Biomedicine & Pharmacotherapy 144 (2021) 112240

Contents lists available at ScienceDirect

Biomedicine & Pharmacotherapy

journal homepage: www.elsevier.com/locate/biopha

Review

The medicinal properties of Cassia fistula L: A review

Ruth W. Mwangi a, John M. Macharia b, *, 1, Isabel N. Wagara a, Raposa L. Bence b
a
Department of Biological Sciences, Egerton University, Nakuru, Kenya
b
Doctoral School of Health Sciences, Faculty of Health Science, University of Pẻcs, Hungary

A R T I C L E I N F O A B S T R A C T

Keywords: Medicinal plant species contain vast and unexploited riches of chemical substances with high medical potential
Cassia fistula making these plant species valuable as biomedicine sources. Cassia fistula L is an important medicinal plant used
Medicinal properties in many traditional medicinal systems including Ayurveda and Chinese Traditional Medicine. It is a deciduous
Leguminosae
medium sized tree with elongated and rod-shaped fruits having pulp and have bright yellow flowers, earning the
Phytochemicals
name ‘Yellow Shower’. The present review provides a version of updated information on its botanical description
Pharmacological activities
and pharmacological properties including antioxidant, antimicrobial, anti-inflammatory, antidiabetic, anti­
tumor, hepatoprotective among other activities. Pharmacological reviews on medicinal plants will provide
valuable information; thus, Cassia fistula L can provide important discoveries of valuable bioactive natural
products facilitating in developing novel pharmaceuticals products.

1. Introduction employed in the management of different conditions including and not

The healing properties of different plants species have contributed
exceptionally to the derivation as well as the development of several
traditional herbal medicines. Various plant species possess an assort­
ment of phytochemicals, which have been applied in the fields of human
medicine, agriculture and veterinary. These plants with medicinal
properties for example, Cassia species have abundant metabolites
capable of causing explicit physiological effects on the animals, humans,
or plants’ bodies. According to Mondal [1] in the Ayurvedic, the Hindu
traditional medicine, different species found in the genus Cassia are used
for therapeutic purposes and, some Cassia species are well known to
eliminate disease agents in the body and thus, they have grown in their
economic prominence [2].
Herbal medicine practitioners extensively employ the largest num­
ber of the plant species in the genus Cassia L. in traditional medicine.
Herbalists have cited that most Cassia plant species have hep­
atoprotective, anti-inflammatory, antibacterial, antitussive, antifungal
and wound healing properties. Most of these species are rich in tannins,
flavonoids, glycosides, carbohydrates, stearic acids, oleic, oxalic, lino­
leic, oxyanthraquinones and anthraquinones derivatives [1]. All the
plant organs richly possess most of the active phytochemicals including
the leaves, stems, roots, flowers as well as fruits [3]. Cassia fistula is
limited to these: relieving the symptoms of asthma, leprosy, ringworm,
heart related disorders and fever. Extracts from C. fistula are used as
laxative as well as in constipation management; root is employed in
treating of flus and colds whereas the leaves are employed in relieving
pain, edema, and reducing skin irritation as result of swelling. Addi­
tionally, extracts of the stem bark and fruits are used in eliminating
toxins from the blood [4].
Cassia fistula exhibits many applications in therapy particularly in
the traditional medicine system. This is an alien species, and it is
popularly used as an ornamental plant because of its attractive flowers
that are yellow in color. Seeds from this species are used as medicine for
treating gastritis and diarrhea; they are likewise used as an insect re­
pellent. The seeds are as well used to treat biliousness in addition to
improving appetite. The roots are used in the treatment of skin disor­
ders, syphilis, leprosy, and tuberculosis [5]. Root extracts are also used
to relieve burning sensations. The fruits treat throat disorders, inflam­
mation, liver complications, chest problems, asthma, and rheumatism.
In traditional medicine in Thailand, the ripe fruits are used as a laxative
medicine prepared by boiling in water and filtering the extract using a
sieve [4]. The extract is converted into small pellets by evaporating the
excess water from filtrate.

* Correspondence to: Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty Mihály str. 4, 7621 Pécs, Hungary.
E-mail addresses: mwangiruth16@gmail.com (R.W. Mwangi), johnmacharia@rocketmail.com (J.M. Macharia), iwagara@egerton.ac.ke (I.N. Wagara), bence.
raposa@etk.pte.hu (R.L. Bence).
1
https://orcid.org/0000-0002-7535-9478.

https://doi.org/10.1016/j.biopha.2021.112240
Received 19 May 2021; Received in revised form 17 September 2021; Accepted 21 September 2021
Available online 1 October 2021
0753-3322/© 2021 The Author(s). Published by Elsevier Masson SAS. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).
R.W. Mwangi et al. Biomedicine & Pharmacotherapy 144 (2021) 112240

2. Methods deciduous and does well in varied monsoon forests [8]. It attains height
of approximately 1300 m. The plant species can endure rainfall ranging
A systematic search criterion of relevant literature was carried out between 480 and 720 mm, yearly temperature ranging between 18 and
without restricting the search period, race, or country of origin, by 29 ◦ C, in addition to thriving well in a pH of 5.5–8.7 (Plate 1).
searching the Web of Science, Ovid, BMC Springer, Elsevier, Embase and Taxonomic classification of Cassia fistula [9,10].
MEDLINE databases. Google Scholar was also used in search of addi­ Kingdom Plantae
tional information as well as through scrutinizing the lists of references Subkingdom Tracheobinota
to identify related studies. Cassia fistula term was combined with either Division Magnoliophyta
Super Division Spermatophyta
of the following MeSH terms: “phytochemicals”, “pharmacological ac­ Class Magnoliopsida
tivities”, “anti-inflammatory”, “antibacterial”, “antifungal”, “antiviral”, Subclass Rosidae
“anti-diabetic”, “hepatoprotection”, “anti-leishmaniatic”, “anti-pyretic” Order Fabales
and “Purgative activities” to get relevant papers for sufficient review. Family Leguminosae
Subfamily Caesalpinaceae
Additional lists of references were further scrutinized to get related
Genus Cassia
studies. Irrelevant articles were excluded throughout the screening Species Fistula
process and only 85 full articles were relevant and directly related to the
question of medicinal properties of Cassia fistula.
Structures of some of the phytoconstituents reported from
3. Botanical description Cassia fistula
Different anthraquinones have been isolated from numerous sections
Cassia fistula is extensively cultivated in tropics as an ornamental of C. fistula in addition to their characterization. Various research has
plant due to the abundant yellow blossoms. Botanically, C. fistula is a validated that anthraquinone glycosides like rhein, chrysophanol
tree, which attains a height of 6–9 m, with a straight trunk, pale gray, (Fig. 1) and physcion are present in larger quantities in mature leaves
and smooth bark when tender but the barks turn brown and rough when but are present in small quantities in matured pods. Consequently, for
mature. The branches spread out and are slender [6]. The plant species therapeutic purposes, it is prudent to extract anthraquinone glycosides
has compound, pinnate and deciduous leaves that have 3–8 leaflet pairs. from young maturing green pods instead of extracting from fully-grown
It has flowers with pendulous racemes, glabrous, slender and pubescent pods as well as from fully-grown leaves rather than from young devel­
4–7 cm in diameter. A long calyx divided from the base, pubescent; with oping leaves [22] (Table 1).
obtuse and oblong segments, yellow corolla, and antheriferous stamens.
The species has a legume as a fruit with numerous seeds producing a 4. Pharmacological activities
very strong odor. The long immature green pods gradually turn black as
they mature once the flowers have been shed. The species has a dark The different portions of the plant species have exhibited numerous
brown pulp, sticky, mucilaginous and sweetened, with a rather medicinal benefits for instance, hypoglycemic antioxidant and anti­
disagreeable odor characteristic [6]. The bark occurs in curved or flat tumor potentials. Cassia fistula is very important in different traditional
thick fragments; smooth to rough outer surface containing warty spots; medicinal systems because it possesses distinctive properties valuable in
green gray turning red; rough inner surface, red in color showing par­ treating the dermal infections, inflammatory conditions, ulcers, rheu­
allel striations; laminate, fracture; characteristic sweet taste and odor matism, jaundice as well as anorexia [5]. The root has purgative effects;
and astringent [7]. treats heart related illnesses, fever, biliousness, nausea, retained
The species has pendulous pods containing many (40–100) flat seeds
submerged within a murky sugary pulp that is colored. Seeds remain
thick, largely ellipsoid, and somewhat short on the breadth. Within the
pod is segmented by thin, beige colored, crosswise septa at intervals.
Every compartment has a single seed that is reddish brown in color,
horizontal, oval and has a clearly marked raphe [8]. The endosperm of
the seed is white in color and is embedded with a yellow embryo. The
pulp of the fruit is considered a laxative although in Ayurvedic medicine,
self-medication short of medical supervision is strongly prohibited.
Cassia fistula grows well in dry microclimates, and it achieves the
best growth in full sunlight and on properly drained soils. The species is
fairly drought resistant and somewhat salt tolerant, it is slightly resistant
against frost, but can be injured if the frost persists. The species is Fig. 1. Chrysophanol.

