Background

• Extracts of fern species (family Polypodiaceae) have been used traditionally for numerous indications, most commonly in South America and Europe.
• The South American species Polypodium leucotomos L. is commonly known as "calaguala." Extracts of this species, called "anapsos," have been marketed and used as a treatment for multiple indications. Although laboratory and animal studies have reported anti-inflammatory, cytokine-suppressing, and leukotriene inhibitory properties, the small number of available human trials have not demonstrated efficacy for any specific indication

References

• Alcaraz MV, Pathak MA, Rius F, et al. An extract of Polypodium leucotomos appears to minimize certain photoaging changes in a hairless albino mouse animal model. A pilot study. Photodermatol Photoimmunol Photomed 1999 Jun-Aug;15(3-4):120-6.
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• Alonso-Lebrero JL, Dominguez-Jimenez C, Tejedor R, et al. Photoprotective properties of a hydrophilic extract of the fern Polypodium leucotomos on human skin cells. J Photochem Photobiol B 2003 Apr;70(1):31-7.
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• Alvarez XA, Franco-Maside A, Zas R, et al. Anapsos reverses interleukin-1 beta overexpression and behavioral deficits in nbM-lesioned rats. Methods Find Exp Clin Pharmacol 1997 Jun;19(5):299-309.
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• Bernd A, Ramirez-Bosca A, Huber H, et al. In vitro studies on the immunomodulating effects of polypodium leucotomos extract on human leukocyte fractions. Arzneimittelforschung 1995 Aug;45(8):901-4.
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• Dea-Ayuela M, Rodero M, Rodriguez-Bueno R, et al. Modulation by Anapsos (Polypodium leucotomos extract) of the antibody responses against the nematode parasite Trichinella spiralis. Phytother Res 1999 Nov;13(7):566-70.
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• Fernandez-Novoa L, Alvarez XA, Sempere JM, et al. Effects of anapsos on the activity of the enzyme Cu-Zn-superoxide dismutase in an animal model of neuronal degeneration. Methods Find Exp Clin Pharmacol 1997 Mar;19(2):99-106.
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• Gomes AJ, Lunardi CN, Gonzalez S, et al. The antioxidant action of Polypodium leucotomos extract and kojic acid: reactions with reactive oxygen species. Braz J Med Biol Res 2001 Nov;34(11):1487-94.
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• Gonzalez S, Alcaraz MV, Cuevas J, et al. An extract of the fern Polypodium leucotomos (Difur) modulates Th1/Th2 cytokines balance in vitro and appears to exhibit anti-angiogenic activities in vivo: pathogenic relationships and therapeutic implications. Anticancer Res 2000 May-Jun;20(3A):1567-75.
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• Gonzalez S, Pathak MA, Cuevas J, et al. Topical or oral administration with an extract of Polypodium leucotomos prevents acute sunburn and psoralen-induced phototoxic reactions as well as depletion of Langerhans cells in human skin. Photodermatol Photoimmunol Photomed 1997 Feb-Apr;13(1-2):50-60.
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• Gonzalez S, Pathak MA. Inhibition of ultraviolet-induced formation of reactive oxygen species, lipid peroxidation, erythema and skin photosensitization by polypodium leucotomos. Photodermatol Photoimmunol Photomed 1996 Apr;12(2):45-56.
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• Martinez-Fernandez AR, Nogal-Ruiz JJ, Lopez-Aban J, et al. Vaccination of mice and sheep with Fh12 FABP from Fasciola hepatica using the new adjuvant/immunomodulator system ADAD. Vet Parasitol 2004 Dec 15;126(3):287-98.
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• Middelkamp-Hup MA, Bos JD, Rius-Diaz F, et al. Treatment of vitiligo vulgaris with narrow-band UVB and oral Polypodium leucotomos extract: a randomized double-blind placebo-controlled study. J Eur Acad Dermatol Venereol 2007 Aug;21(7):942-50.
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• Middelkamp-Hup MA, Pathak MA, Parrado C, et al. Oral Polypodium leucotomos extract decreases ultraviolet-induced damage of human skin. J Am Acad Dermatol 2004 Dec;51(6):910-8.
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• Middelkamp-Hup MA, Pathak MA, Parrado C, et al. Orally administered Polypodium leucotomos extract decreases psoralen-UVA-induced phototoxicity, pigmentation, and damage of human skin. J Am Acad Dermatol 2004 Jan;50(1):41-9.
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• Navarro-Blasco FJ, Sempere JM. Modification of the inflammatory activity of psoriatic arthritis in patients treated with extract of Polipodium leucotomos (Anapsos) Br J Rheumatol 1998 Aug;37(8):912.
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