Antidiarrhoeal Activity of Musa paradisiaca Sap in Wistar Rats

Role of green banana consumption in the treatment of acute and persistent diarrhea in children: a systematic review and meta-analysis of randomized controlled trials

Green banana Musa paradisiaca (GB) has been traditionally used to aid in the treatment of diarrhea. This systematic review and meta-analysis aimed to evaluate current evidence of the effect of GB consumption as a complement to standard treatment in the population with acute or persistent diarrhea. We searched PubMed, Scopus, Web of Science, and LILACS from inception to January 2024; there was no language restriction. Only randomized controlled trials using GB as an intervention were included, and studies using antidiarrheal medication were excluded. A meta-analysis was performed to compare the effect of GB on the resolution of acute and persistent diarrhea. To measure the certainty of evidence, the GRADE assessment was used. Nine randomized controlled trials (seven open and two blinded) were included. Studies were conducted in the pediatric population comprising a total of 3996 patients aged 8 to 34 months, eight studies were written in English and one in Spanish. GB-based food consumption significantly increased the hazard of resolution of diarrhea compared to standard treatment (HR 1.96, 95% CI [1.62; 2.37], p < 0.01; I2 = 52%). The subgroup analysis showed a higher hazard of resolution of diarrhea for children with persistent diarrhea (HR 2.34, 95% CI [1.78; 3.08] compared to acute diarrhea (HR 1.74, 95% CI [1.45; 2.09]).Conclusions: The use of green banana-based foods as a complement to standard treatment in children is probably associated with a faster resolution in acute diarrhea and may aid in the treatment of persistent diarrhea. More clinical trials are necessary to assess if a synergistic effect between GB and other foods exists and proves to be better than GB alone. These findings need to be confirmed in diverse socioeconomic contexts, within the adult population, and under varying health conditionsTrial registration: CRD42024499992.

Review of Medicinal Plants Traditionally Used to Treat Diarrhea by the People in the Amhara Region of Ethiopia

Background

Diarrheal illness is the second-most common cause of death in under-five children. Worldwide, it results in about 1.7 billion illnesses and 525,000 deaths among under-five children annually. It is the leading cause of malnutrition among under-five children. Different people use medicinal plants to treat diarrhea. The present study aimed to review the medicinal plants used to treat diarrhea by the people in the Amhara region and to diagnose whether the antidiarrheal activities of the medicinal plants have been confirmed by studies using animal models.

Methods

The author searched 21 articles from worldwide databases up to December 2022 using Boolean operators ("AND" and "OR") and the terms "ethnobotanical studies," "ethnobiology," "traditional medicine," "ethnobotanical knowledge," and "Amhara region."

Results

From the 21 studies reviewed, 50 plant species grouped into 28 families were reported to treat diarrhea by the people in the Amhara region. The top most used families were Lamiaceae (12%), Fabaceae (8%), Asteraceae, Cucurbitaceae, Euphorbiaceae, and Poaceae (6% each). The modes of administration of the plant parts were orally 98.88% and topically 1.12%. The different extracts of 18 (or 36%) of the medicinal plants traditionally used to treat diarrhea by the people in the Amhara region have been proven experimentally in animal models.

Conclusions

The people in the Amhara region use different medicinal plants to treat diarrhea. Most of them take the medicinal plants orally. The traditional claim that 60% of medicinal plants are antidiarrheal has been confirmed in in vitro studies.

Quercetin-3-O-β-D-glucopyranoside-rich fraction demonstrated efficacy against infectious, secretory, and osmotic models of diarrhoeal rats

BACKGROUND

The prevalence of diarrhoea remains high despite efforts by governments and NGOs to reverse trend. This study investigated the antidiarrhoeal activity and mechanism of Spondias mombin leaf fraction rich in quercetin-3-O-β-D-glucopyranoside (Q3G-RF) because of the acclaimed therapeutic efficacy. Secretory, osmotic, and infectious diarrhoea models using castor oil, magnesium sulphate, and Shigella flexneri respectively were evaluated at the doses of 100, 200, and 400 mg/kg in Wistar rats. Enteropathy was induced with castor oil and magnesium sulphate, while gastrointestinal motility was determined with charcoal meal.

