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Advances in Applied Science Research, 2016, 7(3):1-12
ISSN: 0976-8610
CODEN (USA): AASRFC
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Recent advances in pharmacological potential of Syzygium cumini:
A review
Deepti Katiyar
1*
, Vijender Singh
2
and Mohd. Ali
3
1
Department of Pharmacognosy, KIET School of Pharmacy, Ghaziabad, UP, India
2
Department of Pharmacognosy, BBS Institute of Pharmacy, Greater Noida, UP, India
3
Department of Pharmacognosy and Phytochemistry, Faculty of Pharmacy, Jamia Hamdard,
New Delhi, India
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ABSTRACT
Syzygium cumini (Linn.) Skeels. (Myrtaceae) (Synonym. Eugenia jambolana), commonly known
as Jamun or Black Plum is indigenous to India. The plant has traditionally been used for its rich
nutrition and medicinal value. The current review focuses on the recent research investigations
involving the studies on diverse pharmacological actions of Jamun. The electronic database
search was performed in order to achieve this aim. Jamun plant has been reported to be
enriched with an array of phytoconstituents like ellagic acid, glucoside, anthocyanins,
kaempferol, isoquercetin, myrecetin and so on. The seeds which are mostly utilized for their
medicinal value are said to contain an alkaloid- jambosine and glycoside-jambolin or antimellin
which inhibit the conversion of starch to sugar. Different plant parts have been claimed to
contain different constituents, due to which they possess an assorted pharmacological
prospective. Jamun has been used for the treatment of diabetes since ages. Apart from this it has
also shown its beneficial potential as anti-allergic, antibacterial, anticancer, anticlastogenic,
anti-diarrhoeal, anti-fertility, anti-fungal, anti-hyperlipidemic, anti-hypertensive, anti-
inflammatory, anti-lieshmanial, anti-nociceptive, anti-oxidant, anti-viral, ascaricidal,
cardioprotective, chemoprotective, diuretic, gastroprotective, hepatoprotective, hypothermic,
neuropsychopharmacological and radioprotective agent. These actions and the lacunas in the
specific areas have been discussed in this article. This will provide a platform for the future
researchers especially in the less explored areas.
Keywords: Syzygium cumini, Pharmacological activity, Anti-diabetic
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INTRODUCTION
Syzygium cumini (S. cumini) (L.) Skeels (family: Myrtaceae), synonyms- Syzygium jambolana
DC., Eugenia cumini (Linn.) Druce., Syzygium jambolanum (Lam.) DC., Myrtus cumini Linn.,
Eugenia djouant Perr., Eugenia caryophyllifolia Lam., Calyptranthes jambolana Willd.,
commonly known as Black Plum in English, Jamun in Hindi, Jambu in Sanskrit and Jaman in
Urdu is a large evergreen tree indigenous to India, though Syzygium cumini (SC) trees are found
throughout the Asian subcontinent, South America, Eastern Africa, Madagascar and so on [1].
Different plant parts have been reported to contain a variety of components. The fruit pulp
contains Vitamin A & C, nicotinic acid, riboflavin, folic acid, maleic acid, choline, sugar, amino
acid, K, Ca, Na, P, Fe, Mn, Zn. Gallic acid is said to be responsible for the sourness of the fruit
while anthocyanins for the colour. The leaves are enriched with acylated flavonol glycosides,
myricetin, myricitin, quercetin, galloyl carboxylase, esterase and tannins. The flowers are rich in
quercetin, kaempferol, myricetin, oleanolic acid, quercetin-3-D-galactoside, eugenol-triterpenoid
A & B. The roots contain flavonoid glycosides and isorhamnetin 3-O-rutinoside. The stem bark
has betulinic acid, β-sitosterol, quercetin, kaempferol, ellagic acid, gallic acid, myrecetin etc. The
seeds contain glycoside jambolin, gallic acid, essential oils and so on [2]. The various parts of
the tree have been used traditionally for the treatment of various human ailments. SC find its
place in numerous traditional systems of medicine like Ayurveda, Siddha, Unani and
Homeopathic systems of medicine. It was one of the best remedy for diabetes before the
discovery of insulin [3]. As per Ayurveda, the barks of SC possess astringent, acrid, digestive
and wound healing properties. They are beneficial for the treatment of biliousness, dysentery,
sore throat, bronchitis, thirst, asthma and ulcers. According to Siddha system of medicine, it
supposed to be semen promoting, haematinic and hypothermic. Unani System of medicine
characterizes it to be a tonic for liver, to enrich blood, reinforce teeth and gums [4].
