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Meta-analysis on Copaiba Oil: Its Functions in Metabolism
and Its Properties as an Anti-inflammatory Agent
Marcelo Ferro1S. Masso2R. R. de Souza1M. Moreno1E. Moreira1
1Department of Aging S ciences, Universidade São Judas Tadeu –USJT,
São Paulo, SP, Brazil
2Departamente of Biological Science, Florida International University
-FIU,Florida,UnitedStatesofAmerica
J Morphol Sci 2018;35:161–166.
Address for correspondence MarceloFerro,Departamentode
Ciências do Envelhecimento, Universidade São Judas Tadeu–USJT,
Rua Taquari, 546, Mooca, São Paulo, SP 03166-000, Brazil
(e-mail: marceloferro26@gmail.com).
Introduction
A great number of Brazilian/Amazonian flora has shown to
provide effective treatment for a multitude of aliments. One
derivative of these plants is copaiba oil found in Copaifera
reticulata Ducke, a natural product of the Amazon’s biodi-
versity.1It has been used for more than 390 years as an anti-
inflammatory, antimicrobial, and antifungal agent, and to
prevent various types of cancer.2,3
Recent studies demonstrated that one of the major compo-
nents of the copaiba oil, β-caryophyllene, has an anti-inflam-
matory effect.4Copaiba oil is extracted from the copaifera, a
Keywords
►copaiba oil
►anti-inflammatory
►antimicrobial
►antitumor
►healing
Abstract Many medicinal plants are sought as alternative therapies for various conditions, as
opposed to synthetic alternatives. The Brazilian Amazon provides a plethora of plants
with various therapeutic and medicinal properties. One of them is copaiba oil, a natural
product of the biodiversity of the Amazon. The anti-inflammatory and antimicrobial
properties of copaiba oil have been drawing the attention of the scientific community
as a great alternative in the treatment of illnesses associated with inflammatory and
infectious processes. The purpose of the present study is to evaluate and analyze the latest
publications on the use of copaiba oil in the PubMed/Medline database from 2014 to 2017.
Forty-two articles were collected, verifying anti-inflammatory activity, antimicrobial
activity, healing, and antitumor activity. The results found on researches with copaiba
oil according to publication dates were 11.9% in 2014, 38.1% in 2015, 16.7% in 2016, and
33.3% in 2017. In the analyzed studies, the proposed administration of copaiba oil was 50%
topical, 28.6% oral, 9.5% enteral, 4.8% subcutaneous, and 7.1% others. In the objectives of
the presente study in relation to the administration of copaiba oil, the result was 31%
antimicrobial, 28.6% anti-inflammatory, 9.5% antitumor, 9.5% healing, and 21% others.
Regarding the types of research, we have found 50% in vitro, 40.4% in vivo animals, 2.4%
in vivo human, 2.4% review and 4.8% others. Regarding the significance factor evaluation,
the result was 100% positive in antitumor activity, 84% positive in infection and inflamma-
tion pathology, 62% positive in others, like dental processes, food technology application
support and as a drug absorption vehicle, and 50% in healing. The results presented in the
current meta-analysis show that copaiba oil is an effective alternative to treatments of
illnesses such as chronic inflammation, infectious diseases, various types of cancer,
autoimmune diseases, and as a vehicle for the absorption of other drugs. Thus, more
studies regarding the benefits of copaiba oil could provide a great contribution to the
medical community in the treatment of the aforementioned illnesses.
received
March 4, 2018
accepted
April 18, 2018
published online
September 24, 2018
DOI https://doi.org/
10.1055/s-0038-1669390.
ISSN 2177-0298.