RESULTS

Findings showed no mortality after 14 days of experimental period and no significant changes in behaviour, food, and water consumption. Relative to control, Q3G-RF inhibited the three models of diarrhoea, enteropathy, and gastrointestinal motility; bacterial colonies were reduced by Q3G-RF, while it improved the relative body weight of the animals. Q3G-RF also increased the intestinal concentration/activity of glucose, total protein, and Na⁺-K⁺ ATPase but reduced the concentration of TNF-α, PGE₂, IL-1β, nitric oxide, Na⁺, K⁺, and Cl^- in the diarrhoeal models. The intestinal fluid level of K⁺, Na⁺, and Cl^- was significantly decreased by Q3G-RF in the enteropathy model. Length of the small intestine in the motility model was also increased by Q3G-RF, while peristaltic index and inhibition of peristalsis were reduced.

CONCLUSION

Overall, quercetin-3-O-β-D-glucopyranoside from Spondias mombin leaves demonstrated efficacy against infectious, secretory, and osmotic form of diarrhoeal and further justified its traditional use in the treatment of diarrhoea due to its antimotility, antisecretory, and antimicrobial properties by mechanism related to enhanced Na⁺-K⁺ ATPase, repressed nitric oxide, and suppressed prostaglandins.

Plant-Derived Products with Therapeutic Potential against Gastrointestinal Bacteria

The rising burden of antimicrobial resistance and increasing infectious disease outbreaks, including the recent COVID-19 pandemic, has led to a growing demand for the development of natural products as a valuable source of leading medicinal compounds. There is a wide variety of active constituents found in plants, making them an excellent source of antimicrobial agents with therapeutic potential as alternatives or potentiators of antibiotics. The structural diversity of phytochemicals enables them to act through a variety of mechanisms, targeting multiple biochemical pathways, in contrast to traditional antimicrobials. Moreover, the bioactivity of the herbal extracts can be explained by various metabolites working in synergism, where hundreds to thousands of metabolites make up the extract. Although a vast amount of literature is available regarding the use of these herbal extracts against bacterial and viral infections, critical assessments of their quality are lacking. This review aims to explore the efficacy and antimicrobial effects of herbal extracts against clinically relevant gastrointestinal infections including pathogenic Escherichia coli, toxigenic Clostridioides difficile, Campylobacter and Salmonella species. The review will discuss research gaps and propose future approaches to the translational development of plant-derived products for drug discovery purposes for the treatment and prevention of gastrointestinal infectious diseases.

Phytochemistry and Pharmacology of Medicinal Plants Used by the Tenggerese Society in Java Island of Indonesia

The archipelagic country of Indonesia is inhabited by 300 ethnic groups, including the indigenous people of Tengger. Based on the reported list of medicinal plants used by the Tengger community, we have reviewed each of them for their phytochemical constituents and pharmacological activities. Out of a total of 41 medicinal plants used by the Tengerrese people, 33 species were studied for their phytochemical and pharmacological properties. More than 554 phytochemicals with diverse molecular structures belonging to different chemical classes including flavonoids, terpenoids, saponins and volatiles were identified from these studied 34 medicinal plants. Many of these medicinal plants and their compounds have been tested for various pharmacological activities including anti-inflammatory, antimicrobial, wound healing, headache, antimalarial and hypertension. Five popularly used medicinal plants by the healers were Garcinia mangostana, Apium graveolens, Cayratia clematidea, Drymocallis arguta and Elaeocarpus longifolius. Only A. graviolens were previously studied, with the outcomes supporting the pharmacological claims to treat hypertension. Few unexplored medicinal plants are Physalis lagascae, Piper amplum, Rosa tomentosa and Tagetes tenuifolia, and they present great potential for biodiscovery and drug lead identification.

