Nutritional and medicinal properties of Star fruit (Averrhoa carambola): A review

Infraspecific Chemical Variability and Metabolomic Profiling by Paper Spray Ionization (PSI-MS) of Averrhoa carambola from Different Brazilian Biomes

This research focused on the molecular diversity of A. carambola collected from three Brazilian biomes (Cerrado, Amazônia, and Mata Atlântica), whose results revealed significant differences in metabolite profiles among these biomes through PSI-MS analysis. Chemometric analysis provided valuable insights into the clustering patterns and metabolic distinctions. Cerrado and Mata Atlântica biomes exhibited a 70 % similarity, indicating a notable degree of resemblance. In Cerrado, carambolaside A was notably abundant, while carambolaside M was low in Amazônia and moderate in Cerrado samples. Carambolaside B was abundant in Amazônia but relatively low in the Cerrado and Mata Atlântica. In contrast, the Amazônia biome samples appeared to be more dissimilar. In Cerrado, epicatechin, kaempferol, and procyanidin B showed lower abundance, while apigenin, quercetin, myricetin, and rutin displayed moderate levels. Mata Atlântica showed relatively higher levels of kaempferol, quercetin, and rutin. This study indicated the environmental influence on secondary metabolites production in A. carambola fruits.

Bioactive aerogels based on native and phosphorylated potato (Solanum tuberosum L.) starches incorporated with star fruit extract (Averrhoa carambola L.)

The aim of this study was to develop a star fruit extract (SFE) and incorporate it into aerogels based on native and phosphorylated potato starches. The phosphorylation of starch enhances its properties by incorporating phosphate groups that increase the spaces between starch molecules, resulting in a more resilient, intact aerogel with enhanced water absorption. The bioactive aerogels based on potato starch and 10, 15, and 20 % (w/w) of SFE were characterized by their morphological and thermogravimetric properties, infrared spectra, water absorption capacity, loading capacity, and antioxidant activity. Epicatechin was the major compound present in SFE. The thermal stability of SFE increased when incorporated into phosphorylated starch aerogels at a concentration of 20 %. The water absorption capacity was higher in phosphorylated starch aerogels (reaching 1577 %) than in their native counterparts (reaching 1100 %). Native starch aerogels with 15 and 20 % SFE exhibited higher antioxidant activity against hydroxyl free radicals compared to phosphorylated starch aerogels, achieving 79.9 % and 86.4 % inhibition for the hydroxyl and nitric oxide radicals, respectively. The ideal choice of freeze-dried aerogel depends on the desired effect, either to act as an antioxidant agent by releasing bioactive compounds from SFE or as a water-absorbent agent in food products.

Phytochemicals and their Potential Mechanisms against Insulin Resistance

Insulin's inception dates back to 1921 and was unveiled through a momentous revelation. Diabetes is a dangerous, long-term disease in which the body fails to generate enough insulin or utilize the insulin it creates adequately. This causes hyperglycemia, a state of high blood sugar levels, which can even put a person into a coma if not managed. Activation of the insulin receptor corresponds to two crucial metabolic functions, i.e., uptake of glucose and storage of glycogen. Type 2 diabetes mellitus (T2DM) exists as one of the most challenging medical conditions in the 21st century. The sedentary lifestyle and declining quality of food products have contributed to the rapid development of metabolic disorders. Hence, there is an urgent need to lay some reliable, significant molecules and modalities of treatment to combat and manage this epidemic. In this review, we have made an attempt to identify and enlist the major phytoconstituents along with the associated sources and existing mechanisms against insulin resistance. The conducted study may offer potential sustainable solutions for developing and formulating scientifically validated molecules and phytoconstituents as formulations for the management of this metabolic disorder.