Plate 1. The aerial parts (flowers, leaves and pods) of Cassia fistula plant species.

2
R.W. Mwangi et al. Biomedicine & Pharmacotherapy 144 (2021) 112240

Fig. 5. Procyanidin B2.

Fig. 2. Sennosides A.

Fig. 6. (+) Epiafzelechin.

Fig. 7. (− ) Epiafzelechin.

Fig. 3. Sennosides B.

Fig. 8. Rhein.

Fig. 4. Physcion.

excretions among other conditions. The extracts from the leaves are
effective in treating ringworm infections, cough in addition to snake­
bites. The fruit pulp is laxative and analgesic; it can relieve obstructions
in the chest, the accumulated heat within the circulatory system as well
as the intense heat accumulated within the liver tissues. It is similarly a
benign aperient for children as well as women, enhances the sight’s Fig. 9. Kaempferol.
sharpness in addition to loosening the bowels for the purposes of

3
R.W. Mwangi et al.
Fig. 10. Catechin.
Table 1
Phytochemicals present in C. fistula.
Plant Phytochemical present
organ
Leaves Anthraquinones like rhein, chrysophanol (Fig. 1) and
physcion, butyric & formic acids, pectin, tannin,
sennosides A (Fig. 2) & B (Fig. 3), oxalic acid, physcion (
Fig. 4), lignans e.g., Syringaresinol, flavonoids e.g.,
Quercetin-O-hexoside, Proanthocyanidin B dimer,
Apigenin-6,8-di-C- Glycoside, Myricetin hexoside,
Apigenin-C-hexoside-Opentoside Phenolic acids e.g.,
Coumaric acid derivative and 3,4-di-O-caffeoylquinic
acid, chrysophanol (Fig. 1) biflavonoids and
triflavonoids, Physcion B2 (Fig. 5) (+-) epiafzelechin (
Figs. 6 and 7)
Flowers Alkaloids, rhein (Fig. 8), leucopelargonidin tetramer,
fistulin, kaempferol (Fig. 9), heptacosanoic acids,
hentriacontanoic, triacontanoic, Nonacosanoic, and
Gibberellic acid
Bark Oxyanthraquinone, and flavonol glycosides,
Dihydroxyanthraquinone, Leucocyanidin, Fistucacidin
(3,4,7,8,4′ -pentahydroxyflavon), and Lupeol
Pods Fistulic acid (Fig. 2), and flavone-3-O-arabinopyranoside,
3-formyl-1-hydroxy-8-methoxyanthraquinone, Catechins
(Fig. 10)
Fruits 1,8-dihydroxy-3-anthraquinolone derivative, Rhein (
Fig. 6), fistulin, oxyanthraquinone, tannin, ceryl
alcohol, Glycosides-Sennosides A & B, volatile oil
(essential oils), Chrysophanol (Fig. 1), resinous and
waxy derivatives
Roots Oxyanthraquinone & phlobaphenes, tannins, and
Rhamnetin-3-O-gentiobioside,
Seeds Anthraquinone derivatives, carbohydrates, proteins,
amino acids, resinous and waxy derivatives, volatile oil,
stetculic and malvalic acids, (2′ S)-7-hydroxy-2-(2′ -
hydroxypropyl)-5-methylchromone, 5-hydroxymethylfur­
fural, Benzyl-2β-O-D-glucopyranosyl-3,6-
dimethoxybenzoate, Benzyl-2-hydroxy-3,6-
dimethoxybenzoate and 5-(2-hydroxyphenoxymethyl)
furfural
Heartwood Fistucacidin (3,4,7,8,4′ -pentahydroxyflavan)
Pulp Barbaloin
relieving constipation [8].
4.1. Antioxidant potential
Compounds with antioxidant potential can reduce the risk of ill­
nesses through quenching free radicals, which would otherwise attack
healthy cells in the body. Antioxidants obtained from naturally occur­
ring sources for instance, plants have the ability of preventing numerous
diseases because they possess rich antioxidant sources [23]. Plant spe­
cies with medicinal properties possess useful elements such as flavo­
noids, tocopherol, and essential amino acids with significant health
benefits in healthcare management [24]. Polyphenols predominantly
bioflavonoids are outstanding antioxidant sources that scavenge free
radicals in the body.
The significance of C. fistula in disease management has a historic
background because it is an excellent source of good antioxidants. Abid
Biomedicine & Pharmacotherapy 144 (2021) 112240
et al. [25] assessed the protective effects as well as antioxidant prop­
erties of C. fistula on oxidative damage induced by hydrogen peroxide on
the red blood cells. Their results demonstrated that the C. fistula extract
extracted using ethanol had significantly high antioxidant potential
because they were able to protect the red blood cells with an efficacy
level of 90%. Water extract of C. fistula exhibited an efficacy level of 75%
antioxidant and protective potential [26].
Sharma [8] demonstrated that methanolic extracts of flowers, leaves,
stem bark and pulp of C. fistula have potent antioxidant properties. The
antioxidant potential was verified to be stronger in the extract of stem
bark then leaf extracts followed by flower extracts and lastly the pulp
extracts. The results correlated with the total contents of polyphenolic
compounds present in the methanolic extracts. The pulp and flower
methanolic extracts displayed significantly weak antioxidant potential
Ref. possibly because of the presence of reducing sugars and pro-oxidants
that might have outcompeted the antioxidant constituents found in
[3,11–16]
the extracts [8]. Therefore, the extract of stem bark showed higher
antioxidant potential with respect to peroxidation inhibition, reducing
power, radical and O2 scavenging capacity [19].
Water extract from flowers of C. fistula showed antioxidant activity in
alloxan and was able to induce diabetes in experimental rats. A note­
worthy drop in products with peroxidation activity i.e., conjugated di­
enes, hydroperoxides, thiobarbituric acid reactive components were
detected in tissues of the heart on treated rats with diabetes. The reduced
activities played by enzymes with antioxidant potential including su­
[12,14,
peroxide dismutase, glutathione peroxidase, glutathione reductase,
15] glutathione, and catalase in rats with diabetes were adjusted towards
near normal range when they were administered the aqueous extract.
Jangir and Jain [27] carried out an investigation on the antioxidant
[12,15]
properties of the fruit extracts of C. fistula to determine its mechanism of
action. His results showed that the hydroalcoholic extract of the fruit
[14,15] pulp demonstrated antioxidant properties because the extract was able
to inhibit hydroxyl and DPPH radicals in addition to effects of reducing
power. The scavenging potential was correlated to the presence of
[12,13,
phenolic compounds found in the extract [28]. DPPH radicals have been
17,18]
applied widely to investigate the scavenging activities of natural com­
pounds. The Color of the reaction mixture change from purple to yellow
when DPPH radicals are scavenged. The bioactive potential attributed to
[20]
polyphenols is essentially facilitated to some level by scavenging the free
[15,21]
radicals, actions of complexing and metal antioxidants [13], their ability
to decrease restricted concentration of O2 as well as to break down
peroxides, their interaction with other enzymes in addition to syner­
gistic effects with different antioxidants [29].
4.2. Anti-inflammatory potential
[14] Tissue injury, infection in addition to various other dynamics might
[14,15]
lead to tissue inflammation. This is an ordinary biological process
capable of causing various pathological alterations. Natural and safe
therapies are essential to monitor the process of inflammation by
proinflammatory cytokine modulation alongside other components
connected to the persisting inflammation. Flavonoids found in the
numerous medicinal plants including C. fistula display anti-
inflammatory properties since the plant species possess powerful sour­
ces of antioxidant compounds. There is some proof that flavonoids play
various functions during the inhibition of several enzymes that are
triggered throughout the inflammation process [30]. To determine the
mechanism of action, the anti-inflammatory properties of the meth­
anolic and aqueous extracts of the bark of C. fistula were examined by
using Wistar albino rats. The extracts from the bark showed significant
ability to scavenge free radicals through lipid peroxidation inhibition
triggered by FeSO4 and CCl4 within the homogenates of the kidney and
liver of the experimental rats [30]. Both the extracts demonstrated
appreciable antioxidant potential against DPPH, Hydroxyradical and
