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Psidium Guajava: A Review of Its Traditional Uses,: Phytochemistry and Pharmacology
Psidium Guajava: A Review of Its Traditional Uses,: Phytochemistry and Pharmacology
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Review
Laboratorio de Investigacion de Productos Naturales, Escuela Superior de Ingeniera Qumica e Industrias extractivas IPN,
Punto Fijo 16, Col. Torres Lindavista C.P. 07708 Mexico, D.F., Mexico
b Medicinal Plant Research Group, Biotechnology Centre, 2 St. Johns Close, University of the West Indies, Kingston 7, Jamaica
c Laboratorio de Investigaci
on de Fitofarmacologa, Universidad Autonoma Metropolitana-Xochimilco A.P. 23-181 Mexico, D.F., Mexico
Received 18 August 2007; received in revised form 26 January 2008; accepted 29 January 2008
Available online 3 February 2008
Abstract
Psidium guajava, is an important food crop and medicinal plant in tropical and subtropical countries is widely used like food and in folk medicine
around of the world. This aims a comprehensive of the chemical constituents, pharmacological, and clinical uses. Different pharmacological
experiments in a number of in vitro and in vivo models have been carried out. Also have been identified the medicinally important phyto-constituents.
A number of metabolites in good yield and some have been shown to possess useful biological activities belonging mainly to phenolic, flavonoid,
carotenoid, terpenoid and triterpene. Extracts and metabolites of this plant, particularly those from leaves and fruits possess useful pharmacological
activities. A survey of the literature shows P. guajava is mainly known for its antispasmodic and antimicrobial properties in the treatment of
diarrhoea and dysentery. Has also been used extensively as a hypoglycaemic agent. Many pharmacological studies have demonstrated the ability of
this plant to exhibit antioxidant, hepatoprotection, anti-allergy, antimicrobial, antigenotoxic, antiplasmodial, cytotoxic, antispasmodic, cardioactive,
anticough, antidiabetic, antiinflamatory and antinociceptive activities, supporting its traditional uses. Suggest a wide range of clinical applications
for the treatment of infantile rotaviral enteritis, diarrhoea and diabetes.
2008 Published by Elsevier Ireland Ltd.
Keywords: Psidium guajava; Myrtaceae; Clinical; Complementary medicine; Phytochemical constituents; Pharmacological actions
Contents
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3.
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.1. Use in traditional medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Phytochemistry. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1. Fruits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.2. Fruit skins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.3. Leaves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Biological activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.1. Anti-diarrhoeal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.2. Antimicrobial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.3. Acne lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.4. Effect on dental plaque . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.5. Antimalarial effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.6. Antitussive effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.7. Hepatoprotective effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Corresponding author at: Punto Fijo No. 16, Col. Torres de Lindavista, C.P. 07708 Mexico, D.F., Mexico.
E-mail address: rmpg@prodigy.net.mx (R.M.P. Gutierrez).
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1. Introduction
Psidium guajava, which is considered a native to Mexico
(Rios et al., 1977) extends throughout the South America,
European, Africa and Asia. Based on archaeological evidence.
It has been used widely and known in Peru since pre-Columbian
times. It grows in all the tropical and subtropical areas of the
world, adapts to different climatic conditions but prefers dry
climates (Stone, 1970). The main traditional use known is as
an anti-diarrhoeal. Other reported uses include gastroenteritis,
dysentery, stomach, antibacterial colic pathogenic germs of the
intestine.
Its medicinal usage has been reported in indigenous system
of medicines in America more than elsewhere. Psidium guajava
Linn. (family Myrtaceae), is commonly called guave, goyave or
goyavier in French; guave, Guavenbaum, Guayave in German;
banjiro in Japanese; goiaba, goiabeiro in Portugal; araca -goiaba,
araca -guacu , guaiaba in Brazil; guayaba, guayabo in Espanol
and guava in English (Killion, 2000). Psidium guajava is a small
tree which is 10 m high with thin, smooth, patchy, peeling bark.