Cytotoxic/antiproliferative and nutraceutical activity of aqueous and ethanolic extracts of green and mature Averrhoa carambola

Averrhoa carambola L. presents in its composition diversity of nutrients and vitamins. The present study aimed to extract water and fat-soluble compounds from this fruit at different stages of maturation (green and mature), perform the physical-chemical characterization as well as evaluate its cytotoxicity against hepatoma cells of Rattus norvegicus (HTC). The physicochemical results showed that the pH and molar acidity is influenced by the fruit maturation state. The fruit presented high percentage of moisture, while the percentage of total minerals (ash) increased according to its maturation stage. The results of the phytochemical screening showed that star fruits present phenolic compounds. The antioxidant activity showed greater potential for the ethanolic extracts of the green and mature star fruit. For HTC cells treated with ethanolic extract of green and mature star fruit the data show absence of cytotoxic effect. The tests with the aqueous extract showed cytotoxic/antiproliferative effect of green and mature star fruit extract, in 24, 48 and 72 hours. The presence of nutraceutical compounds and the cytotoxic/antiproliferative activity were more expressive in the aqueous extract, being an option of easily accessible solvent economic and not harmful to organisms.

Averrhoa carambola L. fruit and stem metabolites profiling and immunostimulatory action mechanisms against cyclosporine induced toxic effects in rat model as analyzed using UHPLC/MS-MS-based chemometrics and bioassays

The Averrhoa carambola L. tree encompasses a myriad of phytochemicals contributing to its nutritional and health benefits. The current study aims at investigating the A. carambola L. the metabolite profile grown in tropical and temperate regions represented by fruit and stem, for the first time using UPLC/MS-based molecular networking and chemometrics. Asides, assessment of the immunostimulatory effect of ripe fruit and stem, was compared in relation to metabolite fingerprints. Eighty metabolites were identified, 8 of which are first-time to be reported including 3 dihydrochalcone-C-glycosides, 4 flavonoids, and one phenolic. Multivariate data analysis revealed dihydrochalcones as origin-discriminating metabolites between temperate and tropical grown fruits. Further, an in vivo immunomodulatory assay in a cyclosporine A-induced rat model revealed a potential immune-enhancing effect as manifested by down-regulation of inflammatory markers (IL-6, INF-γ, IL-1, TLR4, and ESR) concurrent with the up-regulation of CD4 level and the CD4/CD8 ratio. Moreover, both extracts suppressed elevation of liver and kidney functions in serum as well as reduction in oxidative stress with concurrent increased levels of T-protein, albumin, globulin, and A/G ratio. This study pinpoints differences in secondary metabolite profiles amongst A. carambola L. accessions from different origins and organ type and its immunomodulatory action mechanisms.

Carambolaside W Inhibited H1N1 Influenza Virus-Induced Oxidative Stress through STAT-3/BCL-XL Signaling Pathway

The H1N1 influenza virus is highly infectious and pathogenic, and in recent years, it has often presented seasonal mass outbreaks of infection. People infected with H1N1 will develop a high fever and other respiratory infection symptoms. If not treated in time, complications such as pneumonia may occur. In this study, we focused on developing drugs that can effectively fight against with H1N1 virus. A flavonoid glycoside was extracted from the carambola, then characterized by HR-ESI-MS with the molecular formula C47H58O2, and named carambolaside W. The flavonoid glycosides were found to have good anti-H1N1 influenza virus effects. In this study, we verified that carambolaside W has low toxicity and can effectively inhibit influenza virus replication in vitro. H1N1 virus infection induces intracellular oxidative stress damage to accelerate disease progression. The results showed that carambolaside W effectively inhibited the oxidative stress caused by H1N1 infection. The Western blot assay also revealed that carambolaside W alters the expression of apoptosis-related proteins in vitro and exerts a good anti-H1N1 influenza virus effect. In summary, carambolaside W is a low-toxicity natural flavonoid that can effectively treat the H1N1 influenza virus as a potential anti-H1N1 virus agent.

Integration of Volatilomics and Metabolomics Unveils Key Flavor-Related Biological Pathways in Different Carambola Cultivars

Carambola is a tropical fruit that is highly sought after by consumers due to its unique flavor, star shape, and nutritional value. Enhancing the flavor quality of this fruit can increase the consumer acceptance and market demand. However, flavor is an intrinsic characteristic of fruits. Its decoding requires in-depth knowledge based on recognizing key biological pathways relevant to flavor formation and development. In this study, the volatile and non-volatile metabolites contributing to the flavor variation of five carambola cultivars were investigated by a novel strategy combining GC-MS/O-based volatilomics with LC-MS-based metabolomics. Several significant flavor-related pathways, involving biosynthesis or metabolism of amino acids, terpenoids, fatty acids, sugar and organic acid, and flavonoids were identified based on the enrichment analysis of important volatile and non-volatile metabolites. The results indicated that there were metabolites in the flavor-related pathways being up- or downregulated, leading to the differences in flavor traits of different carambola cultivars. This study could provide a valuable reference for breeders and researchers of interest in the mechanisms underlying the regulation of flavor, which would ultimately lead to the creation of carambola cultivars with more attractive flavor profiles and pleasurable consuming experiences.

