Kava

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Kava
Kava (Piper methysticum)

Kava ( Piper methysticum )

Systematics
Magnoliids
Order : Peppery (Piperales)
Family : Pepper family (Piperaceae)
Subfamily : Piperoideae
Genre : Pepper ( piper )
Type : Kava
Scientific name
Piper methysticum
G. Forest.
Kava ( Piper methysticum ) with inflorescence
Young kava plant ( Piper methysticum )

Kava ( Piper methysticum ), and kava kava (kava-kava) or noise pepper called, is a plant type from the kind pepper in the family of the pepper plants (Piperaceae). A traditional drink of the west Pacific region is made from plant components (mostly dried and powdered) , which is mainly consumed as a ceremonial drink on religious and cultural occasions.

Plant description

Kava is related to black pepper and resembles it both in its habit and in its pepper-like taste.

As an evergreen shrub, the kava reaches heights of growth of up to about three meters. It has heart-shaped leaves up to 20 centimeters in size and worm-shaped inflorescences . The plant rarely forms female flowers; these remain sterile even with hand-pollination by humans. The plant is reproduced asexually.

The number of chromosomes is 2n = about 130.

Spread and history

Since the plant has been cultivated for a long time, the original home of the kava is not certain. Mostly it is assumed that it is native to the Fiji Islands and other islands in the southern Pacific, but the plant may also originally come from New Guinea . The first Europeans to report on the plant and its use as a ceremonial drink were the Dutch explorers Jacob Le Maire and Willem Cornelisz Schouten . They sighted them on the Horn Islands , which are now politically part of the French overseas territory of Wallis and Futuna .

The name "Kava (-kava)" comes from Tongan and Marquesan ; other name is ' awa ( Hawaii ),' ava ( Samoa ), yaqona ( Fiji ), and sakau ( Pohnpei ).

Preparation and use

Kava is traditionally consumed in different ways in many cultures of the West Pacific , for example in Polynesia , Vanuatu , Melanesia and parts of Micronesia and Australia , but is also consumed in many Western cultures as medicine or as a luxury food.

Traditional use and preparation

Traditionally, fresh or dried components of the kava root are infused with water . Usually, the rootstock of the Rauschpfeffers ("Piperis methystici rhizoma") is ground to a fine powder or pounded in a mortar ; sometimes parts of plants are chewed and spat into a vessel. If the whole plant is used and kneaded during production, the kava drink will later also contain an enzyme that promotes salivation . In some cultures, however, it is also chewed fresh, which has a stronger effect. Fresh kava is more potent than dried, industrially processed kava. The potency depends on the variety and cultivation. It is consumed with both hot and cold water. Kava is often drunk from halved coconut shells . The taste is slightly hot; the actual aroma depends heavily on whether fresh or dried plants were used for the production. The color is gray to greenish.

In the traditional societies of Polynesia , Micronesia and Melanesia , the consumption of kava was and is usually a purely men's business, even if it is offered to male and female guests in well-developed tourist areas on Tahiti , Fiji or Guam, even on purely folkloric occasions.

In Hawaii, around 30 different types of kava have been used for medicinal, religious, political, cultural and social purposes by all social classes - both men and women. Kava had a role similar to beer as an after-work drink for relaxing and loosening muscles . Kava was also given to restless toddlers to calm them down and help them sleep better.

On many Austronesian islands, communal kava drinking was originally a very intimate and religious ceremony.

On Nauru it was used as an initiation ritual for young men. The kava ritual on Nauru still plays an important, mostly festive role today .

In Vanuatu , kava is drunk at night in a place called “nakamal” (“place of peace”). Men drink kava there from mussels or empty coconut shells; Women were originally prohibited from consuming kava. In traditional medicine, another type of kava is used for fever , asthma and all kinds of pain.

On Pohnpei , a Micronesian island, kava is consumed from coconut shells under the name Sakau . The plant is particularly important in the ceremonial and ritual area. In addition to consumption, the production of the extract is also an important social activity. Apart from that, there are numerous public Sakau bars on Pohnpei.

