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Mariann Garner-Wizard Shari Henson Dani Hoots
Samaara Robbins Gavin Van De Walle, MS, RD, LN
Executive Editor – Mark Blumenthal Managing Editor – Lori Glenn
Consulting Editors –Thomas Brendler, Meghan Henshaw, Kristen McPhee, MSciTH, Beth Quintana, ND, Carrie Waterman, PhD

File: ■ Gall Oak (Quercus infectoria, Fagaceae)

■ Quercus infectoria galls (Galla Turcica)
■ Gallic Acid

HC 072111-671

Date: August 31, 2021

RE: Quercus infectoria Galls May Provide a Multitude of Medicinal Benefits

Elham A, Arken M, Kalimanjan G, Arkin A, Iminjan M. A review of the phytochemical,

pharmacological, pharmacokinetic, and toxicological evaluation of Quercus infectoria
galls. J Ethnopharmacol. June 12, 2021;273:113592. doi: 10.106/j.jep.2020.113592.

Traditional medicine is derived from natural products primarily from plants but also from
animals, minerals, and their processed products. The gall oak (Quercus infectoria,
Fabaceae) is susceptible to galls produced by the gall wasp (Cynips gallae tinctoriae,
Cynipideae). Gall oak galls (QIG; Galla turcica) have been used in traditional medicine to
treat diarrhea, hemorrhage, and skin disease. Some studies have shown it to be an
effective anti-MRSA, antiviral, antifungal, larvicidal, and antioxidant. Its powdered form
has been used as a remedy for inflamed tonsils, skin edema, hemorrhoids, and
inflammation. The purpose of this review was to compile a contemporary and
comprehensive analysis of the medicinal uses and properties of QIG. Literature was
compiled in both English and Chinese; details of the literature search were not included.

Formed by gall wasp larva, QIG are 1-2.5 cm in diameter, with a 2-3 mm wall and an
earthy yellow verrucous appearance. They contain flavonoids, alkaloids, sterols,
polyphenols, tannins, volatile oils, saponins, glycosides, sugars, organic acids,
anthraquinones, proteins, and amino acids. Tannins comprise 50-70%. Gallic acid (GA)
is the main phenolic acid (2-4%). Four triterpenoids and three steroids have been
identified in QIG, along with several minerals. Only two flavonoids, amentoflavone and
isocryptomerin, have been reported; consequently, flavonoids in QIG have not been
studied.

Spectral analysis of QIG aqueous solutions found that the molecular structure is
unaffected by ultrafine grinding before and after extraction; however, more refined high-
performance liquid chromatography analysis showed that of three target compounds, the
extract increased significantly with decreasing particle size. Additionally, ultra-micro
pulverization exposes and releases compounds resulting in additional chemical
components. Studies have found 21 compounds in QIG extract, including four phenolic
acids, 15 gallotannins, and GA. Using different testing methods, the antioxidant and
antibacterial properties of QIG have been confirmed. Baseline chemical composition has
been identified to prevent adulteration or misuse in the future.
 Pharmacological studies focused on the anti-inflammatory and antibacterial properties
identified in QIG extracts and GA. In vitro studies have demonstrated the strong anti-
inflammatory effects of QIG. In vivo oral and topical administration of QIG alcohol
extracts have been shown to prevent the production of some inflammatory markers.
Other studies have also confirmed its use as an anti-inflammatory.

Numerous studies showed beneficial uses of QIG as an antibacterial and antiviral. Both
methanol and aqueous QIG extracts have demonstrated effectiveness against candida.
Studies have also shown QIG to be effective against oral bacteria known to cause dental
caries; thus, suggesting its use as an effective phytotherapeutic agent for the prevention
of oral pathogens. Over-use of antimicrobials has led to multiple-drug-resistant strains of
microbes. Several studies that QIG has the ability to kill pathogens and remove chronic
drug-resistant infections.

Studies have shown GA has a significant inhibitory effect on tumor necrosis factor-
(TNF-interleukin-6 (IL-6), and histamine, which alleviate cell-induced inflammatory
anaphylaxis. Showing promise in treating colorectal, pancreatic, lung, prostate, cervical,
and skin cancer in vitro and in animal models, GA initiates apoptosis in tumor cells. It
has also been shown to induce apoptosis in cells containing human papillomavirus. Low
quantities of GA (< 25 µg mL-1) have been shown to enhance mitochondrial antioxidant
capacity and increase cell proliferation following radiation damage. This same study
showed that high concentrations of GA (> 25 µg mL-1) have the opposite effect. Both in
vivo and in vitro studies have shown that GA protects DNA and cell membranes.

GA has been shown to have hepatoprotective benefits. It can act as a potential anti-
fibrotic with an affinity for killing hepatic stellate cells, which are activated by liver injury
and often lead to fibrosis. GA has also demonstrated the ability to regulate insulin
secretion and inhibit the rate of -amylase activity, indicating a metabolic effect. Finally,
GA was demonstrated to have protective qualities for the nervous system. A moderate
analgesic effect was demonstrated with QIG methanol extract using animal studies. QIG
was shown in vivo and in vitro to protect against protozoan parasites. In vivo studies
showed a positive effect on metabolism.

The authors conclude that QIG shows promise as a strong anti-inflammatory and
antibacterial agent. While they present evidence of antitumor effects and other positive
benefits on the human system, the authors strongly recommend that future studies are
needed using human participants to study the mechanism of pharmacology, toxicology,
and metabolism. Several studies did not clarify whether the test subjects were human.
The authors imply that that article serves as a basis for future research on the
application of medicinal plants.

The authors declare no conflicts of interest.

—Samaara Robbins
The American Botanical Council has chosen not to reprint the original article.

The American Botanical Council provides this review as an educational service. By providing this service, ABC does not warrant
that the data are accurate and correct, nor does distribution of the article constitute any endorsement of the information contained or
of the views of the authors.

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