Death associated with ingestion of starfruit (Averrhoa carambola) in a patient with chronic kidney disease

We detail a case of a 74-year-old female with a history of chronic kidney disease (CKD) and diabetes mellitus (DM) who initially presented to the Emergency Department (ED) with intractable hiccups after ingesting two whole starfruit (SF) and quickly became critically ill while in the ED. Our patient was admitted and received several rounds of hemodialysis, but efforts proved futile, as the patient expired during her hospital course. To the best of our knowledge, this is the first fatality reported due to SF ingestion in the U.S, and highlights the need for both a better understanding of SF intoxication and clearer guidelines and timing for treatment. Due to the increased mortality of patients who consume SF with a medical history of CKD or DM, it is prudent that Emergency Physicians are familiar with the clinical presentation and management options for SF toxicity.

Effect of Na and Al doping on ZnO nanoparticles for potential application in sunscreens

This study investigated the environment-friendly production and characterization of zinc oxide nanoparticles (ZnO NPs) doped with sodium (Na) and aluminum (Al) metals to decrease the photocatalytic activity of ZnO for use in sunscreen. The metal-doped zinc oxide (ZnO) materials were prepared by the microwave method using extracts of Averrhoa carambola, also known as star fruit, as a reducing agent. The effects of metal-ion doping on the crystal structure, morphology, and optical characteristics of ZnO were analyzed by X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive x-ray spectroscopy (EDX), transmission electron microscopy (TEM), and ultraviolet-visible (UV-Vis) spectroscopy. The sun protection factor (SPF) of the sunscreen formulations containing undoped ZnO, Na-doped ZnO (Na/ZnO), and Al-doped ZnO (Al/ZnO) NPs were found to be 10.10, 25.10, and 43.08, respectively. Therefore, Na/ZnO and Al/ZnO showed increased SPF. Additionally, the prepared nanomaterials and sunscreens were effective against Gram-positive and Gram-negative bacteria and showed antioxidant activities. The methylene blue (MB) degradation was used to evaluate the photocatalytic activities of the undoped ZnO, Na/ZnO, and Al/ZnO NPs, which were found to be 66%, 46%, and 38%, respectively. Therefore, due to the structural defects of ZnO NPs, their photocatalytic activity was decreased with Na- and Al- doping. Additionally, Al/ZnO is an ideal candidate as an ingredient in sunscreens.

Averrhoa carambola L., Cyphomandra betacea, Myrciaria dubia as a Source of Bioactive Compounds of Antioxidant Properties

Natural bioactive compounds play an important role in the prevention of various diseases. The exotic fruits Averrhoa carambola L. (star fruit), Cyphomandra betacea (tamarillo) and Myrciaria dubia (camu-camu) can be valuable sources of phytochemicals with antioxidant properties. The aim of this study has been to compare the antioxidant properties of these exotic fruits, the structure of polyphenolic compounds and the content of vitamin C and β-carotene. All the juices were analyzed for their antioxidant capacity (DPPH and ABTS assays) and the composition of phenolic compounds (TP and FBBB assays, total flavonoid content, total anthocyanins). In addition, HPLC assays were performed to analyse the content of phenolic acids, flavonoids, vitamin C and β-carotene. The results demonstrated that juice from the Myrciaria dubia fruit had the highest antioxidant capacity, which was 4.5-fold higher than that of juice from Averrhola carambola L., and nearly 7-fold higher than the antioxidant capacity of Cyphomandra betacea fruit juice. Additionally, juice from the camu-camu fruit had a 3- to 4-fold higher total polyphenol content (8290 ± 254 mg GAE L^-1) and a high level of vitamin C (8410.8 ± 16.9 mg AA kg^-1). In turn, tamarillo juice had a high content of total anthocyanins (5796 mg CGE L^-1) and phenolic acids (mostly chlorogenic acid and caffeic acid). Juice produced from carambola had a high content of total flavonoids (1345 mg CAE L^-1), and the composition of these compounds was dominated by flavanols (epicatechin). The research results justify the conclusion that fruits of Myrciaria dubia, Averrhoa carambola L., Cyphomandra betacea are rich sources of bioactive compounds with antioxidant properties, and in the near future may serve as healthful food ingredients.

