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The Influence of Using Bauhinia Forficata Link in Glycemic, Lipid and Toxicological Profile in in Vivo Experimental Models: a Systematic Review

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The Influence of Using Bauhinia Forficata Link in Glycemic, Lipid and Toxicological Profile in in Vivo Experimental Models: a Systematic Review Vol. 7(31), pp. 2343-2348, 17 August, 2013 DOI: 10.5897/JMPR2013.5107 Journal of Medicinal Plants Research ISSN 1996-0875 ©2013 Academic Journals http://www.academicjournals.org/JMPR Full Length Research Paper The influence of using Bauhinia forficata Link in glycemic, lipid and toxicological profile in in vivo experimental models: A systematic review Paula do Nascimento Batista 1*, Thaisa Cardoso de Oliveira 2, Francisco Rodrigues Leal 3, Afrânio do Nascimento Batista 4, Maria das Graças Freire de Medeiros 1 and Lívio César Cunha Nunes 1 1Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Piauí, 64049-550,Teresina, Piauí, Brasil. 2Departamento de Farmácia, Universidade Federal do Piauí, 64049-550,Teresina, Piauí Brasil. 3Núcleo de Plantas Aromáticas e Medicinais, Universidade Federal do Piauí, 64049-550, Teresina, Piauí, Brasil. 4Departamento de Farmácia, Faculdade CET, 64001-070, Teresina, Piauí, Brasil. Accepted 19 July, 2013 Bauhinia forficata Link, popularly known as ‘cow's paw ’, is characterized as a plant species widely used in traditional medicine as hypoglycemiant. Given its high empirical use for therapeutic purposes coupled with the high interest in research with this plant species, this study aimed to perform a systematic review on B. forficata L. seeking for evidence-based information on the influence of the use of this plant in glycemic, lipid and toxicological profile in in vivo experimental models, using a secondary survey of experimental studies conducted and published on this plant species. A search strategy was established and a total of 36 articles were found in the search, after exclusion of duplicate articles and application of inclusion criteria, only 12 were evaluated in detail. The glucose dosing was the most performed biochemical determination, found in 100% of the studies. Most articles proved the hypoglycemiant action of preparations from B. forficata L. Regarding the influence on lipid parameters, there were discordant results, and concerning toxicity, few articles on the subject were found, but the results indicated that the use of the aqueous extract from the plant is safe. Thus, it was possible to demonstrate the pharmacological potential of this plant species. Key words: Bauhinia forficata Link, diabetes, hypoglycemiant, systematic review. INTRODUCTION The history of pharmacy and medicines evolution is processing of medicinal plants and the importance of this marked by the use of plants for medicinal and therapeutic sector in primary health care, led this area to become the purposes. Over the years, the scientific proof of the subject of intense research and investments by the existence of pharmacological actions derived from plant herbal industry and also government institutions (Siani, species became real and this fact, combined with the 2003; Souza et al., 2009). excellent benefit-cost ratio in the production and This scenario led to the adoption, in July 2006, of the *Corresponding author. E-mail: [email protected]. 2344 J. Med. Plants Res. Medicinal Plants and Herbal Medicines National Policy by consensus between the researchers or evaluation by a third author. the federal government and later the disclosure, by the Ministry of Health, of the National List of Medicinal Plants of Interest to the National Health System (RENISUS) RESULTS AND DISCUSSION whose aim is to direct scientific research in the area. This list includes 71 plant species with potential to generate A total of 36 articles were found in the search, and after herbal medicines which may be provided by the Unified exclusion of duplicate articles and application of inclusion Health System (SUS) (Brazil, 2009). criteria, only 13 were evaluated in detail. Figure 1 shows Bauhinia forficata Link is in this list and is one of the a schema on the choice of the articles included in this most studied species in Brazil, because of its broad study. popular use as an aid in the treatment of diabetes and also for its wide geographic distribution (Pizzolatti et al., 2003; Vaz and Tozzi, 2005). It is popularly known as ‘cow Biochemical measurements analyzed in response to paw’ due to the characteristic bilobulated aspect of its the use of B. forficata L. leaves (Cunha et al., 2010). In the current therapy, many drugs are used to manage The analysis of the articles included in this study showed diabetes, however, the perfect glycemic control is rarely that the determination of plasma glucose, in order to achieved. Thus, the search for complementary therapies investigate the hypoglycemiant action arising from B. is very common (Silva et al., 