Leaves are opposite, short-petiolate, the blade oval with prominent pinnate veins, 515 cm long. Flowers are somewhat showy,
petals whitish up to 2 cm long, stamens numerous (Stone, 1970).
Fruit are fleshy yellow globose to ovoid berry about 5 cm in
diameter with an edible pink mesocarp containing numerous
small hard white seeds. There has been a tremendous interest
in this plant as evidenced by the voluminous work. Therefore,
we aimed to compile an up to date and comprehensive review
of Psidium guajava that covers its traditional and folk medicine
uses, phytochemistry and pharmacology.
1.1. Use in traditional medicine
More recent ethnopharmacological studies show that Psidium guajava is used in many parts of the world for the treatment
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of a number of diseases, e.g. as an anti-inflammatory, for diabetes, hypertension, caries, wounds, pain relief and reducing
fever (Table 1). Some of the countries with a long history of traditional medicinal use of guava include Mexico and other Central
American countries including the Caribbean, Africa and Asia.
Some of these uses will be outlined here.
Medicinal plants are an important element of the indigenous
medical systems in Mexico (Lara and Marquez, 1996). These
resources are part of their traditional knowledge. The Popoluca
Indians of Veracruz rely on medicinal plants for their health care.
They appear to have developed a system whereby they select
and continue to use plants that they find the most effective for
health care purposes. The folk use of guava has been documented
in the indigenous groups of Mexican Indians, Maya, Nahuatl,
Zapotec and Popoluca. A decoction of the leaves is used to cure
cough. According to communities of Nahuatl and Maya origin
and Popoluca of the region of the Tuxtlas, Veracruz, they use a
guava leaf decoction to treat digestive suffering associated with
severe diarrhoea. This is a frequent disease in rainy weather
(Heinrich et al., 1998).
P guajava (Myrtaceae) is widely used in Mexico to treat
gastrointestinal and respiratory disturbances and is used as an
anti-inflammatory medicine (Aguilar et al., 1994). Commonly
roots, bark, leaves and immature fruits, are used in the treatment
of gastroenteritis, diarrhoea and dysentery. Leaves are applied
on wounds, ulcers and for rheumatic pain, while they are chewed
to relieve toothache (Heinrich et al., 1998). A decoction of the
new shoots is taken as a febrifuge. A combined decoction of
leaves and bark is given to expel the placenta after childbirth
(Martnez and Barajas, 1991). A water leaf extract is used to
reduce blood glucose level in diabetics. This hot tea was very
common among the local people of Veracruz (Aguilar et al.,
1994).
The leaf of Psidium guajava is used traditionally in South
African folk medicine to manage, control, and/or treat a plethora
Table 1
Ethnomedical uses of Psidium guajava
Place, country
Part(s) used
Preparation(s)
Reference(s)
Colombia, Mexico
Leaves
Indigenous Maya,
Nahuatl, Zapotec and
Popoluca of the region
Tuxtlas, Veracruz,
Mexico
Latin America,
Mozambique
Mexico
Leaves
Leaves
Infusion or decoction
Pontikis (1996)
Decoction, poultice
Leaves
Leaves
Infusion or decoction
Diabetes mellitus
Diarrhoea, antiseptic, Diabetes mellitus
Astringent, ulcers, wounds, diarrhoea
Infusion or decoction
Infusion or decoction
Decoction and poultice
India
Ghana
Peru
Leaves
Leaves
Leaf, bark, unripe
fruit, roots
Leaves,
shoots
Flower buds, leaves
Decoction or infusion
Kinshasa, Congo
Leaves, bark
Senegal
Uruguay
Shoots, roots
Leaves
Fiji
Tahiti, Samoa
Leaves
Leaves