PHARMACOLOGICAL ACTIONS OF SYZYGIUM CUMINI
1.Anti-allergic
Allergy is an abnormal reaction of the body to the allergen introduced by ingestion, injection,
inhalation or skin contact. A novel, safe and effective remedy is required for this ailment. In an
investigation, the aqueous extract of SC leaves (25-100mg/kg, p.o.) inhibited the rat paw edema
induced by 48/80 (allergenic compound), histamine and 5-HT. However, the extract could not
produce any beneficial effects against the platelet aggregating factor-induced paw edema [5].
2.Antibacterial
Now a days, people have started using antibiotics as OTC (Over The Counter) drugs which has
led to antibiotic resistance, thus safer novel antibacterial agents are required. In case of SC, its
stem, leaf and fruit extracts were found to be effective against all the bacterial strains used in the
study. Best results were observed against Roultella plantikola (zone of inhibition-25 mm) [6].
Microbroth dilution and Agar well diffusion assays were utilized to study the antibacterial effects
of SC seeds against multidrug-resistant human bacterial pathogens and it was found that the ethyl
acetate fraction from the ethanol extract was most effective. Then, the ethyl acetate fraction was
subjected to phytochemical analysis and TLC-bioautography which exhibited the phenolics to be
the main component responsible for the activity [7].
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Ethyl acetate, petroleum ether and methanolic extracts of the SC leaf were found to be effective
against Salmonella typhimurium, Bacillus subtilis, Pseudomonas aeruginosa, Staphylococcus
aureus and Enterobacter aerogenes [8].
Acetone, aqueous and ethanolic bark extracts were evaluated for their antibacterial effects
against twelve strains of Vibrio cholera, of which the ethanolic extract was found to be most
effective [9].
Aqueous leaf extract of SC has shown beneficial effects against Klebsiella sp., Salmonella
paratyphi A & B, Citrobacter sp., Proteus mirabilis, Escherichia coli, Staphylococcus aureus,
Shigella sonnei, Pseudomonas aeruginosa, Salmonella typhimurium, Shigella boydii,
Streptococcus faecalis, Shigella flexneri and Salmonella typhi [10].
3.Anti-cancer
Various treatment strategies for cancer involve surgery, hormonal therapy, chemotherapy,
radiation therapy and targeted therapy (e.g. monoclonal antibody therapy and immunotherapy).
Apart from killing cancerous cells, some normal, healthy cells may be destroyed and may affect
many vital organs such as kidney, heart, lungs, nervous system etc. Many herbal anti-cancer
drugs are being used to avoid the unwanted side effects.
Ellagitannins isolated from SC have shown to inhibit Wnt signaling in a transfected human 293T
cell line [11].
A few of the current investigations have proved the selective cytotoxic activity of jamun fruit
extract after studying its pro-apoptotic and antiproliferative effects on estrogen independent
(MDA-MB-231) breast cancer cells, estrogen dependent/aromatase positive (MCF-7aro)and
normal/nontumorigenic (MCF-10A) breast cell line [12] [1].
Anti-cancer effects of 40% SC extract have been studied on human cervical cancer cells (11.8%
growth inhibition observed in SiHa (HPV-16 positive) cells and 14.4% in HeLa (HPV-18
positive) cells) [13].
4.Anticlastogenic
Anticlastogenic agent is one which protects the disruption or breakages of chromosomes. SC
extract has exhibited its utility in mutagenesis prevention and carcinogenesis initiation. The
alcoholic seed extract decreased the hydroxyl radical induced strand breaks in pBR322 DNA in
vitro and the aqueous extract was found to reduce the chromosomal aberrations in mice (induced
by DBMA and urethane) [14].
5.Anti-diabetic
Various preclinical and clinical studies have been performed to evaluate the anti-diabetic
potential of SC [15].
Numerous investigations performed in the past have indicated that SC seeds [16] [17] [18] [19]
[20] [21], fruit pulp [22] [23] [24], whole fruit [25] [26], bark [27] [28], leaves [29] and flowers
[30] possess anti-diabetic activity.