Nitric oxide activated procedures of in-vitro assays. The two extracts
demonstrated protecting effects that were dose-dependent against
4
R.W. Mwangi et al.
production of peroxidation of lipids as well as free radicals in the ho­
mogenates of the kidney and liver. This demonstrated that aqueous and
methanolic extracts of the bark of C. fistula have significant properties of
anti-inflammation [31].
Aziz [32] studied the anti-inflammatory properties of C. fistula and
compared the findings with standard medicines (diclofenac and indo­
methacin). They used dextran, carrageenan, and histamine stimulated
paw edema on rats, as well as evaluating the anti-inflammatory activity
to counter all phlogistic elements. The results indicated that the leaf
ethanoic extracts considerably suppressed the carrageenan-stimulated
edema of the back paw as well as the granuloma of cotton-pellet
following a dose dependent fashion. Research was done to assess the
anti-inflammatory potent of aqueous and alcoholic extracts of the bark
of C. fistula using sub-acute simulations. The findings on inflammation
validated those extracts and demonstrated significant anti-inflammatory
effects on both granuloma of cotton-pellet and air-pouch simulations
[33]. Cotton-pellet-induced granuloma formation is an established in­
flammatory reaction and can serve as sub-chronic and chronic inflam­
matory models and it is employed to assess the transductive and
proliferative components of chronic inflammation [10]. An efficacy of
50% inflammation reduction level using ethanolic leaf extract (ELE) has
been cited and demonstrated by Gobianand et al. [10].
4.3. Antifungal potential
Diethyl ether, acetone and methanol solvents used to prepare
C. fistula leaf extracts were investigated against Candida albicans for
antifungal properties through diffusion assay using paper disks. The
methanol extract displayed a significantly high activity i.e., 2.1 cm in­
hibition zone which was comparable to clotrimazole, an antifungal
antibiotic set as a standard [34]. The flower extract of C. fistula prepared
in Ethyl acetate exhibited antifungal activity because of the presence of
Rhein (1, 8-dihydroxyanthraquinone- 3-carboxylic acid), an organic
acid that was previously isolated from C. fistula flowers. The Ethyl ac­
etate extract of flowers displayed the capacity to impede the normal
growth of various species of fungi and these included Trichophyton
mentagrophytes (MIC 31.25 µg/ml), T. rubrum (MIC 62.5 µg/ml), T. simii
(MIC 125 µg/ml) as well as Epidermophyton floccosum (MIC 31.25 µg/ml)
[24]. From a different study, Rajput et al. [35] examined the antifungal
properties of leaf extracts of C. fistula prepared in acetone, methanol,
and diethyl ether against C. albicans and they got significant results. The
extract from the seeds demonstrated appreciable activity on the profile
of C. albicans growth through the time kill bioassays whereas the in vivo
efficacy was conducted using animal simulations. The C. albicans growth
was entirely repressed using the seed extract of C. fistula using a con­
centration at 6.25 mg/ml. In a separate study, Nayan and Shukla [36]
demonstrated that as compared with standard drugs, C. albicans
exhibited high sensitivity as compared to A. niger and A. clavatus. The
growth inhibition zone measured ranged from 14 to 20 mm for fungal
the strains. Additionally, time-kill bioassays proved that the seed extract
of C. fistula showed capacity to impede the yeast normal growth when
incubated for a long time [36].
Hada and Sharma [37] studied the efficacy of fruit extracts of
C. fistula on Alternaria solani. According to their results, 100% crude
extract prepared using chloroform conferred 53.27% mycelial growth
inhibition of A. solani fungi. On the other hand, the partly purified
extract of chloroform conferred 93.88% inhibition of the mycelial
growth of the same fungal species. A 100% of acetone, benzene, and
petroleum ether extracts from C. fistula fruits significantly inhibited the
mycelial growth of A. solani. However, 50% extract of C. fistula prepared
using methanol displayed significant reduction in inhibition of A. solani
fungi [38].
4.4. Antibacterial potential
Fractions of leaves of C. fistula were made in chloroform, petroleum
5
Biomedicine & Pharmacotherapy 144 (2021) 112240
ether, ethanol, water, and methanol. These fractions were tested on
bacterial strains pathogenic to human, including gram negative and
positive [39]. All the extracts displayed antibacterial activity with
ethanolic extracts displaying the highest potential. Arulpandi and San­
geetha [39] demonstrated that all the extracts significantly inhibited all
the Gram-positive bacterial strains. The bacterial strains employed in
the experiment comprised of three Gram-positive i.e., Bacillus cereus,
Staphylococcus epidermidis, and S. aureus in addition to two
Gram-negative bacterial strains viz. Klebsiella pneumonia and Escherichia
coli [38]. All the five extracts used in the study displayed promising
antibacterial efficacy against the bacterial strains. However, the highest
activity was exhibited by ethanolic extract. The minimum inhibition
concentration ranged from 94 to 1500 μg/ml. The researchers observed
that the extracts from leaves had broad-spectrum effect and therefore
could be employed in the management of infectious diseases [36].
Nayan and Shukla [36] observed that antibacterial and antifungal
activities of leaves extracts increased linearly with increase in concen­
tration of extracts (μg/ml). As compared with standard drugs, they
further observed that in extracts for bacterial activity, S. pyogenes and S.
aureus were more sensitive as compared with E. coli and P. aeruginosa.
The growth inhibition zone measured ranged from 11 to 20 mm for all
the sensitive bacteria [36]. Seyyednejad et al. [40] demonstrated that
the antimicrobial activity depends on the contents of phenolic compo­
nents of the plant extracts. High amounts of phenolic group in the aerial
parts of C. fistula implied that these components may be the active
compounds, which may be responsible for the antibacterial activity
[40].
Seeds of C. fistula contain lectins and Ali et al. [41] isolated and
purified some of these lectins. They identified some of these lectins as
CSL-1, CSL-2, and CSL-3. The ability of the lectins to inhibit human
pathogenic bacterial species was studied by use of 30 µg/disc. The
bacterial pathogenic species included Pseudomonas aeruginosa Bacillus
subtilis, B. megaterium, Streptococcus haemolyticus, S. aureus, Sarcina lutea,
Klebsiella sp., Escherichia coli, Shigella sonnei, S. shiga, S. flexneri, S. boydii,
S. dysenteriae, and Salmonella typhi. CSL-3 was active against all the
bacterial species tested, however, Shigella boydii Bacillus megaterium, and
Streptococcus haemolyticus, were inhibited significantly [41]. CSL-2
significantly repressed the colonial growth of S. haemolyticus although
other bacterial species resisted the antibacterial effects of CSL-2. On the
other hand, CSL-1 had some significant effects only on S. haemolyticus
and Sarcina lutea but was not active against all other bacterial strains
[41]. The brine shrimp was susceptible to all the purified lectins as they
were toxic and caused mortality on the brine shrimp. The CSL-2
demonstrated the highest toxicity of 6.7 µg/ml while CSL-1 was
moderately toxic demonstrating toxicity of 10.5 µg/ml while CSL-3 had
the least toxicity of 13.3 µg/ml [42]. Using disc diffusion method; the
C. fistula water extract was evaluated against all the bacterial species.
The aqueous extract significantly inhibited the colonial growth of
Staphylococcus aureus, but the extract was not toxic to other bacterial
strains tested. Extract prepared using alcohol showed higher toxicity and
formed larger zones of inhibition on S. aureus compared to water extract.