Trinidad
Leaves
Leaves
USA
Leaf
Caribbean
China
Philippines
Decoction or infusion
Infusion or decoction
Infusion or decoction,
tisane
Infusion or decoction
Infusion or decoction
Boiled preparation
Infusion or decoction
Infusion or decoction
Decoction
Decoction
Conway (2002)
Mashed, Decoction
Decoction
Diarrhoea, dysentery
Vaginal and uterine wash, especially in
leucorrhoea
Diarrhoea, coughs, stomach-ache, dysentery,
toothaches, indigestion, constipation
Table 2
Commercial applications of Psidium guajava
Fruit
Wood and leaves
Wood
Wood
Wood
Wood
Leaves
Leaves
Bark
Wood flowers
Malaya
India
Guatemala
El Salvador
Nigeria
Southeast Asia
Indonesia
Africa
Mexico
Rodarte (1994)
Rodarte (1994)
Morton (1987)
Morton (1987)
Lucas et al. (2006)
Rodarte (1994)
Rodarte (1994)
Burkill (1985)
Argueta et al. (1994)
acid, asiatic acid, ilelatifol d and -sitosterol-3-O--dglucopyranoside, have been isolated from the leaves of
Psidium guajava. guajavolide (2a-,3-6-,23-tetrahydroxyurs12-en-28,20-olide, and guavenoic acid, were isolated from
fresh leaves of Psidium guajava.
Bark: It contains 1230% of tannin (Burkill, 1997), resin and
crystals of calcium oxalate (Nadkarni and Nadkarni, 1999).
Roots: They contain tannins, leukocyanidins, sterols, gallic
acid, carbohydrates and salts. Root, stem-bark and all leaves
contain a large percentage of tannic acid (Quisumbing, 1978).
Seeds: They contain 14% oil, dry weight, with 15% proteins and
13% starch (Burkill, 1997), phenolic and flavonoid compounds
including quercetin-3-O--d-(2 -O-galloyl-glucoside)-4 -Ovinylpropionate (Michael et al., 2002). Some isolated
compounds are cytotoxic (Salib and Michael, 2004).
Floral bud: Buds have the highest concentrations of
myricetin (256 mg kg1 ), quercetin (3605 mg kg1 ), luteolin (229 mg kg1 ), kaempferol (229 mg kg1 ) and apigenin
(252 mg kg1 ) (Vargas et al., 2006).
Twigs: Contain calcium (0.301.00%), magnesium
(0.060.30%), phosphorous (0.100.38%), potassium
(0.210.39%), and sodium (0.030.20%). The concentration of fluoride ranged from 0.02 ppm to 0.11 ppm, copper
(0.020.14 ppm), iron (2.865.14 ppm), zinc (0.310.57 ppm),
manganese (0.000.26 ppm), and lead (0.000.11 ppm)
(Okwu and Ekeke, 2003). Contains Flavonoid, sesqui-terpenes
alcohols and acids triterpenoids (Hegnauer, 1969).
3. Biological activity
Scientific investigations on the medicinal properties of guava
dates back to the 1940s. A summary of the findings of these
studies performed is presented below.
3.1. Anti-diarrhoeal
Diarrhoea has long been recognized as one of the most
important health problems faced globally particularly by the
population of developing countries. Each year diarrhoea is estimated to kill about 2.2 million people globally, the majority
of whom are infants and children below the age of 5 years
(Venkatesan et al., 2005). Ethanol and aqueous extracts of
Psidium guajava at a concentration of 80 g/ml in an organ
bath, exhibited more than 70% inhibition of acetylcholine
and/or KCl solution-induced contractions of isolated guineapig ileum. The rates of propulsion in the small intestine in male
SpragueDawley rats as a means of assessing antidiarrhoeal
activity of aqueous extracts of the leaf of Psidium guajava using
morphine as the standard drug of reference measured (Tona
et al., 1999; Lutterodt, 1992). A dose of 0.2 ml/kg fresh leaf
extract produced 65% inhibition of propulsion. This dose is equitable with 0.2 mg/kg of morphine sulphate. The antidiarrhoeal
action of the extract may be due, in part, to the inhibition of the
increased watery secretions that occur commonly in all acute
diarrhoeal diseases and cholera.