Antidiabetic Potential of Commonly Available Fruit Plants in Bangladesh: Updates on Prospective Phytochemicals and Their Reported MoAs

Diabetes mellitus is a life-threatening disorder affecting people of all ages and adversely disrupts their daily functions. Despite the availability of numerous synthetic-antidiabetic medications and insulin, the demand for the development of novel antidiabetic medications is increasing due to the adverse effects and growth of resistance to commercial drugs in the long-term usage. Hence, antidiabetic phytochemicals isolated from fruit plants can be a very nifty option to develop life-saving novel antidiabetic therapeutics, employing several pathways and MoAs (mechanism of actions). This review focuses on the antidiabetic potential of commonly available Bangladeshi fruits and other plant parts, such as seeds, fruit peals, leaves, and roots, along with isolated phytochemicals from these phytosources based on lab findings and mechanism of actions. Several fruits, such as orange, lemon, amla, tamarind, and others, can produce remarkable antidiabetic actions and can be dietary alternatives to antidiabetic therapies. Besides, isolated phytochemicals from these plants, such as swertisin, quercetin, rutin, naringenin, and other prospective phytochemicals, also demonstrated their candidacy for further exploration to be established as antidiabetic leads. Thus, it can be considered that fruits are one of the most valuable gifts of plants packed with a wide spectrum of bioactive phytochemicals and are widely consumed as dietary items and medicinal therapies in different civilizations and cultures. This review will provide a better understanding of diabetes management by consuming fruits and other plant parts as well as deliver innovative hints for the researchers to develop novel drugs from these plant parts and/or their phytochemicals.

The ability of yoghurt supplemented with dietary fibers or brans extracted from wheat or rice to reduce serum lipids and enhance liver function in male hypercholesterolemic rats

This study was undertaken to evaluate the effect of yoghurt supplementation with rice and wheat brans or dietary fibers on serum lipid profile, liver, and heart functionalities, and hepatopathological aspects of the liver of hypercholesterolemic rats. 48 male rats were divided into 8 groups. Group 1 was kept as negative control and fed with a standard diet, and groups 2 to 6 were fed a hypercholesterolemia-induced diet supplemented with brans or dietary fibers of both grains. G2 received yoghurt without supplementation. The experiment lasted for 4 weeks. Results revealed that hypercholesterolemic rats administrated yoghurt supplemented with brans or dietary fibers reduced serum glucose from 113.9 ± 2.72 to 85.5 ± 4.94 in the serum of animals that received dietary fibers of rice and wheat, respectively. In addition, lipids profile and liver antioxidant status were improved. In addition, liver and heart functionalities and liver histopathological architecture were all improved depending on the type of administrated brans or fibers added to yoghurt. The inclusion of 0.5% of rice or wheat brans could be recommended to be added to yoghurt. PRACTICAL APPLICATIONS: Yoghurt is the most famous fermented milk in the world. Supplementation of yoghurt with rice and wheat brans or dietary fibers increased its nutritional value. We proved that this new product contributes to reducing serum glucose, improving lipids profile, and enhancing liver and heart functions in hypercholesterolemic rats. This study confirmed the suitability to add a thesis type of brans or dietary fibers as bioactive ingredients to yoghurt and increased the varieties of functional foods.

