Elsevier

Journal of Ethnopharmacology

Volume 195, 4 January 2017, Pages 20-38
Journal of Ethnopharmacology

Review
Bletilla striata: Medicinal uses, phytochemistry and pharmacological activities

https://doi.org/10.1016/j.jep.2016.11.026Get rights and content

Abstract

Ethnopharmacological relevance

Bletilla striata (Thunb.) Reichb. f. (Orchidaceae), also known as Hyacinth Orchid and Baiji (Simplified Chinese: 白及), not only has been widely used for the treatment of hematemesis, hemoptysis, and traumatic bleeding due to the efficacy of arresting bleeding with astringent action, but also has been applied topically to overcome ulcers, sores, swellings, and chapped skin due to the efficacy of dispersing swelling and promoting tissue regeneration. Additional medical applications include the treatment of tuberculosis, malignant ulcers, hemorrhoids, anthrax, eye diseases, and silicosis.

Aim of this review

This review aims to provide up-to-date information on the botanical characterization, medicinal uses, chemical constituents, pharmacological activities, and toxicity of B. striata. In addition, this paper also focuses on the possible exploitation of this plant for the treatment of different diseases, and uncovers opportunities for future research.

Materials and methods

The relevant information on B. striata was gathered from worldwide accepted scientific databases via an electronic search (Google Scholar, Web of Science, ScienceDirect, ACS Publications, PubMed, Wiley Online Library, SciFinder, CNKI). Information was also obtained from The Plant List, Chinese pharmacopoeia, Chinese herbal classics books, PhD and MSc dissertations, etc.

Results

A comprehensive analysis of the literature obtained through the above-mentioned sources confirmed that the ethnomedical usages of B. striata have been recorded in Mongolia, Korea, Japan, and China. Phytochemical investigations revealed that the major chemical constituents of B. striata are polysaccharides, bibenzyls, phenanthrenes, triterpenoids and its saponins, steroids and its saponins, which also have been proven to be the main bioactive substances capable of exhibiting numerous pharmacological activities including wound healing, antiulcer, hemostasis, cytotoxicity, antimicrobial, anti-inflammation, anti-oxidation, immunomodulation, anti-fibrosis, antiaging, anti-allergy, and anti-itch.

Conclusions

Preliminary investigations on pharmacological properties of B. striata have shown that B. striata is an outstanding astringent hemostatic medicinal, B. striata polysaccharides (BSP) as the major bioactive components not only capable of promoting wound healing, but also show good performance as a kind of promising natural biomaterial. More importantly, BSP are also reported to be excellent embolic material. However, further investigations need to be carried out to fully clarify its efficacy of dispersing swelling and promoting tissue regeneration. Moreover, this plant also needs a lot more investigations to clarify the pathways of absorption, distribution, metabolism and excretion, and to evaluate its long-term in vivo chronic toxicity before proceeding to the development of pharmaceutical formulation.