The bark tincture showed fungicidal activity at different concentrations but exhibited only fungistatic property in case of
Candida albicans (Dutta and Das, 2000).
Ethanolic extract from the shell of ripe fruit presenting activity on Streptococcus mutans and Escherichia coli (Neira and
Ramirez, 2005). Results supported the utilization of Psidium
guajava in traditional medicine for intestinal diseases produced
by microorganisms.
3.3. Acne lesions
Acne vulgaris is a chronic inflammatory disease involving
colonization of Propionibacterium acnes, plus activation of neutrophils and lymphocytes. Circumstantial evidence suggests that
antigen-independent and -dependent immune responses against
Propionibacterium acnes are involved in the pathogenesis of
inflammatory acne. Epidermal keratinocytes are also suggested
to be involved in initiation and progression of cutaneous inflammation. Psidium guajava leaf extracts have potent antimicrobial
activities against Propionibacterium acnes and may be beneficial in treating acne especially when they are known to have
anti-inflammatory activities (Qadan et al., 2005).
3.4. Effect on dental plaque
The adhesion of early settlers of dental plaque to the tooth
surface has a role in the initiation of the development of dental plaque. The hydrophobic surface properties of the bacteria
cell wall are indirectly responsible for the adhesion of the bacteria cell to the acquired pellicle on the tooth surfaces. Tooth
brushing is considered a superior technique for reducing plaque
accumulation. Chemical agents may be used to reduce plaque
accumulation on tooth surfaces. The treatment of the early
plaque settlers with 1 mg/ml aqueous extract leaf of Psidium
guajava reduced the cell-surface hydrophobicity of Staphylococcus sanguinis, Staphylococcus mitis and Actinomyces sp. by
54.1%, 49.9% and 40.6%, respectively (Razak et al., 2006).
These results provide some scientific rationale for its use in
the treatment of dental diseases and suggested that guava leaf
extracts may inhibit the caries-inducing properties of Streptococcus and thus may be beneficial for the dental care.
3.5. Antimalarial effects
The parasite lactate dehydrogenase (pLDH) assay method,
a recently developed in vitro enzymatic method for evaluating
antimalarial compounds, was used to examine the antiplasmodial activities of the aqueous leaf, stem-bark and fruit
extracts of Psidium guajava. An in vitro antiplasmodial assay
carried out using a chloroquine-sensitive strain of malarial
parasite, Plasmodium falciparum D10 showed antigiardiasic
activity with trophozoite mortality (87% 1.0); guava stembark extract showed IC50 values of 1020 g/ml (Ponce et al.,
1994; Nundkumar and Ojewole, 2002). In another study, leaves
and stem bark of Psidium guajava inhibited Entamoeba histolytica growth with MAC < 10 g/ml (Tona et al., 1998).
and caffeic acid (Jimenez et al., 2001). Guava leaf extracts are a
potential source of natural antioxidants (Ojan and Nihorimbere,
2004).
Other studies show that guava fruits also exert antioxidant
and radioprotective activity in the assay with technetium-99m
[(99m)Tc] (Abreu et al., 2006).
3.9. Antigenotoxic and antimutagenic effects
Generation of DNA damage is considered to be an important initial event in carcinogenesis. A considerable battery of
assays exists for the detection of different genotoxic effects
of compounds in experimental systems, or for investigations
of exposure to genotoxic agents in environmental or occupational settings. Treatment with the aqueous whole plant extracts
of Psidium guajava afforded protection (anti-genotoxic activity) against mitomycin C, nalidixic acid and hydrogen peroxide
(three genotoxins) (Bartolome et al., 2006). In another study,
a pre-treatment with an aqueous guava leaf extract was found
to be effective in inactivating the mutagenicity of direct-acting
mutagens 4-nitro-o-phenylenediamine and 2-aminofluorene in
the tester strains of Salmonella typhimurium. Therefore aqueous
leaf extracts of Psidium guajava show promising antigenotoxic/antimutagenic activity (Grover and Bala, 1993).