Nutritional Composition and Bioactive Compounds of Native Brazilian Fruits of the Arecaceae Family and Its Potential Applications for Health Promotion

The fruits from the Arecaceae family, although being rich in bioactive compounds with potential benefits to health, have been underexplored. Studies on their composition, bioactive compounds, and effects of their consumption on health are also scarce. This review presents the composition of macro- and micronutrients, and bioactive compounds of fruits of the Arecaceae family such as bacaba, patawa, juçara, açaí, buriti, buritirana, and butiá. The potential use and reported effects of its consumption on health are also presented. The knowledge of these underutilized fruits is important to encourage production, commercialization, processing, and consumption. It can also stimulate their full use and improve the economy and social condition of the population where these fruits are found. Furthermore, it may help in future research on the composition, health effects, and new product development. Arecaceae fruits presented in this review are currently used as raw materials for producing beverages, candies, jams, popsicles, ice creams, energy drinks, and edible oils. The reported studies show that they are rich in phenolic compounds, carotenoids, anthocyanins, tocopherols, minerals, vitamins, amino acids, and fatty acids. Moreover, the consumption of these compounds has been associated with anti-inflammatory, antiproliferative, antiobesity, and cardioprotective effects. These fruits have potential to be used in food, pharmaceutical, and cosmetic industries. Despite their potential, some of them, such as buritirana and butiá, have been little explored and limited research has been conducted on their composition, biological effects, and applications. Therefore, more detailed investigations on the composition and mechanism of action based on in vitro and/or in vivo studies are needed for fruits from the Arecaceae family.

Post-harvest Anthracnose of Carambola (Averrhoa carambola) Caused by Colletotrichum fructicola in China

Carambola (star fruit), a popular fruit of Averrhoa carambola in many parts of the world, is considered to have many beneficial nutritional and medicinal effects (Lakmal, K., et al,2021). In March 2020, anthracnose disease was observed on carambola (about 15% of the fruit showed similar symptoms) in multiple local agricultural markets (113°36'E, 23°11'N) of the Yuancun district in Guangzhou, China. Initial symptoms of infected fruit samples appeared as water-soaked, brown lesions. As the disease progressed, numerous acervuli appeared on fruit surfaces. Salmon-colored spore masses were observed on some fruit. To isolate and identify the pathogen, small pieces (3-5 mm2) were excised from the lesion margins of the fruit, which were surface disinfested by 1% NaOCl (60 s), 70% ethanol (30 s) and then washed twice with sterile distilled water. After surface disinfestation, the tissues were cultured on potato dextrose agar (PDA). Pure cultures were obtained by transferring hyphal tips onto fresh PDA. Fungal isolates (YT-5/6/9) were obtained and the strain YT-5 was selected for further study. The colony of strain YT-5 grown on PDA for 7 days appeared to be cottony, white to pale gray with the presence of multiple masses of conidia. Conidia 13.5-20 × 4.8-6.5 μm (n = 50), hyaline, aseptate, straight and cylindrical with rounded ends. Perithecia were thick-walled and globose with a prominent, narrow neck. Asci 37.1-60.2 × 7.1-11.3 μm (n = 25), 4-8 spored, clavate to cymbiform. Ascospores 7.1-17.2 × 4.5-6.5 μm (n = 35), hyaline, large guttulate at the center, slightly curved with rounded ends. Based on the morphological characteristics, the strain was identified as Colletotrichum fructicola (Prihastuti et al. 2009). The molecular identity of the isolates was confirmed by sequencing the internal transcribed spacer (ITS) rDNA region, chitin synthase (CHS-1), actin (ACT), glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and beta-tubulin (TUB2) genes (Prihastuti et al. 2009, Weir et al. 2012). BLASTN analysis of isolate YT-5 sequences, which were deposited in GenBank (ON428449, ON462353, ON886225, ON886224, ON462354) showed 100% identity with those of Colletotrichum fructicola (MW513778.1, MT918417.1, MW426526.1, MN525875.1, MT941526.1), respectively. A phylogenetic tree analysis based on the concatenated sequences confirmed the isolate YT-5 as C. fructicola. Pathogenicity tests were conducted on fresh fruit of carambola with the isolate YT-5. Healthy fruit was surface disinfested and inoculated with 5 mm mycelial discs of the strain YT-5 after being wounded with a needle or unwounded. Control fruit was inoculated with sterilized PDA plugs. All inoculated fruit was incubated at 26°C for 10 days post inoculation. Control fruit remained asymptomatic, whereas inoculated fruit developed symptomatic at the point of inoculation. The pathogenicity test was performed in duplicate. The pathogenic isolate of C. fructicola was successfully re-isolated on PDA from the symptomatic fruit, thus confirming Koch's postulates. C. fructicola has also been reported as a dominant and aggressive causal agent of anthracnose on sandy pear and avocado in China (Zhang et al. 2015; Li et al. 2022). To our knowledge, this is the first study to isolate and characterize C. fructicola causing carambola anthracnose and evaluate its pathogenicity in China, which will provide a better strategy for accurate diagnosis and effective management of anthracnose disease on carambola. References: Lakmal, K., et al. 2021. Food Sci Nutr 9.3. Prihastuti, H., et al. 2009. Fungal Divers. 39:89. Weir, B. S., et al. 2012. Stud Mycol. 73:115-180. Zhang P.F., et al. 2015. Eur J Plant Pathol.143:651-662. Li S.N., et al. 2022. Plant Dis. The authors declare no conflict of interest. Keywords: Anthracnose, Colletotrichum fructicola, carambola, China.