Some strains of S. aureus that resist the effects of chloramphenicol
antibiotic, were inhibited by C. fistula alcoholic extract. From these re­
sults, C. fistula alcoholic extracts could be recommended to be in the
management of the communicable diseases [34].
4.5. Antiviral potential
Ethanoic extract of C. fistula fruits significantly inhibited the virus
that causes Foot and Mouth Disease (FMDV). Ethanoic extract of fruit
pod and stem bark of C. fistula was found toxic against the virus (RDV)
responsible for the Ranikhet disease. Sundararaju and Saritha [43] re­
ported that these extracts were active against Vaccinia virus (VV) and for
both viruses (RDV & VV), 100% mortality was observed. Hot water leaf
and pod extracts of C. fistula were tested against infectious boive rhino­
tracheitis (IBR) virus. The C. fistula antiviral potential was evaluated
R.W. Mwangi et al.
using various concentrations of safe doses of the two extracts against
10TCID dose of IBR virus using the MDBK cell lines [44]. Microscopi­
cally, cytopathic effects were detected which were confirmed by use of
assay involving up-take of MTT dye. According to the result of Shankar
and Mathew [45], the pod and leaves of C. fistula hot water extract
displays anti IBR virus properties that is dose dependent.
4.6. Antitumor potential
Cancer diseases have become a huge burden and a leading cause of
death around the globe and particularly in the third world countries.
Due to changes in lifestyles as well as eating habits along with accessi­
bility of therapeutic treatment for numerous communicable diseases,
cancer is beating other illnesses as a topmost of cause indisposition and
mortality even in the technologically advanced countries. Chemo­
therapy, radiotherapy, and surgery that are reputable modalities for
therapy to manage various cancers are expensive, mutilating, and are
associated with grave side effects. These therapy modalities are likewise
connected to residual morbidity as well as recurrent relapses. A study
was done to determine the activities of methanolic extract of C. fistula
seeds on the lifespan of mice with tumors as well as the Ehrlich ascites
carcinoma growth. The results of Irshad et al. [46] indicated that the
extract prolonged the lifespan, reduced the volume and size of the tumor
in addition to decreasing the number of viable cells with tumors.
Cytological studies likewise showed reduction of mitotic activity in
addition to decrease of the vacuoles in the intra-cytoplasmic alongside
membrane blebbing on the treated cells bearing tumors. There was
improvement on hematological parameters [46] after treating the tumor
cells using methanolic extract. These hematological parameters
comprised of red blood cells counts, cell count on bone marrow as well
as the content of hemoglobin of the mice with tumor bearing cells [47].
The results of this study propose that the extracts of seeds of C. fistula
prepared using methanol could be used to treat cancerous cells, because
they have antitumor effects.
An investigation was conducted by Duraipandiyan et al. [48] on
adenocarcinoma cell line found in human colon including COLO 320 D
to test the anticancer potential of rhein, isolated and purified from Cassia
species as an anthraquinone. The results indicated that rhein was cyto­
toxic at a 200 μg/ml concentration and the cytotoxicity improved with
extended incubation in which after 72 h of incubation, they observed
80.25% cytotoxicity [49]. Rhein repressed the proliferation of the cells
using a mechanism that appears to take in directly the mitogen activated
protein (MAP) kinase pathway. An amount of 1 µ/ml of rhein signifi­
cantly curtailed proliferation of cells accompanied by MAP kinase acti­
vation [50]. Rhein has an inherent capacity to avert DNA damage using
anti-Rhein lysinate that suppresses the growth of cancer cells in the
breast [49]. In addition, Irshad et al. [47] performed a different study to
assess the anticancer properties of various fruit extracts of C. fistula on
cell lines such as breast cancer and human cervical cancer. Their results
indicated that seeds and pulp suppressed the two cancer cell lines and
up-regulated the p53 and Bax genes, down-regulated the Bcl-2 gene as
well as increasing caspase-3, 7 & 10, and the activities of nine enzymes.
Moreover, Al-fatlawi et al. [51] reported that Rhein inhibited the growth
of cancerous cell lines including hepatocellular carcinoma (HepG2),
human cervical cancer (SiHa) along with breast adenocarcinoma
(MCF-7), in a fashion that was dose-dependent.
4.7. Wound healing potential
In treating of wounds, infection presents a grave hindrance because
of secondary infection caused by fungi and bacteria. Occasionally these
pathogenic fungi and bacteria become resistant against the antibiotics
rendering them ineffective. Kumar et al. [52] carried out a study to
assess the potential of leaf extracts of C. fistula to aid in wound healing
and they used albino rats. They extracted the juice from the C. fistula
leaves using methanol as a solvent and the juice was converted into a
6
Biomedicine & Pharmacotherapy 144 (2021) 112240
gel. Two concentrations i.e., 5% and 10% w/w of formulated gel were
applied on two different wounds (excision and incision) [53]. The gel
displayed appreciable properties of healing on the tested wounds. After
treating the rats, they showed superior wound closure, improved
regeneration of tissues at the site of the wound, and supportive histo­
pathological elements connecting to healing of the wounds.
Ahmad et al. [54] reported that the matrix metalloproteinase
expression in addition to biochemical analysis were consistent with the
outcomes, thus approving C. fistula’s efficacy in treating wounds. The
outcomes were likewise compared to results obtained using nitro­
furazone, a standard drug, regarding tensile strength, ability to contract
the wound, period of epithelization as well as tissue regeneration at the
site of the wound. The C. fistula healing potential offers a scientific
rationalization for the traditional application of the plant species in
treating wound infections on the skin. This plant species should further
be studied as an alternative for the treatment of infected wounds to
avoid overreliance on conventional antibiotics [52].
4.8. Hepatoprotective potential
Hepatotoxicity occurs when the liver is impaired or malfunctioning.
It is imperative for the liver to work correctly so that it can filter out
poisonous materials formed in the body, including carbon tetrachloride
(CCl4), alcohol, various medicines such as paracetamol, antibiotics,
chemotherapy among others [55]. Various chemicals such as con­
sumption of excess alcohol, overdose of
anti-pyretic/paracetamol/anti-analgesic toxic substances in addition to
infections bring about changes within the cells of the liver commonly
through lipid peroxidation [56]. Within this panorama, natural products
have demonstrated as essential in liver management through detoxi­
fying the toxic substances or excreting the toxic substances via urine
formation [57].
The hepatoprotective property of C. fistula leaves’ extract prepared
using the n-heptane was investigated through stimulating hepatotoxicity
in rats using paracetamol [58]. The dosage of the extract was adminis­
tered orally at 400 mg/kg body weight. This dose exhibited appreciable
protective effect through decreasing the alkaline phosphatase (ALP)
levels, serum glutamic oxaloacetic transaminase (SGOT), bilirubin and
serum glutamic pyruvic transaminase (SGPT) [59]. This dose improved
the oxidative stress and hepatic toxicity markers in the rats treated with
the extract unlike the control ones. The produced effects were like those
of a standard agent with hepatoprotective effects. Another study was
conducted using aqueous extract of leaves of C. fistula. The results