In vitro evaluation of bioactive properties of banana sap

Banana sap is currently designated as a waste subsequent to utilization of pseudo stem in pulp and paper industry as well as other applications which is contributing to the environmental pollution. In the present study, banana sap and its crude extracts were evaluated for antimicrobial, antioxidant and anticancer properties. The role of oxidized and un-oxidized banana sap for its antimicrobial potential against a microbial test panel comprising gram positive as well as gram negative bacteria and Candida albicans using in vitro micro broth dilution assay. The un-oxidized banana sap exhibited a significantly higher antibacterial potential as evident by a lower minimal inhibitory concentration (MIC) ranging between 15.625 to 62.5 mg/mL. In vitro radical scavenging activity of dichloromethane (DCM) extract of banana sap by DPPH method exhibited 54.62 ± 1.09 (µg/mL) IC₅₀ value at the concentration of 1 mg/mL. Dichloromethane extract of banana sap showed maximum cytotoxic effect with human breast cancer (MCF-7) cell proliferation at the concentration of 100 µg/mL which was 78.37 ± 0.05% and the cytotoxic effect significantly increased with increasing concentration of banana sap extract. Furthermore, LCMS studies revealed the presence of bioactive compounds in dichloromethane extract of banana sap, such as rescinnamine derivative, dihydrorescinnamine and epimedin A. The present study suggested that banana sap is a promising source of bioactive compounds with relevant antimicrobial, antioxidant and anticancer properties.

Antisecretory and Spasmolytic Activities of Aqueous and Ethanolic Stem Bark Extracts of Nauclea diderrichii in Wistar Rats

Background

Diarrheal diseases are a major cause of morbidity and mortality throughout the world and particularly in developing countries. Nauclea diderrichii is a plant used in traditional medicine in the treatment of anemia, fever, gastric ulcer, malaria, abdominal pain, skin infections, and diarrhea. The present work is aimed at evaluating the antisecretory and spasmolytic activities of aqueous and ethanolic stem bark extracts of Nauclea diderrichii in Wistar rats.

Methods

The effect of aqueous and ethanolic extracts of Nauclea diderrichii was tested at doses of 100, 200, and 300 mg/kg on castor oil-induced secretory diarrhea, misoprostol-induced fluid accumulation, and the effect of pretreatment with yohimbine and glibenclamide. They were also tested on normal motility and castor oil- and carbachol-induced hypermotility.

Results

The results showed that the aqueous and ethanolic extracts of Nauclea diderrichii significantly (p < 0.001) inhibited castor oil-induced secretory diarrhea at all the doses. Both extracts significantly (p < 0.001) inhibit fluid accumulation induced by misoprostol. The pretreatment with glibenclamide reduced the antidiarrheal activity of aqueous extract of Nauclea diderrichii. The pretreatment with yohimbine did not alter the effect of the aqueous extract of Nauclea diderrichii. On intestine transit as on castor oil- and carbachol-induced motility, the aqueous and ethanolic extracts at doses of 100 and 200 mg/kg reduced significantly (p < 0.05, p < 0.01, and p < 0.001) the travelled distance by charcoal and peristaltic index.

Conclusions

The study demonstrated that the aqueous and ethanolic extracts of Nauclea diderrichii possess antisecretory and antispasmolytic properties hence its use in traditional medicine against diarrhea.

Antimicrobial Activity against Oral Pathogens Confirms the Use of Musa paradisiaca Fruit Stalk in Ethnodentistry

Background

Ethnodentistry is the use of indigenous oral cleansing agents such as plant parts by local folks not only to maintain oral hygiene but also to treat oral infections. Mostly, ethnodentistry is inspired by traditions and belief systems of local communities. Musa paradisiaca is extensively cultivated and used in many cultures for its nutritional and medicinal values. In Ghana, the fruit stalk of Musa paradisiaca is used as an oral cleansing agent to maintain oral hygiene; yet this folk claim remains to be ascertained scientifically.