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Mycaminose (50 mg/kg) - a compound isolated form SC seeds and ethyl acetate & methanol
fraction at the doses of 200 and 400 mg/kg showed a significant (p<0.05) decrease in blood
glucose level when evaluated for the anti-diabetic activity in streptozotocin (STZ)-induced
diabetes in rats [31].
The aqueous and alcoholic SC extracts were evaluated for their anti-diabetic potential in alloxan
induced diabetic rabbits. It was found that the aqueous extract was more effective in improving
blood glucose in glucose tolerance test and in decreasing fasting blood glucose [24].
Numerous studies have been performed to show the beneficial effects of SC extract in
normalizing the elevated lipid profiles of diabetic rats [16] [22] [32], elevating the serum insulin
[16] [32] and increasing SOD and GPx activities [16]. The SC seeds possess protective effect
against diabetes related complications like neuropathy [33], gastropathy [33], nephropathy [33],
diabetic cataract [34] and also reduced peptic ulceration [35].
SC possesses the potential to inhibit the carbohydrate hydrolyzing enzymes [36]. A polyherbal
formulation (ADJ6) containing SC and some other antidiabetic herbs have shown a significant
inhibitory action against α-glucosidase and α-amylase [37]. SC seeds have shown the pancreatic
islet cells regeneration potential in streptozotocin [38] and alloxan [39] diabetic rats.
Various clinical studies have been performed to validate the use of SC in diabetes [40] [26]. In a
recent open labeled randomized parallel designed controlled study, Type II diabetic individuals
were administered the standardized SC seed powder which exhibited a reduction in fasting blood
sugar, insulin resistance and elevation in HDL cholesterol at the end of 3rd month [41].
6.Anti-diarrheal
Natural products are a drug of choice for diseases like diarrhea. SC ethanolic extract (400 mg/kg)
administered orally has exhibited a reduction in gastrointestinal activity in PGE2 induced
enteropooling and castor oil induced diarrhea in rats [42].
7.Anti-fertility
A review has stated that oleanolic acid – a phytoconstituent isolated from the flowers of SC has
the potential to arrest spermatogenesis, thus exhibiting the anti-fertility action in the male albino
rats [4].
8.Antifungal
The indiscriminate utilization of medicines has led to resistance against some fungal species,
thus there is a requirement of a safer remedy.
The methanolic fruit extract of SC has shown excellent antifungal action against the targeted
pathogenic fungi - Fusarium oxysporium, Rhizoctonia solani and Sclerotium rolfsii [43].
A research investigation utilized different concentrations of n-hexane, alcohol and aqueous
extracts of different plant parts of SC (barks of stem and roots, fruits and leaves) to study their
antifungal potential against Ascochyta rabiei-the causative agent for blight disease of Cicer
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arietinum. All the aqueous extracts, n-hexane extract of stem-bark and alcoholic extracts of both
the barks exhibited significant antifungal activity [44].
The aqueous, benzene, chloroform, ethanol, methanol and petroleum ether extracts of SC leaf
were evaluated against various species of Aspergillus i.e., A. tamari, A. niger, A. ochraceus, A.
flavus, A. columnaris, A. fumigates, A. candidus and A. flavipes. The results revealed that the
methanolic extract was most potent [10].
9.Anti-hyperlipidemic
Of the various lipid-lowering drugs available in the market, the herbal drugs are found to be
more safe and efficacious. The anti-hyperlipidemic potential of SC fruit pulp was evaluated in
diet induced hyperlipidaemic rats. The results revealed that the fruit pulp was as potent as
simvastatin in reducing serum LDL cholesterol, triglycerides & total cholesterol and elevating
HDL cholesterol [45].
Flavonoids isolated from the seeds have exhibited hypolipidemic effects in diabetic rats [21]
[20].
The ethanoilc extract of SC kernels (100 mg/kg b.w.) was evaluated for its hypolipidemic
potential for the levels of triglycerides, cholesterol, phospholipids, free fatty acids in the plasma,
kidney and liver tissues of STZ (55 mg/kg b.w.) induced diabetic rats. The results showed that
the extract was able to restore all the parameters to their normal range [46].
10. Anti-inflammatory
The anti-inflammatory drugs are those which help to overcome a localized physical condition in
which part of the body becomes reddened, swollen, hot, and often painful, especially as a
reaction to injury or infection.