Anti-Obesity Evaluation of Averrhoa carambola L. Leaves and Assessment of Its Polyphenols as Potential α-Glucosidase Inhibitors

Averrhoa carambola L. is reported for its anti-obese and anti-diabetic activities. The present study aimed to investigate its aqueous methanol leaf extract (CLL) in vivo anti-obese activity along with the isolation and identification of bioactive compounds and their in vitro α-glucosidase inhibition assessment. CLL improved all obesity complications and exhibited significant activity in an obese rat model. Fourteen compounds, including four flavone glycosides (1–4) and ten dihydrochalcone glycosides (5–12), were isolated and identified using spectroscopic techniques. New compounds identified in planta included (1) apigenin 6-C-(2-deoxy-β-D-galactopyranoside)-7-O-β-D-quinovopyranoside, (8) phloretin 3′-C-(2-O-(E)-cinnamoyl-3-O-β-D-fucopyranosyl-4-O-acetyl)-β-D-fucopyranosyl-6′-O-β-D fucopyranosyl-(1/2)-α-L arabinofuranoside, (11a) phloretin3′-C-(2-O-(E)-p-coumaroyl-3-O-β-D-fucosyl-4-O-acetyl)-β-D-fucosyl-6′-O-(2-O-β-D-fucosyl)-α-L-arabinofuranoside, (11b) phloretin3′-C-(2-O-(Z)-p-coumaroyl-3-O-β-D-fucosyl-4-O-acetyl)-β-D-fucosyl-6′-O-(2-O-β-D-fucosyl)-α-L-arabinofuranoside. Carambolaside M (5), carambolaside Ia (6), carambolaside J (7), carambolaside I (9), carambolaside P (10a), carambolaside O (10b), and carambolaside Q (12), which are reported for the first time from A. carambola L. leaves, whereas luteolin 6-C-α-L-rhamnopyranosyl-(1-2)-β-D-fucopyranoside (2), apigenin 6-C-β-D-galactopyranoside (3), and apigenin 6-C-α-L-rhamnopyranosyl-(1-2)-β-L-fucopyranoside (4) are isolated for the first time from Family. Oxalidaceae. In vitro α-glucosidase inhibitory activity revealed the potential efficacy of flavone glycosides, viz., 1, 2, 3, and 4 as antidiabetic agents. In contrast, dihydrochalcone glycosides (5–11) showed weak activity, except for compound 12, which showed relatively strong activity.

A Review of Traditional Uses, Phytochemistry and Pharmacological Properties of Some Vietnamese Wound-Healing Medicinal Plants

Wound healing is a sophisticated process that results in the repair of damaged tissues. Any impairment to this process can lead to non-healing (chronic) wounds. Since these can cause a massive burden on the healthcare system, alternative therapies that promote wound healing should be considered. Therapies of natural origins that are safe and with no adverse side effects are especially promising. Vietnam, a tropical-climate country, has many medicinal plants that possess the potential for healing wounds. This report explores the use of some common plants used in Traditional Vietnamese medicine and their molecular mechanisms.

