Butcher’s broom (Ruscus aculeatus)

Ruscus aculeatus, commonly called Butcher’s broom due to its hard roots and antibacterial properties being traditionally used to clean the cutting boards of butchers. It is a short evergreen shrub of the Liliaceae family. Ruscus aculeatus L. rhizomes are well-known constituents of a great number of food supplements utilized to prevent microcirculation diseases.

Butcher’s broom (Ruscus aculeatus)

Uses

Both the leaves and rhizome of the plant are believed to have diuretic and mild laxative properties. The plant extracts are widely used to treat varicose veins, hemorrhoids, and lymphedema. Primarily used as supportive therapy for discomforts of chronic venous insufficiency, such as pain and heaviness, as well as cramps in the legs, itching, and swelling, and supportive therapy for complaints of hemorrhoids, such as itching and burning.

The underground parts of Ruscus plants are a source of steroidal saponins that can be classified into two structural classes: the hexacyclic spirostanol saponins and the pentacyclic furostanol saponins. The main aglycones are ruscogenin and neoruscogenin. From the pharmacological point of view, the most studied Ruscus species is undoubtedly R. aculeatus, a very ancient phlebotherapeutic agent. Preparations based on Ruscus species are currently used for the treatment of chronic venous insufficiency, varicose veins, hemorrhoids, and orthostatic hypotension.

Chemistry/Pharmacology

Clinical Studies

Ruscogenin, one of the major constituents of the plant, demonstrated anti-inflammatory effects in vivo. Small clinical studies revealed the efficacy of butcher broom extracts in controlling lymphedema and chronic venous insufficiency.

Biomechanical Mechanism

Ruscogenin, one of the major components of butcher’s broom, exerts anti-inflammatory effects likely by inhibiting TNF-alpha-induced over-expression of ICAM-1 both at the mRNA and protein levels. It also suppresses NF-kappaB activation by decreasing NF-kappaB p65 translocation and DNA binding activity. In another study, ruscogenin was shown to inhibit elastase, one of the enzyme systems involved in the turnover of the main components of the perivascular amorphous substance. It also increases the activity of noradrenaline at the level of the synapse where it contacts veins via acting through its alpha receptors.

The phenolic compounds and saponins isolated from butcher’s broom decreased the thrombin-induced hyperpermeability of human microvascular endothelial cells (HMEC-1) in vitro.

Sources/Articles

Barbič M, Willer EA, Rothenhöfer M, Heilmann J, Fürst R, Jürgenliemk G. Spirostanol saponins and esculin from Rusci rhizoma reduce the thrombin-induced hyperpermeability of endothelial cells. Phytochemistry. 2013 Jun;90:106-13.

Barbič M, Schmidt TJ, Jürgenliemk G. Novel phenyl-1-benzoxepinols from butcher’s broom (Rusci rhizoma). Chem Biodivers. 2012 Jun;9(6):1077-83.

Boyle P, Diehm C, Robertson C. Meta-analysis of clinical trials of Cyclo 3 Fort in the treatment of chronic venous insufficiency. Int Angiol. 2003 Sep;22(3):250-62.

Cappelli R, Nicora M, DiPerri T. Use of extract of Ruscus aculeatus in venous disease in the lower limbs. Drugs Exp Clin Res 1988;14(4):277-83.

Cluzan RV, et al. Treatment of secondary lymphedema of the upper limb with CYCLO 3 FORT. Lymphology 1996 Mar;29(1):29-35.

De Marino S, Festa C, Zollo F, Iorizzi M. Novel steroidal components from the underground parts of Ruscus aculeatus L. Molecules. 2012 Nov 26;17(12):14002-14.

Facino RM, Carini M, Stefani R, Aldini G, Saibene L. Anti-elastase and anti-hyaluronidase activities of saponins and sapogenins from Hedera helix, Aesculus hippocastanum, and Ruscus aculeatus: factors contributing to their efficacy in the treatment of venous insufficiency. Arch Pharm (Weinheim). 1995 Oct;328(10):720-4.

Guex JJ, Enriquez Vega DM, Avril L, Boussetta S, Taïeb C. Assessment of quality of life in Mexican patients suffering from chronic venous disorder - impact of oral Ruscus aculeatus-hesperidin-methyl-chalcone-ascorbic acid treatment - ’QUALITY Study’. Phlebology. 2009 Aug;24(4):157-65.

Guex JJ, Avril L, Enrici E, et al. Quality of life improvement in Latin American patients suffering from chronic venous disorder using a combination of Ruscus aculeatus and hesperidin methyl-chalcone and ascorbic acid (quality study). Int Angiol. 2010 Dec;29(6):525-32.

Huang YL, Kou JP, Ma L, et al. Possible mechanism of the anti-inflammatory activity of ruscogenin: role of intercellular adhesion molecule-1 and nuclear factor-kappaB. J Pharmacol Sci. 2008 Oct;108(2):198-205.

Longo L, Vasapollo G. Determination of anthocyanins in Ruscus aculeatus L. berries. J Agric Food Chem. 2005 Jan 26;53(2):475-9.

Peralta, GR Aguilar, J. Arevalo Gardoqui, FJ Llamas Macías, VH Navarro Ceja, SA Mendoza Cisneros, and CG Martínez Macías. "Clinical and capillaroscopic evaluation in the treatment of chronic venous insufficiency with Ruscus aculeatus, hesperidin methylchalcone and ascorbic acid in venous insufficiency treatment of ambulatory patients." International angiology 26, no. 4 (2007): 378. https://www.proquest.com/openview/3890e3d6000fe7f3748a0183a17d6aea/1?pq-origsite=gscholar&cbl=46530

Redman, Deborah A. "Ruscus aculeatus (butcher's broom) as a potential treatment for orthostatic hypotension, with a case report." The Journal of Alternative and Complementary Medicine 6, no. 6 (2000): 539-549. https://www.liebertpub.com/doi/abs/10.1089/acm.2000.6.539

Vanscheidt W, et al. Efficacy and safety of a Butcher’s broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency. Arzneimittelforschung 2002;52:243-50.

Vanscheidt, Wolfgang, Volker Jost, Peter Wolna, Peter W. Lücker, Alfred Müller, Christoph Theurer, Brigitte Patz, and Karen I. Grützner. "Efficacy and safety of a Butcher’s broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency." Arzneimittelforschung 52, no. 04 (2002): 243-250. https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0031-1299887