Introduction

Bletilla striata (Thunb.) Reichb. f. (Orchidaceae) known as Hyacinth Orchid, Hyacinth Bletilla, Urn Orchid, Chinese Ground Orchid, Common Bletilla Tuber, Japanorchidee (German), Mikadoblomma (Swedish), Mikadoblomst (Danish), Shiran (Japanese), Jaran (Korean), and Baiji/白及 (Chinese), is not only an ornamental garden or a pot plant in Europe and United States, but an important astringent hemostatic medicinal plant native to East Asia (Bown, 1995, Wiart, 2012). B. striata which is mainly distributed through southern and eastern China near the Yangtze River, Japan, Korea, south to Vietnam, Thailand and Myanmar grows wild in sandy soils amongst grassy patches on cool mountain slopes (Flora of China Editorial Committee, 2009, Yeung, 1985). Due to excessive exploitation and destruction of natural habitats, the wild natural resources of B. striata reduced sharply. More than ten years ago, B. striata was listed as one of the key protected wild medicinal plants (http://rep.iplant.cn/). In order to solve the problem of B. striata resources, the artificial cultivation of B. striata and its related species has been developed in the majority of regions in China (Li and Wang, 2006). More importantly, research on strengthening the selection and breeding of excellent varieties of B. striata also has been launched (Zhang et al., 2012). B. striata has been used as an astringent hemostatic medicinal for thousands of years, its pseudobulbs resembling spreading corms (Fig. 1) are generally regarded as the medicinal part. Traditional Chinese Medicine (TCM) holds that it is capable of restraining leakage of blood and stopping bleeding, and dispersing swelling and promoting tissue regeneration, and thus it could be effectively applied in the treatment of hematemesis, hemoptysis, traumatic bleeding, chapped kin, and ulcerative carbuncle (Chinese Herbalism Editorial Board, 1999, Wu, 2005). Additional medical applications of B. striata include treatment of the tuberculosis, malignant ulcers, hemorrhoids, anthrax, eye diseases, and silicosis (Hossain, 2011). Besides, B. striata as vascular embolizing agent for treating primary hepatic carcinoma has been reported to be more effective than conventional gelfoam (Zheng et al., 1998). Moreover, B. striata particles as embolic material also have been shown to achieve better efficacy in alleviating hypersplenism than gelfoam (Liu et al., 2011). Currently, China Food and Drug Administration (CFDA) has approved four patent drugs including Bai Ji Pill, Bai Ji Capsule, Bai Ji Syrup, and Bai Ji Granule, which all only contain B. striata as the medicinal ingredient (http://www.sda.gov.cn/WS01/CL0001/). Remarkably, the typical dose of Bletillae Rhizoma (i.e., dried tubers of B. striata) depends on conditions being treated. Officially, Chinese Pharmacopoeia recommends its dosage between 6 and 15 g or at an appropriate amount for external application, and meanwhile states that its dosage should be between 3 and 6 g when taken internally as powder. In addition, Bletillae Rhizoma is incompatible with Aconiti Radix, Aconiti Kusnezoffii Radix, and Aconiti Lateralis Radix Praeparata (China Pharmacopoeia Commission, 2015). Furthermore, non-medical uses of B. striata include rubbing its mucilaginous roots in inkstones with vermilion for writing (Lawler, 1984), and another use is as an insecticide (Perry and Metzger, 1990). In Japanese folk medicine, the tubers are used for the same purposes as salep (Lawler, 1984). At present, several cosmetics and daily necessities containing B. striata are commercially available (Zhang et al., 2012). And as early as 1955, B. striata mucilage as tablet binder was regarded to be an outstanding substitute for arabia gum or gum trargacanth in the pharmaceutical industry (Koo et al., 1955).

Studies focusing on secondary metabolites have resulted in the isolation of bibenzyls, dihydrophenanthrenes, biphenanthrenes, phenanthrenes, triterpenoids and its saponin, steroids and its saponins, cyanidin glycosides and anthocyanins, phenanthraquinones, anthraquinones, lignans, organic acids, and glucosyloxybenzyl 2-isobutylmalates. In addition, B. striata is also rich sources of polysaccharides, which have been recently used as a variety of biomedical materials for wound healing, or as vehicles for drug delivery (Dong et al., 2009, Lin et al., 2012, Liu et al., 2014, Liu and Huang, 2010, Wu et al., 2010, Zhan et al., 2014). Reviewing the available literatures, no review concerning B. striata is available. In this review, we intend to provide a comprehensive insight into the botanical characterization, medicinal uses, chemical constituents, pharmacological effects, and toxicity of B. striata to provide knowledge to researchers for better utilization of this plant.

Section snippets

Botanical characterization

B. striata is 18–60 cm tall. The rhizome is compressed, subglobose or irregularly shaped and 1–3 cm in diameter. The stem is 3–25 cm, stout, and has 4–6 leaves. The leaves are widely spaced. The peduncle is 14–34 cm long, slender, and usually with a single sheathing bract. The rachis is flexuous or pendulous, 2–7 cm long, and has 3–10 flowers. The flowers are erect, purplish red, and showy. The sepals are purplish red or pink, narrowly oblong. The lateral sepals are oblique and acute at the apex.

