Arecoline - And you thought tobacco was a public health threat

Arecoline is the principal alkaloid found in betel nut, a preparation consisting of the seed of the Areca palm (Areca catechu) wrapped with slaked lime in the leaves of the betel plant (Piper betle). Hundreds of millions of people across Asia regularly dose themselves with arecoline by chewing betel nut as a pick-me-up [1]. Chewing this stuff results in a delightful red-brown discolouration of the mouth and staining of the teeth, and can lead to always-fun precancerous lesions and subsequently one or more varieties of oral cancer (might I interest you in a buccal carcinoma?). It has been suggested that arecoline is the agent in betel nut that is responsible for these cancers [1].

As it binds to muscarinic receptors in the brain, arecoline has been investigated as a possible treatment for Alzheimer's disease. It can improve patient outcomes, but most of the literature out there is at least a decade old [2, 3]. The whole possible carcinogen thing likely put a damper on its development. Arecoline has also been used in the past by veterinarians to kill intestinal worms in dogs and cattle [4].

[1] Giri S, Poindexter KM, Sundar SN, Firestone GL. (2010). Arecoline induced disruption of expression and localization of the tight junctional protein ZO-1 is dependent on the HER 2 expression in human endometrial Ishikawa cells. BMC Cell Biol 11: 53.
[2] Christie JE, Shering A, Ferguson J, Glen AI. (1981). Physostigmine and arecoline: effects of intravenous infusions in Alzheimer presenile dementia. Br J Psychiatry 138: 46-50.
[3] Raffaele KC, Berardi A, Asthana S, Morris P, Haxby JV, Soncrant TT. (1991). Effects of long-term continuous infusion of the muscarinic cholinergic agonist arecoline on verbal memory in dementia of the Alzheimer type. Psychopharmacol Bull 27: 315-319.
[4] Trejos A, Szyfres B, Marchevsky N. (1975). Comparative value of arecoline hydrobromide and bunamidine hydrochloride for the treatment of Echinococcus granulosus in dogs. Res Vet Sci 19: 212-213.