Ethyl-acetate and methanolic extracts of SC leaves and seeds (both at the doses of 200 and 400
mg/kg p.o.) showed a significant anti-inflammatory activity in carrageenan induced paw oedema
in wistar rats [47] [48].
11. Antilieshmanial
Antilieshmanial agents are those that destroy protozoa of the genus Leishmania. The essential oil
of SC and its main component α-pinene was evaluated for its antilieshmanial action against
Leishmania amazonensis. α-pinene showed its efficacy with IC50 of 19.7 mg/ml.
Immunomodulatory action was considered as the most probable mechanism of action [49].
12. Antinociceptive
Antinociceptive activity is a process of blocking the detection of a painful or injurious stimulus
by sensory neurons. With SC, the hydro-alcoholic leaf extract was evaluated for its analgesic
potential in rats. To assess the cutaneous nociception, hot plate and formalin tests were used
while for muscular nociception, forelimb grip force was measured. The extract at the dose of
100–300 mg/kg i.p. exhibited a significant decrease in the pain scores in all the phases of the
formalin test but extract even at the dose of 300 mg/kg was not able to modify the grip force in
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intact rats. Therefore, the extract exhibited an excellent analgesic activity (on cutaneous and deep
muscle pain) [50].
The methanolic extract of SC fruits exhibited a significant central analgesic activity which was
investigated using the Eddy’s Hot Plate method [43].
13. Antioxidant
Generation of free radicals initiates/aggravates various diseases like cancer, AIDS, arthiritis,
Alzheimer and diabetic complications. Thus, there is a requirement of safer drugs that have
property of scavenging the free radicals.
With regard to SC fruit, polyphenols have shown outstanding antioxidant capacity when
compared to the standard polyphenols [51].
The methanolic extract of leaves, bark and seeds of SC were fractionated in different solvents: n-
hexane, chloroform, ethyl acetate, butanol and water. These fractions were studied for their
antioxidant and free radical scavenging activities. Of all the fractions, the polar ones i.e., ethyl
acetate and water fractions showed excellent results [52].
The leaf and seed extract of SC exhibited a significant antioxidant activity when they were
assessed by various in vitro methods such as Ferric reducing antioxidant power (FRAP) assay,
2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging assay, Nitric oxide radical scavenging, ABTS
Assay, Total Reducing antioxidant potential, Total antioxidant activity, Reducing power and
Hydroxyl radical scavenging activity[53].
RSC (Radical Scavenger Capacity) of SC was determined by using DPPH (2, 2-diphenyl-1-
picrylhydrazyl radical) assay. The second order rate constants-k2 was evaluated to determine
RSC and then these were compared to natural and synthetic antioxidants. The k2 value of SC
was determined to be 15.60 L/mol g s in methanol at 25°C proving that it has a excellent anti-
oxidant potential [54].
14. Antiviral
With the changing environment, new viral diseases are being identified, so there is a demand for
a safer, non-toxic remedy. The cold and hot aqueous extracts of leaves and barks of SC were
evaluated for their antiviral potential against H5N1 (avian influenza virus which causes a highly
contagious disease of poultry) using CPE reduction assay to establish virucidal, pre-exposure and
post-exposure potential of these extracts. With hot and cold aqueous bark extracts and hot
aqueous leaf extracts, 100% inhibition of the virus was observed in virus yield reduction assay
and in egg based in ovo assay. CC50/EC50 (selective index) for cold aqueous extract (43.5) and
hot aqueous extract (248) of bark exhibited their potency against H5N1 virus [55]. The aqueous
extract of leaves was also found to inhibit the goatpox virus [56] and the buffalopox virus [57].
15. Ascaricidal
Different SC extracts were used to study their ascaricidal action against Tetranychus urticae
Koch. The results showed the inhibition rate of 98.5%, 94% and 90% respectively for ethanolic,
hexane and ethyl acetate extracts [58].
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16. Cardioprotective
In case of SC, the hydroalcoholic extract of leaves was evaluated in spontaneously hypertensive
and normotensive wistar rats. The findings of the research investigation revealed that the extract
decreased the blood pressure as well as the heart rate. Extracellular calcium influx and inhibition
of arterial tone were suggested as the most probable mechanism of action [59]. The
hydroalcoholic extract of SC was evaluated for its antihypertensive, and vasorelaxant effect.