Medicinal uses

B. striata as inferior herbal item was firstly recorded in Shennong's Classic of Materia Medica (Simplified Chinese: 神农本草经). It is bitter, sweet and puckery in flavour, slightly cool and astringent in nature, and it acts on the lung, liver and stomach meridians (China Pharmacopoeia Committee, 2015, Wu, 2005). Generally, B. striata is collected in summer and autumn with the fibrous roots removed, the cleaned pseudobulbs are used as the medicinal part, which are soaked in boiling water or placed

Chemical constituents

B. striata is a rich source of different classes of natural products with varying structural patterns. Since a Japanese research group conducted continuous studies on B. striata from 1983, a large number of compounds including bibenzyls, dihydrophenanthrenes, biphenanthrenes, phenanthrenes, triterpenoids and its saponin, steroids and its saponins, cyanidin glycosides, phenanthraquinones, anthraquinones, lignans, organic acids, and glucosyloxybenzyl 2-isobutylmalates have been isolated from B.

Wound healing activity

Wound dressings with high performance should be capable of keeping the wound moist, and be able to ensure the solubilization of growth factors and support fibroblast growth. Besides, the ability to absorb exudate and exchange oxygen could also favor healing process (Patrulea et al., 2015). Furthermore, it also has been suggested that it could be better to exhibit antibacterial activity and biocompatible property. U.S. Food and Drug Administration (USFDA) has approved to develop wound dressing

Toxicity assessment

Acute toxicity test revealed that the oral administration of Kunming mice with B. striata polysaccharides (4000 mg/kg) did not result in mortality, and any changes in behavior, food intake, fur, body weight. Rabbit vaginal irritation test revealed that no any abnormal phenomena including hyperemia, swelling, and cells shedding to vagina, uterus, and ovary occurred upon administration of B. striata polysaccharides (3000 mg/kg) (Liu et al., 1992). Besides, it has been suggested that BSP could be a

Conclusion

B. striata has been used as an astringent hemostatic medicinal for thousands of years. Currently, a great deal of studies have been conducted to display B. striata's numerous biological activities and quite a few of which are in accord with their traditional uses. In TCM, excepting taken internally for the treatment of lung atrophy, lung decay, and hemoptysis caused by lung impairment, Bletillae Rhizoma ground into a fine powder is mainly topically applied to injured skins or bleeding wounds.

Acknowledgments

This work was supported by Administration of Traditional Chinese Medicine of Shaanxi Province (13-JC-030); Xi’an Foundation for Development of Science and Technology, China (No. SF1423(3)).

References (103)

  • F. Heller et al.

    Interleukin-13 is the key effector Th2 cytokine in ulcerative colitis that affects epithelial tight junctions, apoptosis, and cell restitution

    Gastroenterology

    (2005)
  • M.M. Hossain

    Therapeutic orchids: traditional uses and recent advances–an overview

    Fitoterapia

    (2011)
  • H. Morita et al.

    Antimitotic activity and reversal of breast cancer resistance protein-mediated drug resistance by stilbenoids from Bletilla striata

    Bioorg. Med. Chem. Lett.

    (2005)
  • I. Ordás et al.

    Ulcerative colitis

    Lancet

    (2012)
  • V. Patrulea et al.

    Chitosan as a starting material for wound healing applications

    Eur. J. Pharm. Biopharm.

    (2015)
  • Q. Peng et al.

    Structure and immunobiological activity of a new polysaccharide from Bletilla striata

    Carbohydr. Polym.

    (2014)
  • Y. Qu et al.

    Optimization of infrared-assisted extraction of Bletilla striata polysaccharides based on response surface methodology and their antioxidant activities

    Carbohydr. Polym.

    (2016)
  • T. Reinecke et al.

    Characterization of bibenzyl synthase catalysing the biosynthesis of phytoalexins of orchids

    Phytochemistry

    (1993)
  • N. Saito et al.

    Acylated cyanidin glycosides in the purple-red flowers of Bletilla striata

    Phytochemistry

    (1995)
  • A.J. Sun et al.

    Two novel phenanthraquinones with anti-cancer activity isolated from Bletilla striata

    Bioorg. Med. Chem. Lett.

    (2016)
  • S. Takagi et al.