Copyright © 2018 by Thieme Revinter
Publicações Ltda, Rio de Janeiro, Brazil
THIEME
Review Article 161
type of tree. Previous studies have claimed that copaiba oil,
extracted from the copaibeira, could befound in more than 60
species cataloged worldwide.1However, in later studies it has
been reported that there are currently 72 species of copai-
beiras in the world, all exclusively in Brazilian soil.3
The anti-inflammatory and antimicrobial properties of
copaiba oil have been drawing the attention of the scientific
community as alternatives in the treatment for illnesses
associated with inflammatory and infectious processes
within the body.5Currently, the most common use of copaiba
oil is topical.4Other, newer studies are being performed to
find other forms of administration.6,7
In vitro experiments have shown direct damage to the DNA
of cancerous stomach cells with the administration of copaiba
oil. The responsible agent in copaiba oil was found to be
kaurenoic acid. The administration of copaiba oil showed a
reduction to the damage caused by cancerous cells in the
stomach tissue during in vitro testing. This was due to the
kaurenoic acid that makes up, in part, copaiba oil.8Likewise,
the administration of nanoencapsulated copaiba oil signifi-
cantly reducedthe right ventricular hypertrophyof Wistar rats
as well as the oxidative stress.9In another study, the admin-
istration of copaiba oil by gavage reduced the amount of
abdominal adhesions and accelerated the formation of col-
lagen fibers without damaging the early stages of healing.10
Although a large part of the studies showed positive
results with the use of copaiba oil, a small part showed
that copaiba oil did not show significant resu lts in the applied
objectives.3Tobouti et al affirmed that, reported that essen-
tial copaiba oil is a proven efficient medicine against some
microorganisms. However, unlike other well established
herbal medicines, antimicrobial studies on copaiba oil may
show some bias due to lack of standa rdization. Therefore, the
purpose of the presen t meta-analysis is to verify publications
on copaiba oil and its uses as a therapy in the Pubmed/
Medline database between 2014 and 2017.
Materials and Methods
The analyzed material consists of journal articles on the
copaiba oil index in PubMed, seeking the relationship of
copaiba oil with anti-inflammatory activity, antimicrobial
activity, healing and antitumor effects. The data were col-
lected between 2014 and 2017, totaling 42 items. The search
for these articles was made using the keywords: copaiba oil,
anti-inflammatory, antimicrobial, antitumor, and healing.
Results and Discussion
In ►Table 1, we have found 42 articles published in the last
4 years, with 5 articles published in 2014, 16 articles
published in 2015, 7 articles published in 2016, and 14
articles published in 2017. This shows a proportion of
11.9% of publications in 2014, 38.1% in 2015, 16.7% in
2016, and 33.3% in 2017. With this, we can observe a
seasonality in copaiba oil research. Interestingly, there is
an increase in publications in odd-numbered years when
compared with even-numbered years.
In ►Table 2,wefind a 50% proportion of copaiba admin-
istration in topical use in comparison to other administration
methods. In 2014, we did not find any publication adminis-
tering topical use. In 2015, there were 3 times more publica-
tions reporting on the topical use in relation to the oral use. By
2016, those numbers had fallen to nearly half as many. On the
other hand, in 2017, we have found only 1.4 times more
publications for the topical use as compared with the oral
use. It seems that the oral administration of copaiba oil has
been drawing attention in the last year due to its low toxicity
and its antimicrobial and anti-inflammatory power.
These numbers initially demonstrate the potential of
copaiba oil in the aid of the healing process.11,12 Because
of the benefits of applying copaiba oil as a topical use based
on empirical evidence in the past, it is probable that the
scientific community was influenced in researching the use
of copaiba oil in the form most used by local Amazonian
people, who used copaiba oil on the skin. According to Brito
et al,13 the practice of using medicinal plants is common in
developing countries. The Amazon is a nursery of medicinal
plants, and many studies have been made with copaiba oil as
an alternative for aiding in inflammatory processes, such as
healing skin ulcers and infections, with very satisfactory
results in the form of topical use. According to Tobouti
et al,3in 1840, copaiba oil was used in combination with
purgatives for gonorrhea treatments, reporting that the
treatment did not exceed 5 days, when the permanent
cure of the disease was observed. This information was
published by the Provincial Medical & Surgical Journal in a
note written by the Gazette Médicale, and the Edinburgh
Medical and Surgical Journal suggested a combination of
copaiba with purgatives in the treatment of gonorrhea.
Following this publication concerning the properties of the
balsam, the copaiba has received attention from many
explorers and travelers since the early years of its discovery.
The oral administration of copaiba has been used as
another form of alternative therapy with controversial
results. With 28.6%, in the present meta-analysis, the oral
administration of copaiba has been shown to be an effective
agent against certain parasites,14 gastrointestinal cancer,8
Table 1 Scientific publications about copaiba oil between 2014
and 2017
2014 2015 2016 2017 Total
5 16 7 14 42
This table shows the number of articles published each year.