Objective

The study assessed the antibacterial and antifungal effects of three extract fractions (aqueous, ethanol, and ethyl acetate fractions) of Musa paradisiaca fruit stalk against Lactobacillus acidophilus, Aggregatibacter actinomycetemcomitans, and Candida albicans, common oral pathogens implicated in dental caries and periodontitis.

Materials and Methods

Aqueous, ethanol, and ethyl acetate fractions of Musa paradisiaca fruit stalk were prepared by cold maceration and qualitatively screened for their phytochemical composition. Antimicrobial effects of the three extract fractions were assessed by using serial broth dilutions at increasing concentrations (62.5, 125, 250, 500, and 1000 µg/ml) and compared to standard antimicrobial agents (erythromycin, doxycycline, and fluconazole). Subsequently, the absorbances of the microbial suspensions treated with increasing concentrations of the extract fractions were measured at 450 nm, and the cell densities were determined.

Results

Except for the aqueous extract, which was less effective in decreasing microbial growth, the ethyl acetate and the ethanol extract fractions demonstrated antimicrobial efficacies comparable to those of the standard drugs. All three extract fractions demonstrated concentration-dependent growth inhibitory effects on the tested oral pathogens although not as effective as the standard drugs used.

Conclusion

Musa paradisiaca fruit stalk has demonstrated antimicrobial effects against Lactobacillus acidophilus, Aggregatibacter actinomycetemcomitans, and Candida albicans, common oral pathogens implicated in dental caries and periodontitis, and this finding confirms in part folk use of Musa paradisiaca fruit stalk as a traditional dental care agent. Thus, the fruit stalk of Musa paradisiaca could be explored for use as a cheap and readily available dental care agent for people entrapped in the poverty line.

Pathophysiology of high fat diet induced obesity: impact of probiotic banana juice on obesity associated complications and hepatosteatosis

The high fat diet alters intestinal microbiota due to increased intestinal permeability and susceptibility to microbial antigens leads to metabolic endotoxemia. But probiotic juices reported for various health benefits. In this background we hypothesized that pectinase treated probiotic banana juice has diverse effects on HFD induced obesity and non-alcoholic steatohepatitis. 20 weeks fed HFD successfully induced obesity and its associated complications in experimental rats. The supplementation of probiotic banana juice for 5 months at a dose of 5 mL/kg bw/day resulted significant decrease (p < 0.05) in body weight (380 ± 0.34), total fat (72 ± 0.8), fat percentage (17 ± 0.07) and fat free mass (165 ± 0.02). Reduction (p < 0.05) in insulin resistance (5.20 ± 0.03), lipid profile (TC 120 ± 0.05; TG 160 ± 0.24; HDL 38 ± 0.03), liver lipid peroxidation (0.7 ± 0.01), hepatic enzyme markers (AST 82 ± 0.06; ALT 78 ± 0.34; ALP 42 ± 0.22), and hepatic steatosis by increasing liver antioxidant potential (CAT 1.4 ± 0.30; GSH 1.04 ± 0.04; SOD 0.82 ± 0.22) with normal hepatic triglycerides (15 ± 0.02) and glycogen (0.022 ± 0.15) contents and also showed normal liver size, less accumulation of lipid droplets with only a few congestion. It is concluded that the increased intestinal S. cerevisiae yeast can switch anti-obesity, antidiabetic, antioxidative stress, antioxidant and anti-hepatosteatosis effect. This study results will have significant implications for treatment of NAFLD.