Modern application

Nowadays it is also consumed beyond the area of ​​origin of kava - as medicine or as a luxury food . For example, kava bars can be found in many US states. Usually, only products that are obtained from the roots are consumed here - for example, root powder or extracts. It is infused with water or with milk or the like. consumed. Lecithin is often added to allow the kavapyrons to dissolve better in water.

It is also sold as a soft drink, for example in Rzo in Hawaii (pronounced “rizzo”) or Bula in the USA. The drink "Lava Cola" (also called Kava Cola ), advertised for its calming effect, has been available in Pacific Vanuatu and other countries since 2009 .

Kava is available in pharmaceutical products in many countries and is used as a medicine. In Germany , kava root extract was used to treat mild general anxiety states until 2002. Trade names were Antares, Neuronika, Kava-ratiopharm, Kavosporal forte or Kavatino.

ingredients

Piperidine alkaloids in the kava plant

The 2 to 10 kg, very juicy root stocks of the kava plant contain between 3 and 20% kavapyrone . The total content varies depending on the location and the subspecies. Other ingredients are starch (43%), raw fiber (20%), water (12%), sugar (3.2%), proteins (3.6%) and minerals (3.2%). In addition, the roots contain Flavokavin A and B and small amounts of sitosterol , Stigmastendion and Cepharadion A together with small amounts of essential oils, as well as some organic acids (for example: n-Oxo- nonanoic acid , phenylacetic acid , cinnamic acid , p- methoxyphenylacetic acid ).

The visible parts of the plant (leaves, bark), on the other hand, contain the piperidine alkaloids pipermethystine (0.2 to 0.8% in the bark, 1 to 2.4% in the leaves), 3a, 4a-epoxy-5b in addition to the kavapyrone -Pipermethystin (only in cv. 'Isa') and Awain (only in closed leaves, 0.1 to 2.6%), which are believed to contribute to liver damage. These alkaloids are not contained in commercially available preparations of the roots.

effect

The kavapyrons (kavain, methysticin) from the roots and bark of the kava plant have an anxiolytic effect, i.e. reduce anxiety and tension. In the case of social phobia , it was superior to the placebo . Kava also has mild analgesic (pain reliever) and antioxidant effects. The consumption of kava relaxes and reduces unrest; it leads to slight euphoria and talkativeness. Kava relieves muscle spasms; Consumers usually feel relaxed, comfortable and clear-thinking. As a rule, one sleeps restfully after consumption, and there are no after-effects on the following day as long as the preparation does not contain alcohol.

Side effects can include mild, temporary numbness of the lips and tongue , decreased vision, impaired reactions, yellowing of the skin and general allergic skin reactions. Kava should not be used during pregnancy or breastfeeding . With high consumption and long intake as well as pre-existing liver damage, Kava can lead to weight loss, malnutrition, liver damage, kidney damage, rash , pulmonary hypertension , macrocytosis, lymphopenia and reduced platelet volume.

Liver damage controversy

In Germany, drugs containing cava were withdrawn from the market in 2001 after liver damage was observed. It was assumed that the possible use of "peelings" ( bark ) in the manufacture of medicines , which, in contrast to the traditional kava root used , should contain the alkaloid pipermethystin , is the cause of liver damage. This hypothesis is now considered outdated. It has been shown that pipermethystin can cause liver damage. However, an analysis of retained samples of the German kava drugs revealed that pipermethystin was not contained in relevant amounts. In an animal study on rats with an ethanolic kava extract, no liver toxic effects could be determined. Another assumption is therefore that the liver damage could be caused by pre-existing diseases or by possible contamination of the drugs with aflatoxins or other liver-damaging mycotoxins , caused by mold and bacteria . However, studies on this are still pending.

