi et al. 2014: 3ff). It was also demonstrated that an ethanol extract of Picralima nitida could inhibit mucus formation in the respiratory tract when having a disease. In this study, an anti-tussive effect of Akuamma was also noted, with the extract showing activity against cough caused by bacterial infection. Furthermore, it is also believed that Akuamma may have some anxiolytic effect (see Dapaah et al. 2017: 136ff).
SAFETY & TOXICITY
There seem to be very few to no scientific studies on the dosage or long-term effects of regular use of Akuamma. However, the toxicity of "MAMA Syrup" containing Alstonia boonei and Picralima nitida has been studied. No signs of toxicity were found at doses up to 5000mg/kg of the "MAMA Syrup" (see Falodun et al. 2015: 116). Studies showed that the LD50 in laboratory rats for the dried extract of the seeds was 948.68mg/kg (see Inya-Agha et al. 2006: 578). Another study examined the LD50 of an aqueous extract of the seeds in mice, finding it to be 9120.11mg/kg (see N`dri et al. 2015: 123). Studies on toxicity and possible side effects in humans could not be found. Much more scientific research on the safety and toxicity of Akuamma is needed.
NOTE
There seem not to be any scientific studies to date on the dosage, side effects, and long-term consequences of Akuamma use in humans. Therefore, the information gathered should be viewed critically. It is possible that regular use over a long period of time may result in habituation, where higher and higher doses are needed to achieve the same effect. It is also possible that regular use of Akuamma may cause it to lose its medicinal effect (similar to the way resistance can develop when antibiotics are taken too regularly). Therefore, in the case of possible consumption, it is probably better to keep breaks as long as possible between the intakes and to generally use it as sparingly as possible, or to refrain from experimenting in general.
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