Prickly Pear

Generic name: Opuntia Ficus-indica (L.) Mill., Opuntia Fragilis (Nutt.) Haw., Opuntia Streptacantha Lem., Opuntia Tuna (L.) Mill.
Brand names: Barbary Fig, Brittle Pricklypear, Elephantear Pricklypear, Nopal, Prickly Pear, Pricklypear Cactus, Tuna

Usage of Prickly Pear

Anti-inflammatory activity

An active anti-inflammatory principle has been isolated and identified as beta-sitosterol.(Park 2001b)

In vitro data

The polysaccharides from prickly pear cladodes have been studied in vitro for anti-inflammatory/chondroprotective effects in treatment of joint diseases.(Panico 2007)

Clinical data

Prickly pear may inhibit the production of inflammatory mediators associated with the symptoms of alcohol hangover. In a double-blind, placebo-controlled, crossover trial, 55 healthy volunteers received placebo or 1,600 units of O. ficus-indica extract 5 hours before consuming alcohol. Patients consumed 1.75 g of alcohol per kilogram of body weight over 4 hours. In patients treated with O. ficus-indica, C-reactive protein and symptoms such as nausea, dry mouth, and anorexia were reduced.(Wiese 2004)

Antioxidant effects

Opuntia species have antioxidant activity that may be associated with their phenolic content.(Lee 2002)

Clinical data

In a comparative study in healthy volunteers (N=18)(Tesoriere 2004) and a study of patients with familial isolated hypercholesterolemia (N=15),(Budinsky 2001) short-term supplementation with 250 g of fresh fruit pulp once or twice daily reduced oxidative damage to lipids and improved oxidative stress status.

Cardiovascular risk factors/Weight loss

Clinical data

A meta-analysis of 5 blinded randomized controlled trials evaluated the effect of cactus pear (various doseforms of O. ficus-indica at daily dosages ranging from 400 mg to 15 g for durations of 6 weeks to 2 years) on body weight and cardiovascular risk factors. Analysis of data from studies identified through April 2014 revealed a nonsignificant difference in body weight and waist circumference between cactus pear and controls, with statistically significant reductions in body mass index (BMI), percent body fat, blood pressure, and total cholesterol. However, heterogeneity was high, and risk of bias was highly variable. Effect sizes for BMI and percent body fat reductions were small and not clinically important.(Onakpoya 2015)

Diabetes

Animal data

A study conducted in a murine model suggested O. ficus-indica treatment inhibits glucose absorption from the intestine and enhances glucose uptake from insulin-sensitive muscle cells through the AMPK/p38 MAPK signaling pathway.(Ota 2017)

Clinical data

A systematic review showed a lack of evidence to support use of Opuntia spp. fruit products as alternative or complementary therapy to manage or reduce the risk of type 2 diabetes mellitus.(Gouws 2019)

Diuretic effects

Animal data

Prickly pear cladode, fruit, and flower infusions increased diuresis in a rat model.(Galati 2002)

Hyperlipidemia

Animal data

Two animal studies examined the effect of prickly pear seeds or seed oil on serum and lipid parameters in rats, with reductions in serum cholesterol and low-density lipoprotein (LDL) observed in rats treated with seed oil.(Ennouri 2006, Ennouri 2007) In another study, raw O. ficus-indica had beneficial effects on hypercholesterolemia in rats.(Cardenas Medellín 1998) A pectin isolate from prickly pear decreased LDL metabolism in guinea pigs.(Fernandez 1990, Fernandez 1992, Fernandez 1994)

Clinical data

In one small study (N=29), prickly pear significantly reduced cholesterol levels.(Frati-Munari 1983) In another study, 8 healthy volunteers and 8 patients with familial heterozygous hypercholesterolemia were treated with prickly pear edible pulp 250 g/day for 4 weeks. Significant (P>0.01) decreases in total and LDL cholesterol and reduced platelet proteins were observed in both subject groups.(Wolfram 2003)

In a study of women with metabolic syndrome (N=68), consumption of dried leaves from O. ficus-indica as a dietary supplement (NeOpuntia 1.6 g per meal for 6 weeks) was associated with a rapid increase in circulating HDL cholesterol level, a decrease in LDL cholesterol, and a (slight) decrease in triglycerides. These results suggest that prickly pear may exert a hypocholesterolemic effect.(Del Socorro Santos Díaz 2017, Linarés 2007)

A systematic review examined various dosages of prickly pear fruit and cladode consumption in healthy and obese patients, as well as in patients with metabolic illnesses (ie, type 2 diabetes and metabolic syndrome). Prickly pear fruit consumption was associated with significant reductions in total cholesterol versus placebo (P<0.05) in all but one included study. In the remaining studies (n=6), LDL cholesterol levels decreased (P<0.05).(Gouws 2020)

Neuroprotective effects

Animal and in vitro data

Flavonoids isolated from O. ficus-indica var. saboten species had neuroprotective activity against oxidative neuronal injury induced in rat cortical cells.(Dok-Go 2003) In in vitro and in vivo models of cerebral ischemia, O. ficus-indica had a protective effect against neuronal damage induced by global ischemia.(Kim 2006)

Nutrition

Prickly pear fruit liquid has been studied as a natural sweetener.(Sáenz 1998) Opuntia spp. have also been studied as a source of dietary fiber.(Rosado 1995)

Platelet function

Clinical data

In a study evaluating effects of prickly pear on platelet function in healthy volunteers (n=8) and patients with mild familial heterozygous hypercholesterolemia (n=8), prickly pear pulp 250 g/day significantly reduced platelet proteins. The study noted that at least part of prickly pear's beneficial action on the cardiovascular system might be due to decreasing platelet activity, thereby improving hemostatic balance. Prickly pear may have antiplatelet activity, which may be useful in patients with prothrombotic conditions.(Wolfram 2003)

Ulcers

A cytoprotective mechanism is associated with an interaction between the mucilage monosaccharides from prickly pear and membrane phospholipids.(Galati 2007, Vázquez-Ramírez 2006)

Animal data

Histological evidence supports the efficacy of prickly pear cladodes against the formation of ethanol-induced ulcers.(Galati 2001)

Wound healing

Animal data

Histological evidence documents that topical application of polysaccharide extracts from prickly pear cladodes enhanced cutaneous repair and healing of large, full-thickness wounds in a rat model.(Park 2001a, Trombetta 2006)

Prickly Pear side effects

Dermatitis is the most common adverse reaction to prickly pear. Treatment with topical corticosteroids has been recommended.

Prickly pear ingestion, especially of the seeds, can cause large bowel obstruction requiring medical intervention.(Zahra 2018)

Before taking Prickly Pear

Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.

How to use Prickly Pear

Prickly pear is used commercially in foods and is available in various doseforms, including capsules, tablets, powders, and juices. When using commercial products, manufacturer guidelines should be followed. O. ficus-indica dosing, doseforms, and treatment durations used in clinical trials have varied.

Warnings

Patients hypersensitive to any components of prickly pear should avoid use.

What other drugs will affect Prickly Pear

Prickly pear may theoretically exacerbate hypoglycemia in patients being treated with hypoglycemic agents (eg, metformin, glyburide, rosiglitazone, acarbose).(Bush 2007) Prickly pear may also exacerbate diuresis in patients being treated with diuretic agents (eg, furosemide, hydrochlorothiazide). However, these interactions are not well documented.

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