Table 2 Proposal of administration of copaiba oil according to
the articles studied
2014 2015 2016 2017 Total %
Top i ca l –9572150.0
Oral 23251228.6
Enteral 1 2 –1049.5
Subcutaneous –2––02 4.8
Others 2 ––1037.1
Journal of Morphological Sciences Vol. 35 No. 3/2018
Meta-analysis on Copaiba Oil Ferro et al.162
endometriosis,6,7,15 arthritis,16 and other conditions. Con-
trary to w hat was thought, the o ral administration of copa iba
was shown to be non-toxic to rat liver when used as a carrier
for amphotericin B.14
In contrast, in another study, the results revealed that
copaiba oil showed anti-inflammatory and systemic antiox-
idant actions in arthritic rats. These beneficial effects, how-
ever, were counterbalanced by deleterious modifications in
the metabolism and morphology of hepatic cells of healthy
control rats. Thus, the administration of oral copaiba oil16
demonstrates great potential as an alternative treatment to
the aforementioned pathologies.
We can observe that the enteral administration by gavage
was the third most used form in the present meta-analysis,
with 9.5%. Campos et al9administered copaiba in natura and
in nanoencapsulated form and both reported a significant
reduction in the sizes of their right ventricles in induced
pulmonary arterial hypertension (PAH). The same authors
affirm that copaiba oil can be an alternative medicine for the
reduction of hypertrophy of the right ventricle, as well as for
the reduction of oxidative stress.
Researching the other copaiba administration routes, we
have found the subcutaneous form to be effective 4.8% of the
time, and other forms to be effective 7.1% of the time. Accord-
ing to Venturini et al,17 the subcutaneous administration of
copaiba in association with drugs for the treatment of carci-
noma in the skin of pigs brought benefits by the increase in
drug retention on theskin layer. The author states that copaiba
is considered the most promising nanoformulation for the
treatment of skin carcinoma by assisting the absorption of the
drugs applied.
In ►Table 3, we can observe a predominance of the studies
of copaibaoil as an antimicrobial agent with an effectiveness of
31%. As mentioned above, copaiba oil has been drawing the
attention of the scientific community as an antimicrobial
agent for a few years. According to Mizuno et al,18 copaiba
oil is one of the most popular naturalmedicines in the Amazon.
The same authors reported positive effects in both antileish-
manial activity as well as in antitrypanosomal activity with
copaiba oil in topical administrations. In another study, Sven-
tichny et al19 demonstrated positive effects with antifungal
activity in the administration of copaiba oil. Effects of anti-
microbial activity have also been observed in many other
studies, such as the inhibition of Staphylococcus aureus,as
an antileishmanial agent,2the inhibition of Staphylococcus
agalactiae,20 and the inhibition of Streptococcus sp.21 Accord-
ing Otaquiri et al,20 the results of the antibacterial activity of
copaiba oil demonstrated a new alternative as a strategy in the
control of S. agalactiae in neonatal infections. In another study,
Alencar et al22 showed significant antimicrobial and antibio-
film activities withthe administration of copaiba oil, reporting
it to be a promising candidate in the treatment of infections
and in the incorporation of other antimicrobial drugs.
As with the antimicrobial activity of copaiba oil, the anti-
inflammatory activity was present in the present study with
28.6% effectiveness. In a study to investigate the action of the
oral administration of copaiba oil on the systemic inflamma-
tion, the oxidative status, and liver cell metabolism of rats with
adjuvant-induced arthritis, Ghizoni et al16 demonstrated that
copaiba oil presented systemic anti-inflammatory and anti-
oxidant actions in arthritic rats when compared with the
control group. Lucca et al4attribute the anti-inflammatory
action of copaiba oil to β-caryophyllene, a component of the
oil. The anti-inflammatory action of β-caryophyllene is due to
its agonistaction at the cannabinoid receptorsknown as CB2.23
Thus, the anti-inflammatory activity of copaiba oil occurs
because β-caryophyllene binds selectively to CB2 receptors,
being a CB2 agonist.31 When this occurs, there is an inhibition
of adenylate cyclase, triggering a cascade of biochemical
reactions that contribute to the systemic anti-inflammatory
activity.23 Likewise, Teixeira et al1reported an increased
efficiency in the modulation of inflammatory processes,
mainly in the number of macrophages observed. According
to the author,therapies with copaibaoil have been shownto be
of low toxicity when administered in the oral form.