exhibited dose dependent decrease in overall alkaline phosphatase,
SGOT, SGPT, bilirubin, aspartate transaminase, alanine aminotrans­
ferase, as well as increasing the total levels of proteins. The rats treated
with the extract exhibited slight hepatocytic impairment unlike the rats
treated with CCl4 as a control [60]. Pradeep et al. [61] conducted
another research and stated that rats pretreated with 500 mg/kg body
weight every day for seven days with ethanoic extract of leaves of
C. fistula and then administered with CCl4 totally overturned the lipid
peroxidation, the actions of glutathione reductase as well as catalase in
the tissues of the liver towards standard levels.
4.9. Anti-diabetic potential
Diabetes interferes with the capacity of the body’s production or
utilization of hormone insulin. Food eaten is changed into glucose and
taken into sites of storage and utilization through the circulatory system
[62]. The hormone insulin in addition to insulin substrate tissues aid in
maintaining the levels of blood glucose. Generally, two kinds of diabetes
are diagnosed: Type 1 as well as Type 2. For patients suffering from type
1 diabetes, the pancreas is incapable of producing adequate insulin
capable of maintaining blood glucose within the normal range [63].
Type 1 diabetes is also known as juvenile diabetes, since it is commonly
found among kids. Type 2 diabetes often arises after the body is unable
R.W. Mwangi et al.
to utilize insulin commonly referred to insulin resistance or “adult-onset
diabetes”. There are no clear causal agents of diabetes; however, ac­
cording to [64], diet, genetics, obesity as well as failure of exercising the
body significantly contributes to the disease development, particularly
the Type 2 diabetes.
A study was carried out on the properties of extract of C. fistula stem
bark prepared using methanol on diabetic rats induced with Streptozo­
tocin. The results obtained indicated that the extract had the ability of
decreasing the levels of glucose in blood [65]. Hypoglycemic and
hypocholesterolemic activities of the extract of C. fistula stem bark
prepared in hexane on diabetic rats induced with Streptozotocin were
investigated. Diabetic rats were administered with the hexane extract at
a dose of 0.45 g/kg body weight. The outcomes showed substantial
improvement in the groups treated with the C. fistula extract unlike the
control groups [66]. Jarald et al. [67] showed that the C. fistula extracts
and fractions evaluated on anti-diabetic properties showed significant
effects in decreasing the level of glucose in serum in addition to other
impairments associated with diabetes.
Daisy and Saipriya [68] prepared C. fistula extract in water and gold
nanoparticles synthesis and assessed the substances for their hypogly­
cemic properties. They observed that gold nanoparticles prepared in
extract of C. fistula possessed promising effects against diabetes. The
stem barks of Tamarindus indica as well as C. fistula were assessed for
anti-hyperglycemic properties in diabetic rats stimulated with alloxan
[69]. The results of that study indicated a significant drop in level of
glucose in the blood in the diabetic rats that had been treated [27].
4.10. Antipyretic potential
The extract of C. fistula buds prepared in methanol was assessed for
its antipyretic properties and effects on standard body temperature as
well as pyrexia (fever) induced using yeast on rats using the two
experimental groups. The two groups were given methanol extract at a
dosage of 200–400 mg/kg body weight [44]. At the level of 200 mg/kg
dosage, the methanolic extract triggered significant decrease in the
optimal temperature in the body for a period of 3 h. At a dose of
400 mg/kg, the extract triggered remarkable reduction in the normal
temperature in the body for a period of 6 h following administration. For
the experimental group of rats that were yeast-provoked to elevate the
body temperature, the C. fistula extract exhibited dose dependent
decrease of the temperature for a period of 4 h for the two doses [44].
The results from their study correlates those obtained using paraceta­
mol, the standard agent with antipyretic effects. In another study, Singh
et al. [70] assessed the antipyretic activities of C. fistula pods. Their
results established that pod extract prepared in methanol exhibited
antipyretic properties that were significantly higher compared to the
untreated groups.
4.11. Purgative potential
The leaves and pods of C. fistula have anthraquinone glycones in
addition to anthraquinone glycoside that act as a purgative and are
applied in diverse traditional medicine including TCM, Ayurveda among
others since time immemorial [9]. The purgative effect of the anthra­
quinone found in Cassia fistula occurs via two independent methods.
Firstly, one mechanism involves the changing of colonic motility
resulting to a faster large intestinal transportation [71]. Motility changes
arise indirectly because of high demand in the epithelial cells. The other
mechanism involves modification of the colonic absorption along with
secretion that led to accumulation of fluid leading to diarrhea [71].
Nikhat [72] examined the in-vitro effect of infusion of C. fistula on
the small intestine of some isolated guinea pigs. The critical along with
the sub-chronic toxicity of the extract of C. fistula pods and Senokot
tablet as the standard medicine were investigated. The effects of the
extract of C. fistula pods when compared to the reference drug, (Senokot
tablet) indicated that the C. fistula pods extract produced very low
7
Biomedicine & Pharmacotherapy 144 (2021) 112240
toxicity levels, with an LD50 of 6600 mg/kg. The LD50 as well did not
show any pathological or harmful effects on the tissues and organs
observed under a microscope [72].
4.12. Hypolipidemic potential
Jangir and Jain [27] investigated the effects of ethanoic extract of
pods of C. fistula at a concentration of 50% on metabolism of serum lipid
using rats fed with cholesterol. Their results revealed that administra­
tion of pod extract at a dosage of 100 mg/kg, 250 mg/kg and 500 mg/kg
body weight per day accompanied by cholesterol significantly barred
the uptake of the LDL-cholesterol and total serum, phospholipid and
triglycerides in a manner that was dose dependent [73].
4.13. Anti-leishmaniatic potential
The efficacy of the infusion of C. fistula to manage and treat leish­
maniosis using hydroalcoholic and concentrated aqueous extract of
C. fistula was compared with Glucantime injection on the intralesional
[74]. In total, 40%, which was 22 patients were administered with
concentrated C. fistula aqueous extract, 36.4%, representing 20 patients
were administered with hydroalcoholic C. fistula extract, and finally,
65.5%, representing 36 patients were given the reference agent Glu­
cantime [75]. The groups that were administered with Glucantime
showed complete healing, with significantly higher efficacy than the
group treated with concentrated aqueous extract at (P < 0.02) as well as
the second group treated with hydroalcoholic extract at (P < 0.005).
However, the results did not show any significant difference between the
effectiveness of C. fistula hydroalcoholic and concentrated aqueous ex­
tracts [13]. These results prove that C. fistula could be applied on
localized diseased areas together with Glucantime to reduce the dose
and treatment time when using Glucantime.
The efficacy of boiled extract of C. fistula to treat the cutaneous
leishmaniasis was evaluated along with the effectiveness of meglumine
antimonate on the intralesional combined with the fruit gel of C. fistula
to treat the cutaneous leishmaniosis [76]. The study had a sample of 140
patients suffering from cutaneous leishmaniosis. One group was treated
with and injection of meglumine antimonate combined with the fruit gel
of C. fistula on the intralesional region, while the other group acting as
