Croton lechleri

Croton lechleri

Common Names

  • Sangre de Drago
  • Dragon's Blood
  • Sangre de Grado
  • Sangre de Dragón
  • SP-303
  • crofelemer

For Patients & Caregivers

Sangra de Grado has not been shown to treat cancer in humans. An extract of the plant, crofelemer, is effective in treating certain forms of diarrhea

Sangre de Grado is derived from the dark red viscous sap (latex) of Croton lechleri, a tree that is found in many regions of South America. SP-303, an active ingredient of Sangre de Grado was found effective in the treatment of traveler’s diarrhea and diarrhea experienced by AIDS patients. Crofelemer, derived from Croton lechleri, is a botanical prescription drug approved by the FDA to treat HIV-associated diarrhea.

Studies done in animals showed that Sangre de Grado reduced the size of gastric ulcers and also decreased the time required for wound healing but human data is lacking. Laboratory studies indicate that it can kill cancer cells, but no studies have been done in humans.

  • To treat diarrhea
    Clinical trials showed that Sangre de Grado is effective in the treatment of traveler’s diarrhea and the diarrhea experienced by AIDS patients
  • To treat cancer
    Laboratory studies showed that Sangre de Grado can kill cancer cells but human data is lacking
  • To treat viral infections
    One clinical trial found that Sangre de Grado when used topically was no more effective than placebo in treating recurrent genital herpes lesions in AIDS patients
  • To treat gastric ulcers
    Animal studies have shown that Sangre de Grado can reduce the size of gastric ulcers, but there are no human studies
  • For wound healing
    There are no studies in humans that support this use, but animal studies have shown that Sangre de Grado can decrease the time required for wound healing
  • May cause skin irritation.
  • Upper respiratory tract infection, cough, gas, and increase in bilirubin levels reported in clinical study using crofelemer
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For Healthcare Professionals

Croton lechleri

Croton lechleri is a tree that is found in many regions of South America (1). The dark red viscous latex of this plant, also known as Sangre de Grado or Dragon’s blood, has been used in traditional medicine for diarrhea and wound healing.

In vitro and animal studies show that it can promote the healing of gastric ulcers (8), and inhibit cutaneous neurogenic inflammation (15). A proanthocyanidin oligomer isolated from the latex of Croton lechleri has shown benefits in the treatment of traveler diarrhea, and diarrhea experienced by AIDS patients (2) (3). A similar product, crofelemer, is approved by the FDA as a prescription drug to relieve diarrhea associated with antiretroviral therapy in HIV/AIDS patients (17). However, in a study of AIDS patients with recurrent genital herpes, it was found no more effective than placebo (14).

Sangre de Grado demonstrated apoptotic effects in cancer cells in vitro (4). However, it also increased the viability of leukemic cells in vitro (5). Further research is needed to verify such effects.

  • Diarrhea
  • Cancer
  • Antiviral agent
  • Gastric ulcers
  • Neurogenic inflammation
  • Wound repair

SP-303, a mixture of proanthocyanidin oligomers was shown to inhibit cAMP-mediated chloride secretion in two intestinal epithelial cell lines (Caco-2 and T84) (6) (7). The dual inhibitory action of crofelemer, a purified proanthocyanidin oligomer, on two structurally unrelated prosecretory intestinal Cl(-) channels may account for the intestinal antisecretory activity (16). The sap of Sangre de Grado decreased capsaicin mediated chloride secretion in vitro (8) by inhibiting activation of sensory afferent nerves. Sangre de Grado irreversibly altered the microtubule structure of cancer cells, resulting in an inability of the cells to adhere and in turn induced cell death via apoptosis (4). It also inhibited the mutagenicity of 2-Aminoanthracene, although the direct mechanism is unknown (10). Topical application of Taspine, an alkaloid from Sangre de Grado sap, to a wound site produced an increase in wound healing activity (11) and an increase in the wound tensile strength 5-7 days following injury (12). Taspine promotes wound healing via increase in migration of fibroblasts to the wound site (11) by acting as a chemotactic factor for fibroblasts (12).

Localized burning sensation upon topical application.
Upper respiratory tract infection, bronchitis, cough, flatulence, and increased levels of the liver enzyme bilirubin have been reported in a clinical study of crofelemer (17).

Increased bilirubin has reported in clinical study using crofelemer (17).

  1. Jones K. Review of sangre de drago (Croton lechleri)—a South American tree sap in the treatment of diarrhea, inflammation, insect bites, viral infections, and wounds: traditional uses to clinical research. J Altern Complement Med 2003;9(6):877-96.

  2. Sandoval M, Okuhama NN, Clark M, et al. Sangre de grado Croton palanostigma induces apoptosis in human gastrointestinal cancer cells. J Ethnopharmacol 2002;80(2-3):121-9.

  3. Styczynski J, Wysocki M. Alternative medicine remedies might stimulate viability of leukemic cells. Pediatr Blood Cancer 2006;46(1):94-8.

  4. Gabriel SE, Davenport SE, Steagall RJ, Vimal V, Carlson T, Rozhon EJ. A novel plant-derived inhibitor of cAMP-mediated fluid and chloride secretion. Am J Physiol 1999;276(1 Pt 1):G58-63.

  5. Miller MJ, MacNaughton WK, Zhang XJ, et al. Treatment of gastric ulcers and diarrhea with the Amazonian herbal medicine sangre de grado. Am J Physiol Gastrointest Liver Physiol 2000;279(1):G192-200.

  6. Miller MJ, Vergnolle N, McKnight W, et al. Inhibition of neurogenic inflammation by the Amazonian herbal medicine sangre de grado. J Invest Dermatol 2001;117(3):725-30.

  7. Vaisberg AJ, Milla M, Planas MC, et al. Taspine is the cicatrizant principle in Sangre de Grado extracted from Croton lechleri. Planta Med 1989;55(2):140-3.

  8. Porras-Reyes BH, Lewis WH, Roman J, Simchowitz L, Mustoe TA. Enhancement of wound healing by the alkaloid taspine defining mechanism of action. Proc Soc Exp Biol Med 1993;203(1):18-25.

  9. Chen ZP, Cai Y, Phillipson JD. Studies on the anti-tumour, anti-bacterial, and wound-healing properties of dragon’s blood. Planta Med 1994;60(6):541-5.

  10. Orozco-Topete R, Sierra-Madero J, Cano-Dominguez C, et al. Safety and efficacy of Virend for topical treatment of genital and anal herpes simplex lesions in patients with AIDS. Antiviral Res 1997;35(2):91-103.

  11. Pereira U, Garcia-Le Gal C, Le Gal G, et al. Effects of sangre de drago in an in vitro model of cutaneous neurogenic inflammation. Exp Dermatol. 2010 Sep;19(9):796-9.

  12. FDA approves first anti-diarrheal drug for HIV/AIDS patients. FDA News Release. US Food and Drug Administration; December 31, 2012. Accessed January 14, 2013.

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