The genus Rhododendron: An ethnopharmacological and toxicological review

The vast genus Rhododendron includes species that have been used in traditional medicine for the treatment of inflammatory conditions, pain, gastro-intestinal disorders, common cold, asthma, skin disease, etc. Rhododendrons are also well known for their toxicity and some species have been traditionally used as poison.The work reviews and analyses the traditional use, biological activities with the corresponding chemical constituents, and toxicological data on Rhododendron species. The review aims at characterizing the ethnopharmacology of the genus in relation to its toxicity in order to identify the therapeutic potential of Rhododendron species and future directions for research.Data regarding Rhododendron spp. was collected using electronic databases (SciFinder, PubMed, Google Scholar) and library search for selected peer-reviewed articles. Plant taxonomy was validated by the databases The Plant List, Tropicos, eFloras, Flora Iberica and Flora Europaea (RBGE). Additional information on traditional use and botany was obtained from published books. The review encompasses literature, mainly regarding biological activity and toxicological data, from 1898 to the end of December 2012.Rhododendrons have been used in Asian, North American and European traditional medicine mainly against inflammation, pain, skin ailments, common cold and gastro-intestinal disorders. In vivo and in vitro testing of plant extracts and isolated compounds determined diverse biological activities including anti-inflammatory, analgesic, anti-microbial, anti-diabetic, insecticidal and cytotoxic activity. Rhododendron spp. can cause intoxications in humans following intake of rhododendron honey or medicinal preparations. The toxicity is due to grayanotoxins, diterpenes which activate voltage-gated sodium channels and lead to gastro-intestinal, cardiac and central nervous system symptoms.Rhododendron species are useful traditional remedies for the treatment of inflammation, pain, skin ailments, common cold and gastro-intestinal disorders. Pharmacological data has validated most indications of rhododendrons in ethnomedicine and toxicology studies have confirmed the toxicity observed by traditional use. Ethnopharmacological data point to the therapeutic potential of the genus Rhododendron for the treatment of inflammatory conditions and pain and, thus, research should focus on identification of active compounds and related mechanistic studies. Prolonged and high dose intake of traditional formulations containing rhododendrons should be avoided until more in depth toxicity studies become available.