control, received an injection of meglumine antimonate combined with
placebo gel on intralesional region [13].
Effects of the different treatments were defined as being complete
healing, partial healing, and failure of cure. On the 12th week, 67.1%,
representing 47 patients in the first group treated with the C. fistula fruit
gel showed complete healing, in comparison with to 41.4% representing
29 patients on the group that received placebo gel (control) at
(P < 0.001) [65]. These results indicate that the fruit gel of C. fistula
improves the effectiveness of meglumine antimonate on the intrale­
sional for treating the cutaneous leishmaniosis. Therefore, a combined
therapy of fruit gel of C. fistula along with intralesional meglumine
antimonate is recommended for treating the severe cutaneous leishma­
niosis [13].
4.14. Larvicidal and ovicidal potential
Mosquitoes are the leading agents in the diseases spread by vectors
including encephalitis and filariasis, yellow fever and malaria among
other diseases caused by viruses [77]. The synthetic formulations for
instance, insecticides and mosquito coils cause harmful effects on
human and environmental health in addition to developing resistance
on the mosquitoes [68,69]. Various plants species and/or their compo­
nents play insecticidal roles as well as killing or inhibiting the mosquito
growth in addition to being nontoxic and economical. Various studies
reported the efficacy of various plant oils and extracts on larvae of
mosquitoes [78]. The plant species included Mentha piperita Cymbopogan
citrates and Pelargonium citrosa and their extracts exhibited inhibitory
R.W. Mwangi et al.
and larvicidal properties against Anopheles stephensi growth [79].
Kovendan et al. [80] carried out a study to assess the C. fistula leaf
extract prepared in methanol for larvicidal and ovicidal potential
against Anopheles stephensi and Culex quinquefasciatus. The results
showed that the C. fistula extract is promising for larvicidal and ovicidal
agents to eliminate A. stephensi and C. quinquefasciatus insects. Another
research evaluated the larvicidal effectiveness of various flower extracts
against Anopheles subpictus, Aedes albopictus and Culex tritaeniorhynchus
and from the findings, it was determined that the flower crude extracts
would form an excellent agent to control A. subpictus A. albopictus and
C. tritaeniorhynchus larvae of mosquitoes [80]. The efficacy of meth­
anolic leaf extract of C. fistula was assessed on Anopheles mosquito and
the findings confirmed that these extracts possessed promising mos­
quitocidal effectiveness on A. stephensi [81].
5. Conclusion
Before the modern medicines were introduced, herbal remedies
exclusively managed treatment and management of various diseases. It
is projected that roughly 80% of the population around the globe who
reside in the extensive rural areas in the underdeveloped and developing
nations still depend largely on medicinal plant species and their prod­
ucts. Cassia fistula is a medicinal plant traditionally used largely in India
and other nations and has colossal potential for wound healing, anti­
oxidant and hepatoprotective properties. The plant species is extensively
used in medicinal systems around the world and various studies have
reported that the plant species contain anti-inflammatory, hep­
atoprotective, antitussive, antibacterial, antifungal properties and
similarly used for healing of wounds. It is clearly known as an excellent
source of glycosides, tannins, and flavonoids, which might be medically
imperative or/and nutritionally valuable. From literature described
above, it is established that C. fistula possess different therapeutic
properties which can be manipulated particularly in the treatment of
gastrointestinal illnesses. Many investigations confirm that C. fistula is a
valuable herbal plant for managing hepatic conditions and demonstrates
other medical properties. From various studies, extracts of C. fistula have
therapeutic active ingredients. However, more studies should be carried
out to sufficiently assess the potential efficacy of the different extracts
derived from C. fistula. The information in this article provides a basis
upon which selection of specific plant species to investigate the pro­
spective discovery of novel natural bioactive compounds can be based
on.
Funding
This research did not receive any specific grant from funding
agencies in the public, commercial, or not-for-profit sectors.
Conflict of interest statement
The authors declare that there are no conflicts of interest.
References
[1] A. Mondal, Phenolic constituents and traditional uses of Cassia (Fabaceae) plants:
an update, J. Org. Biomol. Chem. 3 (2014) 93–141 (Accessed 10 September 2021).
[Online]. Available, 〈https://docplayer.net/92001323-Phenolic-constituents-an
d-traditional-uses-of-cassia-fabaceae-plants-an-update.html〉.
[2] R. Ploeger, A. Shugar, The story of Indian yellow – excreting a solution, J. Cult.
Herit. 24 (2017) 197–205, https://doi.org/10.1016/j.culher.2016.12.001.
[3] M.A. Nagpal, N. Nagpal, S. Rahar, G. Shah, G. Swami, R. Kapoor, Phytochemical
investigation of methanolic extract of Cassia fistula leaves, Pharmacogn. J. 3 (26)
(2011) 61–69, https://doi.org/10.5530/pj.2011.26.11.
[4] H.A. Jung, M.Y. Ali, J.S. Choi, Promising inhibitory effects of anthraquinones,
naphthopyrone, and naphthalene glycosides, from Cassia obtusifolia on
α-glucosidase and human protein tyrosine phosphatases 1B, Molecules 22 (1)
(2017) 28–43, https://doi.org/10.3390/molecules22010028.
[5] A.V. Pawar, S.J. Patil, S.G. Killedar, Uses of Cassia fistula Linn as a medicinal plant,
Int. J. Adv. Res. Dev. 2 (3) (2017) 85–91 ([Online]. Available), 〈www.ijarnd.com〉.
8
Biomedicine & Pharmacotherapy 144 (2021) 112240
[6] S. Hafez, S. Othman, H. Ibrahim, A. Seida, N. Ayoub, Chemical constituents and
biological activities of Cassia genus: review, Arch. Pharm. Sci. Ain Shams Univ. 3
(2) (2019) 195–227, https://doi.org/10.21608/aps.2019.15746.1008.
[7] C. Yücedağ, N. Bilir, H.B. Özel, Phytohormone effect on seedling quality in
Hungarian oak, For. Syst. 28 (2) (2019) 1–8, https://doi.org/10.5424/fs/2019282-
14604.
[8] M. Saeed, S. Naseer, S. Hussain, M. Iqbal, Phytochemical composition and
pharmacological effects of Cassia fistula, Sci. Inq. Rev. 4 (1) (2020) 59–69, https://
doi.org/10.32350/sir.41.05.
[9] M. Ashraf Ali, Cassia fistula Linn: a review of phytochemical and pharmacological
studies, Int. J. Pharm. Sci. Res. 5 (6) (2014) 2125, https://doi.org/10.13040/
IJPSR.0975-8232.5(6).2125-30.
[10] K. Gobianand, P. Vivekanandan, K. Pradeep, C.V.R. Mohan, S. Karthikeyan, Anti-
inflammatory and antipyretic activities of Indian medicinal plant Cassia fistula
Linn. (Golden Shower) in Wistar Albino rats, Int. J. Pharmacol. 6 (5) (2010)
719–725, https://doi.org/10.3923/ijp.2010.719.725.
[11] E.M. Malik, C.E. Müller, Anthraquinones as pharmacological tools and drugs, Med.
Res. Rev. 36 (4) (2016) 705–748, https://doi.org/10.1002/med.21391.
[12] P. Chandra, R. Pandey, B. Kumar, M. Srivastva, P. Pandey, J. Sarkar, B.P. Singh,
Quantification of multianalyte by UPLC-QqQLIT-MS/MS and in-vitro anti-
proliferative screening in Cassia species, Ind. Crop. Prod. 76 (2015) 1133–1141,
https://doi.org/10.1016/j.indcrop.2015.08.030.
[13] A.H. Rahmani, Cassia fistula Linn: potential candidate in the health management,
Pharmacogn. Res. 7 (3) (2015) 217–224, https://doi.org/10.4103/0974-
8490.157956.
[14] T. Bahorun, V.S. Neergheen, O.I. Aruoma, Phytochemical constituents of Cassia
fistula, Afr. J. Biotechnol. 4 (13) (2005) 1530–1540, https://doi.org/10.4314/
ajfand.v4i13.71772.
[15] G.C.G. Martínez-ávila, C. Castro-lópez, R. Rojas, G.C.G. Martínez, Science
screening of the Cassia fistula phytochemical constituents, Ann. Nutr. Food 2 (2)
(2018) 1–3 (Accessed 11 September 2021). [Online]. Available, 〈http://clinicsinon