Influence of the drying method on the bioactive compounds and pharmacological activities of rhubarb

BACKGROUND

Raw rhubarb samples that have been subjected to different drying procedures will have different therapeutic effects, possibly due to processing-induced variations in the chemical composition. In the present work, the fresh materials were processed by smoking, sun-drying, shade-drying and oven-drying at low, moderate and high temperatures. To facilitate the selection of a suitable drying method for rhubarb, the quality of rhubarb processed under various drying conditions was evaluated based on the simultaneous determination of multiple bioactive constituents in combination with bioactivity assays.

RESULTS

The total concentrations of 12 compounds in smoked rhubarb were higher than the concentrations of the same components in raw rhubarb and rhubarb products processed using other drying techniques. Smoked rhubarb was found to substantially inhibit Na⁺ /K⁺ -ATPase and thrombin. In addition, higher content of anthraquinones led to higher Na⁺ /K⁺ -ATPase inhibitory activities, and higher gallic acid content increased the antithrombin capacity.

CONCLUSION

The results confirmed that post-harvest fresh plant materials, especially roots, were still physiologically active organs that could undergo series of anti-dehydration mechanisms, including the production of related secondary metabolites during the early stages of dehydration. Therefore, the proper design of drying processes could enhance the quality of rhubarb as well as other similar medicinal plants. © 2018 Society of Chemical Industry.

Poly herbal formulation with anti-elastase and anti-oxidant properties for skin anti-aging

Background

Skin forms an important part of human innate immune system. Wrinkles, thinning and roughening of skin are some of the symptoms that affect the skin as it ages. Reactive oxygen species induced oxidative stress plays a major role in skin aging by modulating the elastase enzyme level in the skin. Extrinsic factors that affect skin aging such as UV radiation can also cause malignant melanoma. Here we selected four medicinal plant materials, namely, leaves of Nyctanthes arbor-tristis, unripe and ripe Aegle marmelos fruit pulp and the terminal meristem of Musa paradisiaca flower and investigated their anti-aging properties and cytotoxicity in vitro individually as well as in a poly herbal formulation containing the four plant extracts in different ratios.

Methods

The phytochemical contents of the plant extracts were investigated for radical scavenging activity and total reducing power. Based upon its anti-oxidant properties, a poly herbal formulation containing leaves of Nyctanthes arbor-tristis, unripe and ripe fruit pulp of Aegle marmelos, and the terminal meristem of Musa paradisiaca flower in the ratio 6:2:1:1 (Poly Herbal Formulation 1) and 1:1:1:1 (Poly Herbal Formulation 2), respectively were formulated.

Result

It has been observed that the Poly Herbal Formulation 1 was more potent than Poly Herbal Formulation 2 due to better anti-oxidant and anti-elastase activities in NIH3T3 fibroblast cells. In addition Poly Herbal formulation 1 also had better anti-cancer activity in human malignant melanoma cells.

Conclusion

Based on these results these beneficial plant extracts were identified for its potential application as an anti-aging agent in skin creams as well as an anti-proliferation compound against cancer cells.

Electronic supplementary material

The online version of this article (10.1186/s12906-018-2097-9) contains supplementary material, which is available to authorized users.

Toxicological profile of the aqueous-fermented extract of Musa paradisiaca in rats

OBJECTIVE

This study was conducted to assess the toxicity profile of the aqueous-fermented extract of Musa paradisiaca in rats.

MATERIALS AND METHODS

In acute toxicity test, the rats of different groups were orally administered with a single dose of 500, 1000, 2000 and 5000 mg/kg of fermented extract of M. paradisiaca. The rats were monitored for behavioral changes, toxicity signs and mortality. In sub-acute test, the rats were orally administered with fermented M. paradisiaca extract (200, 400 and 800 mg/kg/day) for 14 days. Haematological and serum biochemical parameters were evaluated and histopathological studies of the liver and kidney were done. The study was performed from June to July 2017.