3.10. Anti-allergic effects
Th1 polarization is one of the mechanisms underlying the
therapeutic effects of herbal medicine. The action of anti-allergic
agents from Psidium guajava on T cell immunity in mice was
investigated. Studies were carried out on methanol and aqueous
extracts of Psidium guajava leaves. These extracts cause potent
inhibition of histamine release from mast cells, and blocked IL10-mediated, in vitro induction of T regulatory (Tr) cells from
CD4+ splenocytes of C57BL/6 mice. The extracts also shifted
the Th1/Th2 balance to a Th1 dominant status by directly attenuating Tr cell activity. Psidum guajava leaf extracts showed
anti-allergic activity on T cell immunity in mice (Seo et al.,
2005).
3.11. Anticancer/antitumour effects
An aqueous extract of Psidium guajava leaves inhibited (the
viability) of the cancer cell line DU-145 in a dose-dependent
manner. At 1.0 mg/ml, the extract reduced the viability of PCa
DU-145 (the androgen independent PCa cells) to 36.1% and
3.6%, respectively after 48 h and 72 h of incubations (Chen et al.,
2007). Essential oil extracted from leaves of Psidium guajava
was highly effective in reducing the growth of human mouth
epidermal carcinoma (KB) and murine leukemia (P388) cell
lines when they were treated with different concentrations of
the oil ranging from 0.019 mg/ml to 4.962 mg/ml. Guava leaf
oil showed the highest anti-proliferative activity with an IC50
value of 0.0379 mg/ml (four times more potent than vincristine)
on P388 cell lines (Manosroi et al., 2006); an effect mostly
attributed to the monoterpenes present in the essential oil (Cito
et al., 2003). A chemopreventive effect was also demonstrated
in another study of a methanol leaf extract on mice-induced cancer inoculated with B16 melanoma cells. A significant decrease
in the incidence and average number of animals with cancer
was found compared to the control group (Fernandes et al.,
1995). These findings suggest that Psidium guajava aqueous
leaf extracts are efficacious for the prevention of tumour development by depressing Tr cells and subsequently shifting to Th1
cells (Seo et al., 2005).
Furthermore, jacoumaric acid (isolated from guava seeds)
was evaluated for its antitumour effect; it was found to significantly reduce the incidence of tumours (Numata et al., 1989).
Phytochemical investigations of the acetone extract of Psidium
guajava seeds has led to the isolation of phenyl-ethanoid
glycosides
(1-O-3,4-dimethoxy-phenylethyl-4-O-3,4dimethoxy cinnamoyl-6-O-cinnamoyl-beta-d-glucopyranose
and
1-O-3,4-dimethoxyphenylethyl-4-O-3,4-dimethoxy
cinnamoyl-beta-d-glucopyranose) which showed cytotoxic
activities in vitro against Ehrlich ascites cells (EAC) and
leukaemia P3888 cells (Salib and Michael, 2004). These
finding suggested that Psidium guaijava extracts have the
potential to be developed as new chemotherapeutic agents to
prevent or to inhibit the growth of tumours and cancers.
3.12. Cardiovascular, hypotensive effects
The effect of an aqueous leaf extract of Psidium guajava on
myocardial injury was studied in the model of global ischemia
followed by reperfusion. High-energy phosphates and malondialdehyde in the reperfused hearts were significantly reduced
with the plant extract (Conde et al., 2003). In another study,
aqueous leaf extract of Psidium guajava exhibited cardioprotective effects against myocardial ischemia-reperfusion injury in
isolated rat hearts. Augmentation of endogenous antioxidants,
maintenance of the myocardial antioxidant status and significant
restoration of most of the altered hemodynamic parameters may
have contributed to its cardioprotective effect (Yamashiro et al.,
2003). The cardio-inhibitory actions in rats and guinea pigs of
the aqueous leaf extract of Psidium guajava also appeared to
be due to cholinergic involvement in the mechanism of action.