cology.com/〉.
[16] P. Chandra, R. Pandey, B. Kumar, M. Srivastva, P. Pandey, J. Sarkar, B.P. Singh,
Are anthranoid laxatives effective in chronic constipation? Nutrafoods 11 (4)
(2012) 131–136, https://doi.org/10.1007/s13749-012-0052-9.
[17] G. Nusko, B. Schneider, I. Schneider, C. Wittekind, E.G. Hahn, Anthranoid laxative
use is not a risk factor for colorectal neoplasia: results of a prospective case control
study, Gut 46 (5) (2000) 651–655, https://doi.org/10.1136/gut.46.5.651.
[18] P. Siddhuraju, P.S. Mohan, K. Becker, Studies on the antioxidant activity of Indian
Laburnum (Cassia fistula L.): a preliminary assessment of crude extracts from stem
bark, leaves, flowers and fruit pulp, Food Chem. 79 (1) (2002) 61–67, https://doi.
org/10.1016/S0308-8146(02)00179-6.
[19] A. Kulkarni, M. Govindappa, C. Cp, Y.L. Ramachandra, P.S. Koka, Phytochemical
analysis of Cassia fistula and its in vitro antimicrobial, antioxidant activities, Adv.
Med. Plant Res. 3 (2015) 8–17.
[20] M.M. Vaishnav, K.R. Gupta, Rhamnetin 3-O-gentiobioside from Cassia fistula roots,
Fitoterapia 67 (1) (1996) 78–79 (Accessed 10 September 2021). [Online].
Available, 〈https://www.cabdirect.org/cabdirect/abstract/19960305043〉.
[21] H. Deshpande, S. Bhalsing, Recent advances in the phytochemistry of some
medicinally important Cassia species: a review, Int. J. Pharma Med. Biol. Sci. 2 (3)
(2013) 60–78.
[22] A. Sakulpanich, S. Chewchinda, P. Sithisarn, W. Gritsanapan, Standardization and
toxicity evaluation of Cassia fistula pod pulp extract for alternative source of herbal
laxative drug, Pharmacogn. J. 4 (28) (2012) 6–12, https://doi.org/10.5530/
pj.2012.28.2.
[23] T. da Costa Silva, Chemical composition, antioxidant activity and inhibitory
capacity of α-amylase, α-glucosidase, lipase and non-enzymatic glycation, Ind.
Crop. Prod. 140 (2019), 111641, https://doi.org/10.1016/j.indcrop.2019.111641.
[24] S. Thabit, H. Handoussa, M. Roxo, N.S. El Sayed, B.C. de Azevedo, M. Wink,
Evaluation of antioxidant and neuroprotective activities of Cassia fistula (L.) using
the Caenorhabditis elegans model, PeerJ 7 (2018) (2018) 1–33, https://doi.org/
10.7717/peerj.5159.
[25] J.W. Einstein, M. Mohd Rais, M.A. Mohd, Comparative evaluation of the
antidiabetic effects of different parts of Cassia fistula Linn, a southeast asian plant,
J. Chem. 2013 (2013) 1–10, https://doi.org/10.1155/2013/714063.
[26] Y. Seo, J.S. Song, Y.M. Kim, Y.P. Jang, Toralactone glycoside in Cassia obtusifolia
mediates hepatoprotection via an Nrf2-dependent anti-oxidative mechanism, Food
Res. Int. 97 (2017) 340–346, https://doi.org/10.1016/j.foodres.2017.04.032.
[27] R. Jangir, G. Jain, Evaluation of protective effects of hydroalcoholic extract of
Cassia fistula Linn. Pod on pancreas in streptozotocin-induced diabetic rats,
Pharmacogn. Res. 10 (2) (2018) 205–212, https://doi.org/10.4103/pr.pr_95_17.
[28] N. Bhalodia, P. Nariya, V. Shukla, R. Acharya, In vitro antioxidant activity of hydro
alcoholic extract from the fruit pulp of Cassia fistula Linn, AYU 34 (2) (2013)
209–214, https://doi.org/10.4103/0974-8520.119684.
[29] M. Srividhya, H. Hridya, V. Shanthi, K. Ramanathan, Bioactive amento flavone
isolated from Cassia fistula L. leaves exhibits therapeutic efficacy, Biotech 7 (1)
(2017) 1–5, https://doi.org/10.1007/s13205-017-0599-7.
[30] N. Zlatić, M. Stanković, Anticholinesterase, Antidiabetic and Anti-Inflammatory
Activity of Secondary Metabolites of Teucrium Species, in Teucrium Species: Biology
and Applications, Springer, Cham, 2020, pp. 391–411.
[31] P. Antonisamy, P. Agastian, C.W. Kang, N.S. Kim, J.H. Kim, Anti-inflammatory
activity of rhein isolated from the flowers of Cassia fistula L. and possible
underlying mechanisms, Saudi J. Biol. Sci. 26 (1) (2019) 96–104, https://doi.org/
10.1016/j.sjbs.2017.04.011.
[32] M.A. Aziz, Qualitative phytochemical screening and evaluation of anti-
inflammatory, analgesic and antipyretic activities of Microcos paniculata barks and
R.W. Mwangi et al.
fruits, J. Integr. Med. 13 (3) (2015) 173–184, https://doi.org/10.1016/S2095-
4964(15)60179-0.
[33] K. Yoshino, N. Higashi, Anti-inflammatory and antioxidant activities, Group 2 (2)
(2005) 70–85.
[34] N. Bhalodia, R. Acharya, P. Nariya, V. Shukla, In vitro antibacterial and antifungal
activities of Cassia fistula Linn. fruit pulp extracts, AYU (Int. Q. J. Res. Ayurveda)
33 (1) (2012) 123–130, https://doi.org/10.4103/0974-8520.100329.
[35] M. Rajput, N. Kumar, Medicinal plants: a potential source of novel bioactive
compounds showing antimicrobial efficacy against pathogens infecting hair and
scalp, Gene Rep. 21 (2020), 100879, https://doi.org/10.1016/j.
genrep.2020.100879.
[36] N.R. Bhalodia, P.B. Nariya, V.J. Shukla, Antibacterial and antifungal activity from
flower extracts of Cassia fistula L.: an ethnomedicinal plant, Int. J. PharmTech Res.
3 (1) (2011) 160–168, https://doi.org/10.4103/2231-4040.82956.
[37] D. Hada, K. Sharma, Isolation and characterization of chemical compounds from
fruit pulp of Cassia fistula and their antimicrobial activity, J. Drug Deliv. Ther. 8 (2)
(2018) 15–20, https://doi.org/10.22270/jddt.v8i2.1664.
[38] P. Sony, M. Kalyani, D. Jeyakumari, I. Kannan, R.G. Sukumar, In vitro antifungal
activity of Cassia fistula extracts against fluconazole resistant strains of Candida
species from HIV patients, J. Mycol. Med. 28 (1) (2018) 193–200, https://doi.org/
10.1016/j.mycmed.2017.07.010.
[39] I. Arulpandi, R. Sangeetha, Antibacterial activity of fistulin: a protease inhibitor
purified from the leaves of Cassia fistula, ISRN Pharm. 2012 (2012) 1–4, https://
doi.org/10.5402/2012/584073.
[40] S.M. Seyyednejad, H. Motamedi, M. Vafei, A. Bakhtiari, The antibacterial activity
of Cassia fistula organic extracts, J. Microbiol. 7 (1) (2014) 1–5, https://doi.org/
10.5812/jjm.8921.
[41] M.A. Ali, M.A. Sayeed, N. Absar, Purification and characterization of three lectins
extracted from Cassia fistula seeds and effect of various physical and chemical
agents on their stability, J. Chin. Chem. Soc. 51 (3) (2004) 647–654, https://doi.
org/10.1002/jccs.200400097.
[42] B.S. Cavada, V.R. Pinto-Junior, V. Osterne, M.V. Oliveira, C.F. Lossio, M. Silva, A.
U. Bari, L.D. Lima, C. Souza-Filho, K.S. Nascimento, Comprehensive review on
Caelsalpinioideae lectins: from purification to biological activities, Int. J. Biol.
Macromol. 162 (2020) 333–348, https://doi.org/10.1016/j.ijbiomac.2020.06.161.
[43] P. Sundararaju, V. Saritha, Effect of leaf extracts of Acalypha indica, Cassia fistula
and Solanum torvum on Pratylenchus coffeae, Indian J. Nematol. 36 (1) (2006)
144–145 (Accessed 10 August 2021). [Online]. Available, 〈https://krishi.icar.gov.
in/jspui/handle/123456789/2494〉.
[44] S. Kainsa, P. Kumar, Pharmacological potentials of Cassia auriculata and Cassia
fistula plants: a review, Pak. J. Biol. Sci. PJBS 15 (9) (2012) 408–417, https://doi.
org/10.3923/PJBS.2012.408.417.
[45] G. Minerva, K. Surinder, T. Manisha, In vitro propagation and assessment of plant
genetic fidelity by RAPD and SSR markers in Gerbera (Gerbera jamesonii), Res. J.
Biotechnol. 7 (4) (2012) 53–57 (Accessed 10 September 2021). [Online].
Available, 〈www.shankargargh.net〉.
[46] Y.B. Park, S.B. Kim, Isolation and identification of antitumor promoters from the
seeds of Cassia tora, J. Microbiol. Biotechnol. 21 (10) (2011) 1043–1048, https://
doi.org/10.4014/jmb.1103.03040.
[47] M. Gupta, U.K. Mazumder, N. Rath, D.K. Mukhopadhyay, Antitumor activity of
methanolic extract of Cassia fistula L. seed against Ehrlich ascites carcinoma,
J. Ethnopharmacol. 72 (1–2) (2000) 151–156, https://doi.org/10.1016/S0378-
8741(00)00227-0.
[48] V. Duraipandiyan, A.A. Baskar, S. Ignacimuthu, C. Muthukumar, N.A. Al-Harbi,
Anticancer activity of Rhein isolated from Cassia fistula L. flower, Asian Pac. J.
Trop. Dis. 2 (1) (2012) S517–S523, https://doi.org/10.1016/S2222-1808(12)
