Graptophyllum pictum (Acanthaceae) relieves some hallmarks of endometriosis in an experimental model in Wistar rats.

Graphical abstract:

Abstract: Current treatments for endometriosis are unsuitable for women who wish to conceive. To verify the supposed beneficial effects of Graptophyllum pictum (G. pictum) on reproductive diseases and inflammation, endometriosis was induced in female Wistar rats using a slightly modified protocol. After verification of successful transplantation (42 days), the animals were co-treated for 7 days with estradiol valerate (E2V; 0.5 mg/kg and the aqueous (GPC) or methanolic (GPM) extracts of G. pictum at doses of 50 and 275 mg/kg. Positive controls received aspirin (3 mg/kg) or letrozole (10 mg/kg). Normal and negative controls received vehicle (distilled water, 10 mL/kg). On day 7, animals were injected with oxytocin 30 min before sacrifice to evaluate some dysmenorrhea-like model parameters. Five animals per group were then sacrificed, and the remaining five animals were mated with males of proven fertility for 25 days. G. pictum extracts at all doses significantly (P < 0.001) increased the time of writhing latency and decreased its frequency and the volume of implant (P < 0.05) at the GPM 50 mg/kg dose. Levels of interleukin-6, tumor necrosis factor-alpha, and vascular angiogenic growth factor were reduced (P < 0.001) with all treatments. They also increased (P < 0.05) the serum superoxide dismutase and glutathione levels and decreased serum nitrite and malondialdehyde levels. In addition, the number of Graafian follicles (P < 0.05), fertility, and pregnancy rates were increased with the treatments. G. pictum extracts showed anti-inflammatory, antioxidant, and fertilizing effects in Wistar rats with endometriosis.

Lay summary: Asymptomatic in some individuals, endometriosis is an estrogen-dependent disease that causes infertility and severe pelvic pain, especially during menstrual periods and sexual intercourse. Higher cesarean rates worldwide have led to more cases of endometriosis (scar endometriosis). The delay of diagnosis (between 2 and 13 years) leads to increased misdiagnosis among patients and healthcare costs. There is no cure, but current treatments aim to alleviate spasms and pain by inhibiting estrogen production, and they are therefore unsuitable for women wishing to conceive, since they affect ovulation. Hence, there is a need to seek medical treatments that do not prevent pregnancy. Apart from its ornamental worth, Graptophyllum pictum, also called caricature plant, is traditionally used to relieve pain and treat reproductive disorders. After abdominal auto-transplantation of uterine fragments in rats, water-based and alcohol-based extracts of G. pictum promoted fertility by improving menstrual pain, egg development, and reducing cell damage and inflammation, which contribute to the progression of endometriosis.