Poisoning by synthetic enantiomers could also be a possible cause, as a dissertation published in 2011 shows. The drugs manufactured in Germany (such as the drug Laitan) not only contained natural substances, but also synthesized kavain for reasons of cost . Artificially produced Kavain is a racemic mixture of (+) - Kavain and (-) - Kavain (also known as DL -Kavain). The kava plant only contains (+) - kavain. In the work it was shown that (-) - Kavain is broken down into harmful para-hydroxy compounds. This would explain why hepatotoxic cases mainly occurred in German-speaking countries, while hepatotoxicity in the Pacific region is virtually unknown. The previous differences to hepatotoxicity in the scientific literature could also be understandable, since the authors do not explicitly state whether the examined kavain is synthetic or comes from the kava plant.

Legal situation

On June 14, 2002, the Federal Institute for Drugs and Medical Devices (BfArM) revoked the approval for drugs containing kava kava and kavain. It responded to 40 documented cases of serious liver damage, including six cases of severe liver failure requiring a transplant and three fatal cases involving the use of kava supplements.

As expected, there were critical voices about the BfArM's decision. Members of the BfArM advisory commission E protested. They assessed the therapeutic efficacy and the risk-benefit ratio of the kava drugs obtained from the rhizome as positive and saw no imminent danger. The cause of the liver damage that occurred in earlier studies was based on overdoses and too long an intake, through pre-existing diseases or possible contamination by aflatoxins or other liver-damaging mycotoxins ; Only in very few individual cases can a causal connection to liver damage be classified as likely if properly treated with kava.

After an objection by the manufacturers, the BfArM ordered the temporary suspension of approval on May 12, 2005 as a less severe measure, which should give the companies the opportunity to prove the effectiveness and harmlessness of the kava preparations through suitable studies. However, the companies did not succeed in adequately demonstrating the safety in suitable animal experiments, which would have been a prerequisite for the approval and implementation of clinical studies. Thus, no new benefit-risk assessment could be made. The BfArM came to the conclusion that the risk was not offset by sufficiently proven, adequate therapeutic efficacy in the claimed indications, and that there were therapeutic alternatives whose efficacy had been proven in the application areas in question.

It revoked the approval again on December 21, 2007. This not only affects finished medicinal products, but also individual preparations and the sale of medicinal drugs. The only exceptions are homeopathic preparations with a final concentration lower than D4. In response to complaints from pharmaceutical manufacturers, the Cologne Administrative Court overturned the revocation notice in May 2014 on the grounds that the risk-benefit ratio of the kava-kava-containing drugs at issue was not unfavorable.

The Higher Administrative Court of North Rhine-Westphalia rejected the appeal in February 2015 and confirmed the first-instance judgment of the Cologne Administrative Court. The prerequisites for a license revocation are not met. The risk-benefit ratio is not unfavorable if certain changes are made to the approvals in order to contain the risks as best as possible. The therapeutic effectiveness of the drugs is to be affirmed. The fact that anxiety disorders are serious, widespread and in need of treatment mental illness also speak for their benefit. There are application risks in the form of hepatotoxic (liver-damaging) events. The number of reported cases in relation to the volume of drug use is low and the cause-effect relationship is often questionable. It is crucial that the hepatotoxic risks can be reduced to an acceptable level if certain measures are observed. These included the requirement to prescribe a doctor, which has existed since 2002, the limitation of the maximum daily dose and the duration of use, the regular determination of liver values ​​and the avoidance of alcohol as well as accompanying medication, in particular with beta blockers , antidepressants and migraine drugs . (" If the measures implemented so far are not sufficient, no revocation is possible, but the approval must be adjusted. ")

The pharmaceutical authorities in Switzerland ( Swissmedic ), France ( AFSSAPS ), the Netherlands ( CBG ) and the British MHRA came to the same assessment based on suspicions at the time. However, these assessments do not coincide with those of other drug authorities: In the US, as in most parts of Australia, kava is freely available. However, the Australian Therapeutic Goods Administration has issued a recommendation that users should not consume more than the kava equivalent of 250 mg kavapyrone per day.