60213-8.
[49] G. Aviello, I. Rowland, C.I. Gill, A.M. Acquaviva, F. Capasso, M. McCann,
R. Capasso, A.A. Izzo, F. Borrelli, Anti-proliferative effect of rhein, an
anthraquinone isolated from Cassia species, on Caco-2 human adenocarcinoma
cells, J. Cell. Mol. Med. 14 (7) (2010) 2006–2014, https://doi.org/10.1111/j.1582-
4934.2009.00815.x.
[50] S. Nataru, Y. Pulicherla, B. Gaddala, A review on medicinal plants as a potential
source for cancer, Int. J. Pharm. Sci. Rev. Res. 26 (1) (2014) 235–248.
[51] M. Liu, P. Lv, R. Liao, Y. Zhao, B. Yang, Synthesis, characterization and biological
activity of Rhein-cyclodextrin conjugate, J. Mol. Struct. 1128 (2017) 239–244,
https://doi.org/10.1016/j.molstruc.2016.08.047.
[52] M. Senthil Kumar, R. Sripriya, H. Vijaya Raghavan, P.K. Sehgal, Wound healing
potential of Cassia fistula on infected albino rat model, J. Surg. Res. 131 (2) (2006)
283–289, https://doi.org/10.1016/j.jss.2005.08.025.
[53] M. Sheeba, S. Emmanuel, K. Revathi, S. Ignacimuthu, Wound healing activity of
Cassia occidentalis L. in albino Wistar rats, Int. J. Integr. Biol. 8 (1) (2009) 1–6
(Accessed 10 July 2021). [Online]. Available, 〈https://www.cabdirect.org/cabdire
ct/abstract/20103084168〉.
[54] S. Ahmad, A. Hassan, W.M. Abbasi, T. Rehman, Phytochemistry and
pharmacological potential of Cassia absus – a review, J. Pharm. Pharmacol. 70 (1)
(2018) 27–41, https://doi.org/10.1111/jphp.12816.
[55] L. Rotundo, N. Pyrsopoulos, Liver injury induced by paracetamol and challenges
associated with intentional and unintentional use, World J. Hepatol. 12 (4) (2020)
125–136, https://doi.org/10.4254/wjh.v12.i4.125.
[56] G. Addolorato, G.A. Vassallo, A. Mirijello, A. Gasbarrini, Diagnosis and
management of alcohol use disorder in patients with liver disease: lights and
shadows, Neurotherapeutics 17 (1) (2020) 127–141, https://doi.org/10.1007/
s13311-019-00802-8.
Biomedicine & Pharmacotherapy 144 (2021) 112240
[57] D. Singh, W.C. Cho, G. Upadhyay, Drug-induced liver toxicity and prevention by
herbal antioxidants: an overview, Front. Physiol. 6 (JA) (2016) 363, https://doi.
org/10.3389/fphys.2015.00363.
[58] P. Paudel, H.A. Jung, J.S. Choi, Anthraquinone and naphthopyrone glycosides from
Cassia obtusifolia seeds mediate hepatoprotection via Nrf2-mediated HO-1
activation and MAPK modulation, Arch. Pharm. Res. 41 (6) (2018) 677–689,
https://doi.org/10.1007/s12272-018-1040-4.
[59] M.Y. Ali, S. Jannat, H.A. Jung, B.S. Min, P. Paudel, J.S. Choi, Hepatoprotective
effect of Cassia obtusifolia seed extract and constituents against oxidative damage
induced by tert-butyl hydroperoxide in human hepatic HepG2 cells, J. Food
Biochem. 42 (1) (2018) 1–12, https://doi.org/10.1111/jfbc.12439.
[60] G. Parthasarathy, V.V. Prasanth, Hepatoprotective activity of Cassia fistula Linn.
Bark extracts against carbon tetra chloride induced liver toxicity in rats, Internet J.
Pharmacol. 6 (2) (2009) 67–70, https://doi.org/10.5580/28f1.
[61] K. Pradeep, C. Victor Raj Mohan, K. Gobi Anand, S. Karthikeyan, Effect of
pretreatment of Cassia fistula Linn. leaf extract against subacute CCl4 induced
hepatotoxicity in rats, Indian J. Exp. Biol. 43 (6) (2005) 526–530.
[62] M.M. Qaid, M.M. Abdelrahman, Role of insulin and other related hormones in
energy metabolism—a review, Cogent Food Agric. 2 (1) (2016) 1–18, https://doi.
org/10.1080/23311932.2016.1267691.
[63] S.Y. Rhee, The role of the kidney in glucose metabolism, J. Korean Diabetes 15
(2014) 142–145, https://doi.org/10.4093/jkd.2014.15.3.142.
[64] R. Ahmed, Y. Iqbal, Evaluation of knowledge, attitude and awareness about
diabetic foot associated complications in Karachi, J. Toxicol. Pharm. Sci. 1 (2)
(2017) 85–90 ([Online]. Available), 〈http://www.jtps.com.pk〉.
[65] P. Daisy, K. Balasubramanian, M. Rajalakshmi, J. Eliza, J. Selvaraj, Insulin mimetic
impact of Catechin isolated from Cassia fistula on the glucose oxidation and
molecular mechanisms of glucose uptake on streptozotocin-induced diabetic
Wistar rats, Phytomedicine 17 (1) (2010) 28–36, https://doi.org/10.1016/j.
phymed.2009.10.018.
[66] D. Pitchai, R. Manikkam, Hypoglycemic and insulin mimetic impact of catechin
isolated from Cassia fistula: a substantiate in silico approach through docking
analysis, Med. Chem. Res. 21 (9) (2012) 2238–2250, https://doi.org/10.1007/
s00044-011-9722-1.
[67] E.E. Jarald, S.B. Joshi, D.C. Jain, S. Edwin, Biochemical evaluation of the
hypoglycemic effects of extract and fraction of Cassia fistula Linn. in alloxan-
induced diabetic rats, Indian J. Pharm. Sci. 75 (4) (2013) 427–434, https://doi.
org/10.4103/0250-474X.119823.
[68] P. Daisy, K. Saipriya, Biochemical analysis of Cassia fistula aqueous extract and
phytochemically synthesized gold nanoparticles as hypoglycemic treatment for
diabetes mellitus, Int. J. Nanomed. 7 (2012) 1189–1202, https://doi.org/10.2147/
IJN.S26650.
[69] A. Agnihotri, V. Singh, Effect of Tamarindus indica Linn. and Cassia fistula Linn.
stem bark extracts on oxidative stress and diabetic conditions, Acta Pol. Pharm.
Drug Res. 70 (6) (2013) 1011–1019.
[70] A. Singh, M.P. Singh, G. Alam, R. Patel, N. Datt, Antipyretic activity of Cassia fistula
Linn. pods, J. Nat. Prod. Plant Resour. 2 (3) (2012) 385–388 ([Online]. Available),
〈http://scholarsresearchlibrary.com/JNPPR-vol2-iss3/JNPPR-2012-2-3-385-388.
pdf〉.
[71] W. Gritsanapan, Ethnomedicinal plants popularly used in Thailand as laxative
drugs. Ethnomedicine: A Source of Complementary Therapeutics 2nd, 661, 2010,
p. 332 340.
[72] F. Nikhat, Meticulous endorsement of Cassia fistula Linn, Asian J. Res. Chem. 12 (3)
(2019) 169–176, https://doi.org/10.5958/0974-4150.2019.00034.8.
[73] R. Abid, R. Mahmood, H.S. Santosh Kumar, Hypolipidemic and antioxidant effects
of ethanol extract of Cassia fistula fruit in hyperlipidemic mice, Pharm. Biol. 54
(12) (2016) 2822–2829, https://doi.org/10.1080/13880209.2016.1185445.
[74] S.A. Bhalerao, T.S. Kelkar, Traditional medicinal uses, phytochemical profile and
pharmacological activities of Cassia fistula Linn, Int. Res. J. Biol. Sci. 1 (5) (2012)
2278–3202 (Accessed 11 June 2021). [Online]. Available, 〈www.isca.in〉.
[75] S. Tabrez, F. Rahman, R. Ali, A.S. Alouffi, B.M. Alshehri, F.A. Alshammari, M.
A. Alaidarous, S. Banawas, A.A. Dukhyil, A. Rub, Assessment of the antileishmanial
potential of Cassia fistula leaf extract, ACS Omega 6 (3) (2021) 2318–2327, https://
doi.org/10.1021/acsomega.0c05629.
[76] F. Jaffary, M.A. Nilforoushzadeh, S. Moradi, R. Derakhshan, N. Ansari,
Concentrated extracts of Cassia fistula versus intralesional injection of meglumine
antimoniate in treatment of acute Cutaneous leishmaniasis, J. Skin Stem Cell 1 (1)
(2014) 1–4, https://doi.org/10.17795/jssc16631.
[77] T. Ahmed, M.Z. Hyder, I. Liaqat, M. Scholz, Climatic conditions: conventional and
nanotechnology-based methods for the control of mosquito vectors causing human
health issues, Int. J. Environ. Res. Public Health 16 (17) (2019) 1–25, https://doi.
org/10.3390/ijerph16173165.
[78] T.K. Lim. Cassia fistula, in Edible Medicinal and Non-Medicinal Plants, Springer,
Dordrecht, 2012, pp. 577–592.
[79] A. Bukar, Z. Tukur, Plant extracts as a source of bio-insecticide for mosquito
control, review, Int. J. Mosq. Res. 6 (6) (2019) 81–84.
[80] K. Kovendan, K. Murugan, S. Vincent, Evaluation of larvicidal activity of Acalypha
alnifolia Klein ex Willd. (Euphorbiaceae) leaf extract against the malarial vector,
Anopheles stephensi, dengue vector, Aedes aegypti and Bancroftian filariasis vector,
Culex quinquefasciatus (Diptera: Culicid), Parasitol. Res. 110 (2) (2012) 571–581,
https://doi.org/10.1007/s00436-011-2525-y.
[81] C. Panneerselvam, K. Murugan, Adulticidal, repellent, and ovicidal properties of
indigenous plant extracts against the malarial vector, Anopheles stephensi
(Diptera: Culicidae), Parasitol. Res. 112 (2) (2013) 679–692, https://doi.org/
10.1007/s00436-012-3185-2.