Ojewole (2005) showed that the aqueous leaf extract caused
hypotension in the experimental animal model used via cholinergic mechanisms. Moreover, acute intravenous administrations
of the leaf extract (50800 mg/kg i.v.) produced dose-dependent,
significant reductions in systemic arterial blood pressures and
heart rates of hypertensive, Dahl salt-sensitive rats. Although
the exact mechanisms of action of the extract remain speculative at present, it is unlikely that the extract causes hypotension
in the mammalian experimental animal model used via cholinergic mechanisms since its cardiodepressant effects are resistant
to atropine pre-treatment (Ojewole, 2005).
Belemtougri et al. (2006) found that aqueous and ethanolic
leaf extracts of Psidium guajava inhibits intracellular calcium
release (Chiesi and Schwaller, 1994; Apisariyakul et al., 1999).
Aqueous leaf extract of Psidium guajava significantly and dosedependently (0.252 mg/ml) contracted the aorta rings. The
effect was evaluated also in the presence of nifedipine and phentolamine. The sensitivity of the aortic rings to cumulative doses
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especially caryophyllene-oxide and -selinene, which potentiated pentobarbital sleeping time and the latency of convulsions
induced by leptazol in mice. Calcium concentrationresponse
curves showed a rightward displacement when hexane extract
was added to isolated guinea-pig ileum depolarized with K+
(60 mm) and cumulative concentrations of CaCl2 , suggesting
that caryophyllene-oxide, a known Ca2+ antagonist agent could
be responsible for the blockade of extracellular Ca2+ (Meckes
et al., 1996).
In the Laboratory of Medicinal Plants Research Unit of Neurological Diseases, Mexico, a randomized double-blind trial
examined the efficacy of a standardized aqueous leaf extract
Psidium guajava ([QG-5] estimated at quercetin-equivalent
1 mg per 500 mg capsule) versus placebo in 100 patients
with infectious gastroenteritis. The experimental group (n = 50)
received 1 capsule of QG-5 orally every 8 h for 3 days, while the
control group (n = 50) received the same regimen with matching placebo capsules. Conventional oral rehydration therapy
was initiated in both groups. Outcome measures included number of daily stools, consistency, presence of mucus, degree of
abdominal pain, number of spasms in 24 h, fever, and number of
vomiting episodes. Results indicated a significant difference in
outcome measures favouring the experimental group, mostly due
to an antispasmolytic effect, which helped reduce the number of
episodes of abdominal pain. No adverse effects were reported
for patients treated with QG-5 (Lozoya et al., 2002). Besides
constipation, no serious adverse reactions have been reported in
patients taking QG-5. Guava is commercially available in capsules, liquids, powders, and tablets in a standardized form for
gastroenteritis.
In Cuba, a longitudinal randomized double blind study was
carried out among 100 adult patients with acute diarrhoea. The
effect of an oral treatment with 10 ml tincture from Psidium
guajava dissolved in water, every 8 h, on the treatment of diarrhoea was determined. The results revealed that this 20% leaf
tincture significantly reduced the time to ceasing diarrhoea and
no adverse reactions were detected (Echemendia and Moron,
2004). Guava offers an effective and safe alternative treatment
for patient with diarrhoea disease.