literature

  • Hermann Mückler : Kava in Oceania: New considerations on a cultivated plant and its meaning in a cultural context . In: Communications of the Anthropological Society Vienna. Volume CXXV, Vienna 1996, pp. 207-224.
  • Ingrid and Peter Schönfelder : The new book of medicinal plants. Botany, medicinal drugs, active ingredients, applications. Franckh-Kosmos, Stuttgart 2011, ISBN 978-3-440-12932-6 .
  • Lutz Roth, Max Daunderer , Kurt Kormann: Poisonous plants plant poisons. 6th edition. Nikol, Hamburg 2012, ISBN 978-3-86820-009-6 .
  • Angelika Prentner: Mind-changing plants from A to Z. Springer, Vienna / New York, NY 2004, ISBN 3-211-23524-8 .

Studies

  • F. Pantano, R. Tittarelli et al. a .: Hepatotoxicity Induced by "the 3Ks": Kava, Kratom and Khat. In: International journal of molecular sciences. Volume 17, number 4, 2016, p., Doi : 10.3390 / ijms17040580 , PMID 27092496 , PMC 4849036 (free full text) (review).
  • LR Olsen, MP Grillo, C. Skonberg: Constituents in kava extracts potentially involved in hepatotoxicity: a review. In: Chemical research in toxicology. Volume 24, Number 7, July 2011, pp. 992-1002, doi : 10.1021 / tx100412m , PMID 21506562 (review).
  • R. Teschke: Kava hepatotoxicity - a clinical review. In: Annals of hepatology. Volume 9, Number 3, 2010 Jul-Sep, pp. 251-265, PMID 20720265 (review).

Web links

Commons : Kava ( Piper methysticum )  - Collection of images, videos and audio files