Minor tropical fruits as a potential source of bioactive and functional foods

Tropical fruits are defined as fruits that are grown in hot and humid regions within the Tropic of Cancer and Tropic of Capricorn, covering most of the tropical and subtropical areas of Asia, Africa, Central America, South America, the Caribbean and Oceania. Depending on the cultivation area covered, economic value and popularity these tropical fruits are divided into major and minor tropical fruits. There is an annual increment of 3.8% in terms of commercialization of the tropical fruits. In total 26 minor tropical fruits (Kiwifruit, Lutqua, Carambola, Tree Tomato, Elephant apple, Rambutan, Bay berry, Mangosteen, Bhawa, Loquat, Silver berry, Durian, Persimon, Longan, Passion fruit, Water apple, Pulasan, Indian gooseberry, Guava, Lychee, Annona, Pitaya, Sapodilla, Pepino, Jaboticaba, Jackfruit) have been covered in this work. The nutritional composition, phytochemical composition, health benefits, traditional use of these minor tropical fruits and their role in food fortification have been portrayed.

Traditional Uses, Phytochemical Constituents and Pharmacological Properties of Averrhoa carambola L.: A Review

Averrhoa carambola L. (star fruit) is an edible fruit that is extensively cultivated in southern China, Southeast Asia, India, and northern South America. It has a sweet and juicy taste and is frequently used in fruit salads and fruit platters, as a garnish in cocktail drinks and beverages, or squeezed into juice and served as a beverage. Traditionally, it has been used for treating diabetes and diabetic nephropathy, arthralgia, vomiting, lithangiuria, coughing, hangovers, and chronic paroxysmal headache for thousands of years. Currently, approximately 132 compounds have been isolated from A. carambola. Among them, flavonoids, benzoquinone, and their glycosides have been considered as biologically active substances, which are responsible for various biological activities. Pharmacological studies have revealed that crude extracts or monomeric compounds from A. carambola exhibit multiple bioactivities, such as anti-oxidant, anti-hyperglycemic, anti-obesity, anti-hyperlipidemic, anti-tumor, anti-inflammatory, hepatoprotective, cardioprotective, anti-hypertensive, neuroprotective, and others. Thus, A. carambola is a valuable treatment in Chinese medicine with therapeutic potential for multiple diseases, especially diabetes and diabetes-related diseases. Even though it is a very promising candidate in the development of functional food and the pharmaceutical industry, reports on its bioactivities have only been conducted in vivo and in vitro and there is a gap in research regarding clinical settings and safety. This review therefore provides a comprehensive and systematic overview of current progress on botany, ethnopharmacology, phytochemistry, pharmacology, and toxicity of A. carambola, providing a valuable reference for further developments and applications of A. carambola in the pharmaceutical industry and functional food.

Nephrotoxicity and neurotoxicity following star fruit (Averrhoa carambola) ingestion: a narrative review

In recent times, star fruit (Averrhoa carambola) nephrotoxicity and neurotoxicity have been increasingly reported, both in individuals with pre-existing renal disease and those with previously normal renal function. We summarise the clinical findings of star fruit toxicity in humans and outline the important pathogenetic insights provided by animal studies. Google Scholar, EMBASE, Scopus and PubMed were searched from 1995 through July 2020 for case reports/series on renal or neurological manifestations of star fruit toxicity in humans and mechanisms of star fruit toxicity in animal studies. Ten case series and 28 case reports in humans (total number of individuals=136) were included and 8 animal studies were analysed. Ninety-four (69.1%) patients had prior renal impairment. Renal histology showed acute oxalate nephropathy with tubulointerstitial nephritis or tubular necrosis. Neurotoxicity manifestations ranged from hiccups to status epilepticus. Oxalate and caramboxin are considered the main substances causing nephrotoxicity and neurotoxicity. Caramboxin inhibits GABA binding and activates the glutamatergic receptors. Haemodialysis improved outcomes in neurotoxicity. Nephrotoxicity and neurotoxicity need to be looked for with star fruit toxicity, both in individuals with abnormal or normal renal function. Once star fruit intoxication is identified, early renal replacement therapy should be considered. Further studies on the mechanisms of star fruit toxicity are needed.