Polyethylene catheters were inserted into the inferior vena cava and lower abdominal aorta in the
anaesthetized rats for dosing and measuring blood pressure. The extract at the doses of 0.5; 1; 5;
10; 20 and 30 mg/kg, i.v. was able to induce hypotension (due to reduction in endothelium
mediated peripheral resistance) and bradycardia (due to meandering cardiac muscarinic
activation) [60].
The elevated serum levels of alanine transaminase (ALT), serum creatine phosphokinase (CPK),
aspartate transaminase (AST), lactate dehydrogenase (LDH), HDL-cholesterol due to
Doxorubicin(1.5 mg / kg/b.w., 15 days) induced cardiotoxicity were brought to normal range
after the administration of aqueous suspension of SC seed extract (100 mg/kg/b.w. for 15 days)
[61].
The oral administration of the methanolic extract of SC at the doses of 250 mg/kg and 500 mg/kg
consecutively for 30 days reversed and retained the activity of AST, ALT, LDH and CPK to
normal levels against the isoproterenol- induced myocardial infarction [62].
17. Chemoprotective
Various herbal drugs have proved their beneficial effect in protecting healthy tissues from the
toxic effects of anti-cancer drugs. The aqueous and ethanolic SC seed extracts have shown
chemoprotective action in the in vivo oxidative stress and genomic damage [63].
It has been reported that SC extract in the doses of 125 and 250 mg/kg/b.w./animal/day exhibited
the cancer chemopreventive properties in the DMBA-induced croton oil promoted two stage skin
carcinogenesis in Swiss albino mice. It was found that the extract was able to decline the tumor
incidence, cumulative number of papillomas and elevate the average latency time as compared to
the control group [64] [65].
The tumor burden, tumor incidence and cumulative number of gastric carcinomas induced by
benzo-a-pyrene were found to decrease after the treatment with 25 mg/kg b.w./day of the SC
extract exhibiting its broad spectrum chemoprotective effects [66].
The genotoxic effects caused by of the carcinogens urethane and DMBA in mice were also found
to decline after the administration of SC seed extract [14].
18. Diuretic
The Diuretics are used for the treatment of various human ailments such as heart failure, high
blood pressure, liver disease, some types of kidney disease and also in cases overdose or
poisoning. Now day’s herbs are a better option as diuretics.
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Petroleum ether, chloroform, methanolic and aqueous extracts of SC bark were evaluated for
their diuretic activity in Wistar albino rats at the dose of 500mg/kg body weight. The methanolic
and aqueous extracts were found to be active as diuretic as depicted by an elevation in total urine
output and in the excretion of electrolyte concentration of sodium and potassium ions [67].
19. Gastroprotective
Natural products provide a safer remedy to protect the gastric mucosa of aggressive or irritating
agents.
Seed kernel extract of SC (200 mg/kg) was evaluated for its antiulcer activity. First, the diabetes
was induced using low dose streptozotocin (35mg/kg) in combination with high fat diet. Then,
the gastric ulceration was produced in diabetic rat’s ethanol and indomethacin models. It was
observed that there was a significant decrease in the gastric ulcer index after the administration
SC extract alone and as well as in combination with Acarbose (5mg/kg) [68].
In another research investigation, the hard liquor (48% ethanol- 1ml/150gm b.w.) and aspirin
(200 mg/kg, orally) were used to induce gastric ulcer in rats. The aqueous extract of SC leaves at
the doses of 200 and 400 mg/kg produced ulcer inhibition (%) of 32.17% and 61.09%
respectively in hard liquor model and 23.01% and 70.33% respectively in aspirin model [69].
SC fruit extract at the dose of 200mg/kg b.w. was administered orally for 10 days to
streptozotocin induced diabetic and to rats exposed to ulcerogens (like aspirin, 95% ethanol,
cold-resistant stress and pylorus-ligation). The observations of the study revealed that there was
a decrease in acid-pepsin secretion, cell shedding and LPO while an increase in the GSH (in
gastric mucosa), mucosal glycoprotein and mucin [35] [70] [71].
20. Hepatoprotective
Hepatoprotective agents are those that provide protection to the liver (which performs important
functions like metabolism, secretion, storage, and detoxification of endogenous and exogenous
substances).
The alcoholic extract of the pulp of SC (100 and 200mg/kg/day) exhibited a significant
hepatoprotective action on paracetamol (PCM)-induced hepatotoxicity in albino rats. The
elevated serum levels of ALT, AST, AP were decreased and histopathological studies depicted a
reduction in fibrosis and necrosis [72].
