Applications of cytisine extraction and detection in biological materials for clinical medicine

Tobacco use is a leading cause of preventable mortality worldwide. New cost-effective smoking cessation treatments are needed especially in some low-to-middle income countries where smoking rates are rising, and current pharmacotherapy treatments remain cost-prohibitive. Since the 1960’s, cytisine has been used as an effective nicotine substitution agent to aid in smoking cessation albeit limited to a selected few Eastern/Central Europe and Central Asian countries. Cytisine is a biologically active alkaloid of plant origin and is known to be a ligand of nicotinic acetylcholinergic receptors (nAChRs). For several decades, the properties of cytisine have been investigated and reported in the biomedical and pharmaceutical literature. Due to the beneficial impact of cytisine on smoking cessation and its costly multistep synthesis, there is a growing interest in extraction from natural sources as well as in analytical identification and quantification for clinical medicine and forensic toxicology. In this paper, we present several current analytical approaches to cytisine extraction and identification from biological samples of plant and human origin. The development of extraction techniques will allow for the widespread use of the drug in experimental and clinical pharmacology, toxicology and forensic medicine.