ABSTRACT
ABSTRACT Objective: To report a case of anterior uveitis caused by Euphorbia milii sap and review all reported cases of keratouveitis related to this species. Methods: A 64-year-old male patient presented with a 10-day history of reduced visual acuity, pain, and photophobia in the left eye after an accidental contact with Euphorbia milii sap. Best-corrected visual acuity was initially 20/200. Upon examination, ciliary injection, mild corneal edema; fine keratic precipitates, and significant anterior chamber reaction. There was no vitritis, and fundoscopy was unremarkable. The patient initiated on topical steroid and tropicamide. Results: Best-corrected visual acuity in left eye improved to 20/20 after using eyedrops for 3 weeks, associated with complete resolution of anterior uveitis. Over the following 6 months, best-corrected visual acuity remained stable, and no evidence of recurrent inflammation was observed. Conclusion: To the best of our knowledge, this is the third reported case of keratouveitis caused by Euphorbia milii sap. As observed in other cases of keratouveitis caused by sap of this species, the clinical course is benign and characterized by moderate reaction of the anterior chamber, and corneal involvement of variable intensity.
RESUMO O objetivo foi relatar um caso de uveíte anterior induzida pela seiva da Euphorbia milii e revisar todos os casos relatados de ceratouveíte causados por essa espécie. Paciente do sexo masculino, 64 anos, apresentou história de 10 dias de evolução com redução da acuidade visual, dor e fotofobia no olho esquerdo, após contato acidental com a seiva da planta Euphorbia milii. A acuidade visual com melhor correção era inicialmente 20/200. O exame revelou injeção ciliar, edema de córnea leve, precipitados ceráticos finos e reação de câmara anterior significativa. Não havia vitreíte, e a fundoscopia não exibia alterações. Foram iniciados colírios de esteroides e tropicamida. A acuidade visual no olho esquerdo melhorou para 20/20 em 3 semanas com a utilização dos colírios, além de se ter alcançado a resolução completa da uveíte anterior. Nos 6 meses seguintes, a acuidade visual permaneceu estável, e não foi observada evidência de recorrência da inflamação. Até então, este é o terceiro caso relatado de ceratouveíte pela seiva da Euphorbia milii. Como visto nos demais casos de ceratouveíte induzidos pela seiva dessa espécie, o curso clínico é benigno e caracterizado por reação moderada da câmara anterior, com envolvimento corneano de intensidade variável.
Subject(s)
Humans , Male , Middle Aged , Uveitis/chemically induced , Euphorbia/adverse effects , Plant Exudates/adverse effects , Keratitis/chemically induced , Plant Poisoning/complications , Plant Extracts/adverse effects , Visual AcuityABSTRACT
Introduction: Euphorbia tirucalli Lineu, commonly known as Aveloz, is a very common plant found in tropical regions [1]. The ingestion or contact with its latex causes symptoms such as vomiting and diarrhea, pallor, skin irritation, hepatotoxicity as well as carcinogenesis [2]. Moreover, the Aveloz latex is also responsible for a few important activities against some infectious and neoplastic diseases. Aveloz latex phytochemical composition may vary according to seasonal aspects and geographic location [3], and it is used either orally or topically in traditional medicine. Popularly known as an antitumoral agent (breast, prostate, lung, kidney), it is used not only in Brazil, but in several other countries. According to the literature, the latex could have a dual behaviour, activating or inhibiting tumoral events [3-6]. However, there are few reports discussing these mechanisms. Besides, the mutagenic and genotoxic potentials of phytochemical and homeopathic Aveloz have not yet been described. Several experimental methods have been used to evaluate the mutagenic and genotoxic effects, such as Inductest, the Ames test and the chromotest. Objective: This study aims to evaluate the genotoxic and mutagenic potentials of Aveloz latex and Aveloz phytotherapic and homeopathic solutions. Methodology: In this study, Aveloz 5 and 30cH are prepared according to Brazilian Homeopathic Pharmacopoeia [7], from Aveloz latex collected in the Center for Natural Products Research (NPPN) at the Universidade Federal do Rio de Janeiro [8]. The Aveloz phytochemical solution was prepared following the doses used in folk medicine: 2 drops diluted in 250ml of water and 2 drops diluted in 25 ml of water. All test solutions were submitted to the following methodologies: (a) Inductest: assesses the ability of physical or chemical agents to promote lysogenic induction as a response to DNA damage in lysogenic bacteria; (b) The Ames test: uses indicator strains of Salmonella typhimurium, which are sensitive to substances that can induce different types of mutation; (c) Chromotest: evaluates the genotoxicity of chemicals through the induction of the bacterial SOS system. Results: In the Inductest there was no decrease in bacterial survival fraction and no increase in lysogenic cycle. As measured by The Ames test and the chromotest no mutagenic or genotoxic potentials were detected. Discussion: The homeopathic and the phytochemical Aveloz solutions were unable to produce lysogenic induction or mutagenesis in bacterial cells and they were also unable to produce genotoxic effects, as measured by chromotest. Conclusion: Our results showed that no mutagenic or genotoxic damages were induced by all Aveloz preparations studied, thus we are led to believe that patients using Aveloz as a complementary therapy present no side effects in relation to mutagenesis and genotoxicity.
Subject(s)
Hydroalcoholic Solution , Carcinogenic Danger , Euphorbia/adverse effects , Phytotherapeutic Drugs , GenotoxicityABSTRACT
Four adult sexually matured and clinically healthy West African Dwarf (WAD) rams aged between 24 and 30 months were used for the study. The rams were first used as control and later as experimental animals upon being orally dosed with Euphorbia hirta extract at 400mg/kg body weight for 14 days. Semen samples were collected from the rams a day after the administration of the plant extra and seven days after. The objective of the study was to investigate the effect of Euphorbia hirta on the semen picture of WAD rams. There were significantly differences (P <0.05) in the semen picture as reflected in a reduction of sperm motility from 80% to 47.5% and live-dead ratio from 90.75% to 32.5% in the control and post-experimental stages of the study respectively. This indicates that the fertilization capacity and livability of spermatozoa were negatively affected. There were no significant differences in the values of body parameters measured across the stages of the study. The plant is therefore not recommended for medicinal purpose in male animals.
Cuatro carneros enanos adultos de África Occidental sexualmente maduros y clínicamente sanos, con edades comprendidas entre los 24 y 30 meses, fueron utilizados para este estudio. Los carneros fueron utilizados como control y, más tarde, como animales de experimentación al ser medicados por vía oral con extracto de Euphorbia hirta en 400mg/kg peso corporal durante 14 días. Se recogieron muestras de semen de los carneros un día después de la administración de la planta y siete días después. El objetivo del estudio fue investigar el efecto de Euphorbia hirta en las imágenes de esperma de carneros enanos África Occidental. Hubo diferencias significativas (P <0,05) en la imagen del semen como reflejo de una reducción de la motilidad espermática del 80% al 47,5% y un ratio de vivos-muertos de 90,75% a 32,5% en la etapa control y después de las fases experimentales del estudio, respectivamente. Esto indica que la capacidad de fertilización y calidad de vida de los espermatozoides fueron afectados negativamente. No hubo diferencias significativas en los valores de los parámetros corporales medidos a través de las etapas del estudio. La planta por tanto no es recomendable para fines medicinales en los animales machos.