Individual evidence

  1. ^ Piper methysticum at Tropicos.org. In: IPCN Chromosome Reports . Missouri Botanical Garden, St. Louis
  2. ↑ kava . In: Merriam-Webster Online Dictionary (2010).
  3. ↑ Augustine Kohler: Sakau - Pohnpei's communal narcotic. In: Charting the Pacific. ABC radio Australia, accessed May 24, 2008 .
  4. ↑ http://rzorzo.com
  5. ↑ Kalm with Kava - Premium Kava and Relaxation Drinks .
  6. ↑ Van Beverage releases new kava drink .  ( Page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice. In: Vanuatu Daily Post , October 4, 2009.@1@ 2Template: dead link / dailypost.vu  
  7. ↑ Vanuatu has high hopes for new Kava based Lava Kola . ABC Radio Australia, March 18, 2010.
  8. ↑ Kava cola, Vanuatu's answer to energy drinks ( Memento from February 29, 2012 in the Internet Archive )
  9. ↑ Advertisement for Lava Cola , focusing on its relaxing effect, on the official YouTube channel of the Vanuatu Kava Store
  10. ↑ R. Hansel: Kava-Kava in modern drug research. In: Zeitschrift für Phytotherapie , 17, 1996, pp. 180-194.
  11. ↑ A. Lopez-Avila, J. Benedicto: Supercritical Fluid Extraction of Kava Lactones from Piper methysticium (Kava) Herb. In: J.High. Resol. Chromatogr. , 20, 1997, pp. 555-559.
  12. ↑ Pittler MH, Ernst E: Kava extract for treating anxiety . In: Cochrane database of systematic reviews (online) . No. 1, 2003, p. CD003383. doi : 10.1002 / 14651858.CD003383 . PMID 12535473 .
  13. ↑ Kava: Don't be afraid of a good mood . In: Interaction
  14. ↑ Fu PP, Xia Q, Guo L, Yu H, Chan PC: Toxicity of kava kava . In: J Environ Sci Health C Environ Carcinog Ecotoxicol Rev . 26, No. 1, 2008, pp. 89-112. doi : 10.1080 / 10590500801907407 . PMID 18322868 .  ( Page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice.@1@ 2Template: Dead Link / pdfserve.informaworld.com  
  15. ↑ Klaus Dragulla, Wesley Y. Yoshidab, Chung-Shih Tang: Piperidine alkaloids from Piper methysticum. In: Phytochemistry , 2003, 63/2, pp. 193–198, doi: 10.1016 / S0031-9422 (03) 00111-0 , PDF ( Memento of the original from December 15, 2006 in the Internet Archive ) Info: The archive link was automatically used and not yet tested. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / jerrycott.com
  16. ↑ a b c Sorrentino L, Capasso A, Schmidt M: Safety of ethanolic kava extract: Results of a study of chronic toxicity in rats . In: Phytomedicine . 13, No. 8, September 2006, pp. 542-9. doi : 10.1016 / j.phymed.2006.01.006 . PMID 16904878 .
  17. ↑ Pratibha V. Nerurkar et al: In Vitro Toxicity of Kava Alkaloid, Pipermethystine, in HepG2 Cells Compared to Kavalactones. In: Toxicological Sciences , 79 / -, 2004, pp. 106-111, oxfordjournals.org
  18. ^ New Evidence Links Kava To Liver Damage .
  19. ^ M Lechtenberg, B Quandt, M Schmidt, A Nahrstedt: Is the alkaloid pipermethystine connected with the claimed liver toxicity of Kava products? In: Pharmazie , 63 (1), 2008, pp. 71-74, PMID 18271308 .
  20. ^ A b R. Teschke, SX Qiu, V. Lebot: Herbal hepatotoxicity by kava: Update on pipermethystine, flavokavain B, and mold hepatotoxins as primarily assumed culprits . In: Digestive and Liver Disease , 2011 [Article in Press]
  21. ↑ Step-by-step plan procedure, level II, to avert drug risks in connection with drugs containing kava-kava and kavain. Decision of the BfArM of June 14, 2002 (PDF)
  22. ↑ Yann Barguil: Etude de trois plantes psychotropes consommées en Nouvelle-Calédonie: kava, cannabis et datura: Aspects médicaux et médico-légaux , pp. 16, 19, 36f., 45f., 51ff. (PDF; 2.9 MB) Nouméa: Université de la Nouvelle-Calédonie, 2011. - Dissertation
  23. ↑ Statement by Commission E: Excerpt from the quotation ( memento of the original dated November 29, 2014 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / verbrauchernews.de
  24. ↑ R. Teschke, W. Gaus, D. Loew: Kava extracts: safety and risks including rare hepatotoxicity. In: Phytomedicine: international journal of phytotherapy and phytopharmacology. Volume 10, number 5, 2003, pp. 440-446, doi : 10.1078 / 0944-7113-00314 , PMID 12834011 (review).
  25. ^ BfArM documents on medicinal products containing kava . Archived from the original on December 11, 2012. Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved November 18, 2014. @1@ 2Template: Webachiv / IABot / bfarm.de
  26. ↑ Cologne Administrative Court, 7 K 2128/12. Retrieved June 30, 2017 .
  27. ^ Higher Administrative Court of North Rhine-Westphalia, judgment of February 25, 2015 (13A1371 / 14)
  28. ↑ Revocation of the approvals of medicinal products with kava-kava and kavain and deletion of kava-kava and kavain from the list of substances C (ruling) . In: Swissmedic Journal . No. 6 , 2003, p. 492–495 ( PDF [accessed February 26, 2019]).
  29. ↑ CIJM Ross-van Dorp: Besluit van 23 april 2003, houdende wijziging van het Warenwetbesluit Kruidenpreparaten (verbod op Kava kava in kruidenpreparaten) (PDF) In: Sdu Uitgevers . Staatsblad van het Koninkrijk der Nederlanden. 2003. Archived from the original on February 27, 2008. Info: The archive link was automatically inserted and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved February 7, 2007. @1@ 2Template: Webachiv / IABot / ipfsaph.org
  30. ^ MHRA Expert Working Group on the safety of Kava . Archived from the original on April 14, 2009. Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved November 18, 2014. @1@ 2Template: Webachiv / IABot / mhra.gov.uk
  31. ↑ Kava fact sheet . Therapeutic Goods Administration, Government of Australia. April 22, 2005. Retrieved February 26, 2019.