2002; Souza et al., 2004). forficata L. preparations, was present in 100% of the The difficulty in its treatment occurs, because this studies. Changes in lipid profile were also evaluated from pathological condition is multifactorial and causes measurements of triglycerides and total cholesterol and disturbances in the metabolism of carbohydrates, lipids its fractions. In addition to these analyzes, there were and proteins. It is characterized by the maintenance of also found studies that conducted enzyme dosing to elevated blood glucose levels and total or partial absence investigate the antioxidant action and toxicity of the of insulin and/or functional deficiency of receptors during preparations obtained from this plant species. An the glucose absorption, which are factors that may overview of the frequency of these biochemical promote this condition (DSBD, 2009). determinations in the articles analyzed is as shown in Given the complexity of this metabolic disease, Figure 2. associated with the high empirical use of B. forficata L. These studies were conducted in different experimental for therapeutic purposes by the population and the high models and using different extractive methods. However, interest in research with this plant species, this study the leaves were the part of the plant used in all aimed to perform a systematic review on B. forficata L. experiments. This reflects the fact that this plant species seeking evidence-based information on the influence of is widely used empirically by the population in the form of the use of this plant in the glycemic, lipid and tea from its leaves. toxicological profile in in vivo experimental models, using, The popular knowledge about the use of this plant as for this purpose, a secondary survey of experimental an adjunct to the treatment of diabetes motivated the studies conducted and published on this plant species. studies found in the literature. Table 1 shows the studies that evaluated various biochemical parameters in response to the use of B. forficata Link in different MATERIALS AND METHODS experimental models. The search strategy sought to achieve experimental articles in the literature that studied the effects of using preparations from B. Glycemic profile forficata L. in animal and humans’ biochemical levels. The articles were researched in the database of the Virtual Health Library (VHL) of BIREME, using the word B. forficata as a descriptor. All this The results of the glycemic parameters showed that the survey took place between January 7 and 8th, 2013. use of aqueous, ethanol, hexane and hydroethanolic Initially, the analysis of the titles and abstracts of the articles extracts, and n-butanol fraction from the leaves of B. found was performed as a way of choosing studies of significant forficata L. was able to reduce the hyperglycemic state in relevance to the research. The repeated and non relevant studies were excluded at this point. After this step, the articles chosen were both mice and humans, demonstrating the ethnopharma- fully analyzed and those that fit the following inclusion criteria cological value of this plant for this purpose. However, established (articles from experimental research related to the when the glycemia in diabetic rats on gestational period possible changes in the biochemical parameters of humans and was assessed, there was no decrease in this parameter. animals caused by the use of preparations from B. forficata L.) were This fact can be explained by factors such as, the selected. There was no restriction regarding the publication date or experimental protocol used, the methodology for obtain- language, and review studies were excluded. All analyzes were independently performed by two authors and ing extracts, environmental, seasonal and collection of the disagreements that occurred by chance were resolved by the plant conditions, besides the cultivation and storage Batista et al. 2345 Duplicate articles VHL (N= 4) (N= 36 Articles ) Review Articles (N= 3) Total of Articles N= 32 Articles eliminated by title and abstract Total of Articles (N= 14) N=29 Unavailable articles Total de Articles (N= 2) N=15 Articles Included N=13 Figure 1. Delineation of choosing studies. (%) requency requency F Figure 2. Frequency of the biochemical measurements analyzed in response to the use of B. forficata L. *Reduced glutathione (GSH), **lactate dehydrogenase (LDH), ***creatine kinase (CK), ****angiotensin converting enzyme (ACE), *****superoxide dismutase (SOD). of it. All these factors may qualitatively and quantitatively pharmacological action, among which kaempferol and influence the presence of the plant’s characteristic quercetin glycosides stand out (Silva et al., 2002; Pepato metabolites that are important to the development of et al., 2010; Souza et al., 2010). 2346 J. Med. Plants Res. Table 1. Studies evaluating the behavior of biochemical parameters in response to the use of
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