RESULTS

Concerning the acute toxicity, no toxicity signs or death were recorded and an LD₅₀ value of >5 g/kg for fermented extract of M. paradisiaca was observed. Regarding the sub-acute toxicity, ingestion of the fermented extract of M. paradisiaca caused no significant effects (p<0.05) in terms of relative organ weight, body weight percentage, haemoglobin, red blood cells count, electrolytes levels, lymphocytes count, basophils count, and aspartate aminotransferase (AST) and alkaline phosphatase (ALP) levels. However, significant differences (p<0.05) were observed in white blood cells, eosinophils, platelets, neutrophils and monocytes counts, and urea, creatinine, alanine aminotransferase (ALT) and high-density lipoprotein (HDL) levels. The histological assessments of the liver and kidney showed normal results.

CONCLUSION

The findings of this study has suggested that daily administration of fermented extract of M. paradisiaca at doses up to 800 mg/kg for 14 days, is not toxic and may be considered safe for therapeutic uses.

Antidiarrhoeal investigation of Apium leptophyllum (Pers.) by modulation of Na+K+ATPase, nitrous oxide and intestinal transit in rats

BACKGROUND

Apium leptophyllum (Pers.) is an annual herb with traditional appreciation for various pharmacological properties; however, the scientific information on this herb is insufficient. The aim of the present investigation was undertaken to evaluate flavonoidal fraction of A. leptophyllum fruit (FFALF) against diarrhoea on albino rats.

METHODS

The antidiarrhoeal study was conducted by castor oil induce diarrhoea, prostaglandin E2 (PGE2) induced enteropooling and intestinal transit by charcoal meal test. The rats were divided into five groups (six/group). Group I served as control and received orally 2% acacia suspension; Group II served as standard and received orally loperamide (3 mg/kg) or atropine sulphate (5 mg/kg); Group III, IV and V served as test groups and received the FFALF at doses of 5, 10 and 20 mg/kg orally, respectively.

RESULTS

In castor oil-induced diarrhoeal model, the FFALF significantly (p < 0.001) reduced the frequency of diarrhoea, defecation and weight of faeces as well as increased the sodium-potassium ATPase (Na+K+ATPase) activity and decreased nitric oxide (NO) content in the small intestine. In prostaglandin induced enteropooling model, it significantly (p < 0.01) and dose dependently slowed the intestinal fluid accumulation by decreasing the masses and volumes of intestinal fluid where as in charcoal meal test, it decreased charcoal meal transit in gastrointestinal tract as compared with control.

CONCLUSIONS

The study reveals that the FFALF possess anti-diarrhoeal properties mediated through inhibition of hyper secretion and gastrointestinal motility which support the traditional use of the plant.

Therapeutic significance and pharmacological activities of antidiarrheal medicinal plants mention in Ayurveda: A review

Diarrhea is a serious problem affecting 3-5 billion people per year around the world, especially children of below 5 years. 70% of the world population uses traditional and indigenous medicine for their primary health care. The facts of these indigenous remedies are passed verbally and sometimes as documents. Since ancient time, Ayurveda is the main system of healing in South East Asian countries. Indian literature from ayurvedic texts and other books claim the potency of several plants in the treatment of diarrhea. As the global prospective of ayurvedic medicine is increasing, interest regarding the scientific basis of their action is parallely increasing. Researchers are doing experiments to establish the relation between the claimed action and observed pharmacological activities. In the present article, an attempt was made to compile the scientific basis of medicinal plants used to cure diarrhea in Ayurveda. Literature was collected via electronic search (PubMed, ScienceDirect, Medline, and Google Scholar) from published articles that reports antidiarrheal activity of plants that were mentioned in Ayurveda classics. A total of 109 plant species belonging to 58 families were reported for their antidiarrheal activity. Several Indian medicinal plants have demonstrated promising antidiarrheal effects, but the studies on the antidiarrheal potentials of these plants are not taken beyond proof of concept stage. It is hoped that the article would stimulate future clinical studies because of the paucity of knowledge in this area.