    Antimicrobial agents from Bletilla striata

    Phytochemistry

    (1983)
  • W. Wang et al.

    Cytotoxic, anti-inflammatory and hemostatic spirostane-steroidal saponins from the ethanol extract of the roots of Bletilla striata

    Fitoterapia

    (2015)
  • W. Wang et al.

    Study on hemostasis of Bletilla striata hemostatic sponge

    J. Pharm. Pract.

    (2016)
  • Y. Wang et al.

    Two natural glucomannan polymers, from Konjac and Bletilla, as bioactive materials for pharmaceutical applications

    Biotechnol. Lett.

    (2015)
  • Y. Wang et al.

    A new glucomannan from Bletilla striata: Structural and anti-fibrosis effects

    Fitoterapia

    (2014)
  • Y. Xiang et al.

    Preparation of wet-spun polysaccharide fibers from Chinese medicinal Bletilla striata

    Mater. Lett.

    (2014)
  • M. Yamaki et al.

    Biphenanthrenes from Bletilla striata

    Phytochemistry

    (1989)
  • M. Yamaki et al.

    Benzylphenanthrenes from Bletilla striata

    Phytochemistry

    (1990)
  • M. Yamaki et al.

    Methylated stilbenoids from Bletilla striata

    Phytochemistry

    (1991)
  • M. Yamaki et al.

    Phenanthrene glucosides from Bletilla striata

    Phytochemistry

    (1993)
  • M. Yamaki et al.

    Three dihydrophenanthropyrans from Bletilla striata

    Phytochemistry

    (1993)
  • M. Yamaki et al.

    Bisphenanthrene ethers from Bletilla striata

    Phytochemistry

    (1992)
  • M. Yamaki et al.

    Blespirol, a phenanthrene with a spirolactone ring from Bletilla striata

    Phytochemistry

    (1993)
  • L. Yang et al.

    A new macrolide and six cycloartane triterpenoids from the tubers of Bletilla striata

    Biochem. Syst. Ecol.

    (2014)
  • L. Yue et al.

    Bletilla striata polysaccharide inhibits angiotensin II-induced ROS and inflammation via NOX4 and TLR2 pathways

    Int. J. Biol. Macromol.

    (2016)
  • X.D. Zhan et al.

    Targeted depletion of tumour-associated macrophages by an alendronate–glucomannan conjugate for cancer immunotherapy

    Biomaterials

    (2014)
  • Q. Zhang et al.

    Wet spinning of Bletilla striata polysaccharide/silk fibroin hybrid fibers

    Mater. Lett.

    (2015)
  • D. Bown

    Encyclopedia of Herbs & Their Uses

    (1995)
  • M.S. Brewer

    Natural antioxidants: Sources, compounds, mechanisms of action, and potential applications

    Compr. Rev. Food Sci. F

    (2011)
  • H.D. Calaway et al.

    Orchid Biology: Reviews and Perspectives, VII

    (1997)
  • China Pharmacopoeia Commission

    Chinese Pharmacopeia

    (2015)
  • Chinese Herbalism Editorial Board

    Zhonghua Bencao

    (1999)
  • R.N. Feinberg et al.

    Hyaluronate in vasculogenesis

    Science

    (1983)
  • G.S. Feng et al.

    Mechanism of inhibition of tumor angiogenesis by Bletilla colloid: an experimental study

    Natl. Med. J. China

    (2003)
  • J.Q. Feng et al.

    Novel bibenzyl derivatives from the tubers of Bletilla striata

    Helv. Chim. Acta

    (2008)
  • W.W. Feng et al.

    A novel ointment to treat donor sites in scald mouse

    Lat. Am. J. Pharm.

    (2015)
  • Flora of China Editorial Committee

    Flora of China

    (2009)
  • G.X. Han et al.

    A new bibenzyl derivative from Bletilla striata

    Acta Pharm. Sin.

    (2002)
  • G.X. Han et al.

    Studies on chemical constituents of Bletilla striata II

    Acad. J. Second. Mil. Med. Univ.

    (2002)
  • G.X. Han et al.

    Studies on the chemical constituents of Bletilla striata

    J. Pharm. Pract.

    (2001)
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