The anthocyanins rich SC pulp extract (50 to 500 ppm) has shown its beneficial effects in
preventing the CCl
4
induced liver damage by declining the lipid peroxidation, suppressing the
CCl
4
-induced release of LDH, and elevating the GPx (antioxidant enzyme) activity [73].
Aqueous leaf extract [74] and methanolic seed extract [75] have also shown hepatoprtective
effects through biochemical estimations and histopathological studies.
21. Hypothermic
In an research investigation, after insertion of a mister probe into the rectum of rats , the basal
body temperature was recorded and then pyrexia was induced by Brewer’s yeast (Sacchromyces
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cerevisiae)( 10mL/kg of 20% suspension, subcutaneous). After 18 hours, the rectal temperature
of the rats was again recorded and the test group was treated with SC methanolic fruit extract
(100 mg/kg, orally). The standard group was administered oral dose of 33mg/kg of paracetamol
and control group was given 0.2 ml normal saline. Upto 3 hours, temperature was recorded
hourly and % reduction in temperature was recorded. The extract exhibited a significant
antipyretic activity as compared to standard [43]. The chloroform and methanolic extracts of SC
have also shown antipyretic activity [76].
22. Inhibits lipid peroxidation
Some enzymatic and non-enzymatic reactions lead to lipid peroxidation associated with
mutagenesis and cellular damage. The fruit pulp, seed coat and kernel extracts were evaluated for
their lipid peroxidation inhibition activity and was seen that the seed and coat and the pulp
extracts were less active than the kernel [77].
An research investigation utilized the pulp extract (enriched with anthocyanins) to study its
potential to inhibit the iron (FeSO4)-induced lipid peroxidation in different organs of rat (Liver,
liver mitochondria, brain, testes etc.) in vitro. A concentration of 5ppm was found to show
beneficial results with highest lipid peroxidation inhibition in liver mitochondria (86%), followed
by liver (83%), testes(72%) and brain(68.3%) [78].
SC seed extract when administered orally for 15 days to alloxan treated rats, exhibited an
elevated antioxidant the enzyme level and declined lipid peroxidation activity [79].
23. Neuropsychopharmacological
Neuropsychopharmacological agents include the studies of anxiety disorders, affective
disorders, psychotic disorders, degenerative disorders, eating behavior, and sleep behavior. The
methanolic SC extract has exhibited the antiamnesic activity against scopolamine induced spatial
impairments in rats [80]. The methanolic and ethyl acetate SC seed extracts at the doses of 200
mg/kg and 400 mg/kg were evaluated for their CNS activity utilizing rota rod and
actophotometer. A significant CNS activity was observed for both the extracts [81].
24. Radioprotective
Radioprotective agents are those that reduce the effect of radiation on tissues. SC leaf extract
provided protection against radiation induced intestinal mucosal damage due to exposure of
different doses of gamma radiations [82].
Dichloromethane extract of SC leaf and Hydroalcoholic seed extract when administered
intraperitoneally exhibited radioprotective effects [83] [84]. SC leaf extract in various
concentrations (0.0, 1.56, 3.125, 6.25, 12.5, 25, 50 and 100 µg/ml) was found to reduce the
radiation induced DNA damage in the cultured human peripheral blood lymphocytes [85].
CONCLUSION
The present article has focused on the recent research investigations carried out on the diverse
pharmacological actions of Jamun. Various parts of the plant and their extracts have been used
for anti-diabetic action, but very less study has been performed on its isolated phytoconstituents
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and very few clinical trials have been carried out. Apart from its utility in diabetes, it is a very
useful drug as anti-bacterial, anti-fungal, anti-viral, anti-cancer, anti-hyperlipidemic,
hepatoprotective, cardioprotective, gastroprotective and so on. Its potential as anti-fertility agent
needs to be explored in order to establish its safety on long term use. Thus, further studies need
to be performed with respect to pharmacological action of its isolated constituents, its
mechanism of action and clinical studies.
Acknowledgements
The authors are thankful to the Principal, KIET School of Pharmacy for motivation. Authors are
also thankful to KIET LIBRARY and NISCAIR, New Delhi for providing the literature.
Conflicts of interest
There are no conflicts of interest.
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