4. Toxicology
This toxicologic study was conducted using dry leaves of
Psidium guajava L. In this plant material, acute toxicologic
study by the following methods: mean lethal dose LD50 test
in Swiss mice and alternative toxicology (acute toxic classes)
in Wistar rats. We also made the genotoxic of 2 extracts, one
of aqueous type, and the other of henaxic type in an in vitro
system of short-term somatic segregation induction assay in the
Aspergillus nidulans fungus and an in vivo assay of the dry drug
in mouse bone marrow micronuclei induction test. No deaths
were observed in the toxicological results of the two experimental models in the dose range using up to 2 g/kg/b.w. Acute
toxicity tests in rats and mice have proven the LD50 of guava leaf
extracts to be more than 5 g/kg. In vitro genotoxicity and mutagenicity tests on Psidium guajava in human peripheral blood
lymphocytes found no disturbances in cell division (Jaiarj et al.,
1999; Manosroi et al., 2006). The histological results did not
suggest any damage attributable to toxicity of the studied plant
material. In the in vitro study with Aspergillus nidulans D-30,
results indicated a lack of genotoxic effect of these extracts,
as well as in the mouse bone marrow micronucelus induction
system (Martinez et al., 2001).
5. Clinical trials
Evidence from a randomized, single-blind, clinical trial suggests that by adding moderate amounts of guava fruit to the diet,
changes in dietary fatty acids and carbohydrates may decrease
lipoprotein metabolism and blood pressure. Two groups of
patients (N = 120) were assessed over 12 weeks; each group
received ripe guava fruit, preferably before meals. At the end of
the period, approximately half of the patients had a net decrease
in serum total cholesterol (9.9%), triglycerides (7.7%), and
blood pressure (9/8 mm Hg), with a net increase in high-density
lipoprotein (HDL) cholesterol (8%) (Singh et al., 1992).
A single-blind, randomized, controlled trial of 145 hypertensive patients found similar results. Patients received a fibre and
11
12
7. Conclusion
The pharmacological studies conducted on Psidium guajava
indicate the immense potential of this plant in the treatment of conditions such as diarrhoeal, gastroenteritis and
rotavirus enteritis, wounds, acne, dental plaque, malaria, allergies, coughs, diabetes, cardiovascular disorder, degenerative
muscular diseases, inflammatory ailments including rheumatism
and menstrual pain, liver diseases, cancer, etc. Not surprisingly,
guava also exhibits antioxidant and anti-inflammatory effects as
oxidative injury underlies many of these diseases. However, the
diverse pharmacological activities of guava extracts and isolated
phytochemicals have only been assayed in in vitro tests using
laboratory animals, and the results obtained may not necessarily
be portable to the situation in humans. While there are gaps in
the studies conducted so far, which need to be bridged in order to
exploit the full medicinal potential of guava, it is still very clear
that this is a plant with tremendous widespread use now and also
with extraordinary potential for the future. On the basis of the low
toxicity of guava extracts and derived phytochemicals and their
use as nutraceutical (fruit) and medicinal (leaves, bark, seeds,
roots) agents, backed by proven activity of both the traditional
formulations (infusions, decoctions, tinctures) and their derived
phytochemicals (phenolics, flavonoids, carotenoids, triterpenes,
essential oil constituents and others), further research, clinical
trials and product development can only cement Psidium guajava as a very important part of our biodiversity to respect and
sustainably use for generations to come.
Appendix A. Constituents of Psidium guayava
Structure
Source
Activities
13
Appendix A (Continued )
Structure
Source
Activities
14
Appendix A (Continued )
Structure
Source
Activities
15
Appendix A (Continued )
Structure
Source
Activities
16
Appendix A (Continued )
Structure
Source
Activities
Acts as a chain-breaking
antioxidant and thus protects
cell against photo-oxidation
Palozza and Krinsky (1992)
17
Appendix A (Continued )
Structure
Source
Zeatin riboside
Zeatin nucleotide
Activities
18
Appendix A (Continued )
Structure
Source
Activities
Source
Activities
19
20
Appendix A (Continued )
Structure
Source
Activities
21
Appendix A (Continued )
Structure
Source
Activities
22
Appendix A (Continued )
Structure
Source
Activities
23
Appendix A (Continued )
Structure
Source
Micellaneous
Activities
24
Appendix A (Continued )
Structure
Source
Activities
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