Another purpose of copaiba oil that drew attention in the
present studywas its antitumor action, with 9.5% of the studies
finding that copaiba oil demonstrated a high antitumor capa-
city. In a study on gastric cancer, Cardoso et al8demonstrated
that the administration of caurenoic acid, extracted from
copaiba oil, significantly reduced mitosis in gastric cancer cells
by inducing apoptosis in these tissue types when compared to
the control group. However, Cavalcante et al24 demonstrated a
genotoxicity in the use of kaurenoic acid using 2.5, 5, 10, 30,
and 50 μg/mL in lung fibroblast cells of hamsters. Likewise,
Ghizoni et al16 reported that although copaiba oil showed
positive results in the treatment of inflammations at doses
between 0.58 and 1.15 g/kg, detrimental changes were found
in the liver metabolism and in the liver morphology. Interest-
ingly, in another study, Campos et al25 demonstrated that the
use of trans-caryophyllene extracted from copaiba oil asso-
ciated with atorvastatin presented significant leukocyte
counts compared with the control group in chemotherapy
treatments in Wistar rats, reporting a potential preventative
effect for secondary leukopenia in induced chemotherapy.
These differences in toxicity reported in the use of copaiba
oil were even more evident when Teixeira et al1demonstrated
that 200 mg/kg/day presented low toxicityand positive results
in inflammatory processes. Similarly, Silva et al6,7 demon-
strated that 50 μg/mL of nanocomposite system (Nano COR)
was developed and a toxicity test was performed. The tests
showed that Nano COR has a greater impact on the behavior of
human endometriotic stromal cells than on the behavior of
eutopic endometrium stromal cells, supporting the idea that
Nano COR, a form of copaiba oil, should be further investigated
Table 3 Objectives of research on the use of copaiba oil
2014 2015 2016 2017 Total %
Antimicrobial 1 7 2 3 13 31.0
Anti-
inflammatory
3 4 2 3 12 28.6
Antitumor –2–249.5
Healing –11249.5
Others 1224921.4
Journal of Morphological Sciences Vol. 35 No. 3/2018
Meta-analysis on Copaiba Oil Ferro et al. 163
as a novel and valuable alternative to treat endometriosis.
These controversies between the toxicity of copaiba oil and of
its components still require further study. Perhaps a dose
adjustment by weight is a path in the search for a safer
treatment with a product as promising as shown in ►Table 4.
We have reviewed the pertinent articles to evaluate the
healing properties of copaiba oil. A curious fact is that,
empirically, in the past, native Amazonians used copaiba
oil for healing. However, in the present study, we have
observed that only 9.5% of the publications aimed to study
this property. Thus, we have looked at some works with
copaiba oil administered via gavage for abdominal adhesion
in rats corrected with Vicryl (Ethicon Inc., Somerville, NJ,
USA) mesh.26 The authors demonstrated that although the
gavage administration showed no statistically significant
difference in adhesions and collagen fibers, the inflamma-
tory response was better in the group that used copaiba oil.
Copaiba oil also showed positive effects on bladder healing,11
and skin healing processes.27
In ►Table 5, we see a predominance of in vitro research,
with 50%, followed closely by the publications of clinical
studies in animals, with 40.4%. In the papers evaluated in the
present meta-analysis, we could see that copaiba oil is
promising in the medical field as a very great potential
alternative therapy as an antimicrobial,19 anti-inflamma-
tory,1as well as an antitumor agent.17 These numbers
show that, until now, the researchers working with copaiba
oil seem to want to corroborate the empiric act of the local
natives with the use of this medicinal plant.
On the other hand, human studies are still lacking to
validate the therapeutic effects of copaiba oil. The publica-
tions with human subjects corresponded to only 2.4% of the
works evaluated in 2017. Observing the anti-inflammatory
potential of copaiba oil, we believe that in the coming years
the scientific community will focus more on publications
with humans, especially in the sports field, because the
inflammatory processes in sports, such as tendinitis, mus-
cular contractures, stretching, and dislocations, are very
common. However, we must not forget the elderly, who
also present with a high incidence of i nflammatory processes
due to their age.
Regarding the publications in review form, we have found
the same percentage of clinical studies in humans, w hich was
of 2.4%. Of these, 4.8% were studies on the chemical compo-
sition of copaiba oil.
In ►Table 4, we can observe the comparative results
presented in these 42 studies on the administration of
copaiba oil. With 84% of positive results and inflammation,
copaiba oil has been shown to have a therapeutic potential
for both conditions. Cont roversial results s till appear because
of the great diversity of copaifera that exists in various parts
of the continent. According to Tobouti et al,3in the scientific
literature about copaiba oil, many articles do not specify
which exact strain is being studied. This makes it difficult to
compare results between studies. Studies with β-caryophyl-
lene present in copaiba oil have been demonstrating its anti-
inflammatory properties and its therapeutic effects.4There-
fore, the use of copaiba oil extracted from trees with low β-
caryophyllene concentration may compromise the results of
the studies.3
Another component from copaiba oil with potent anti-
oxidant and anti-inflammatory properties is kaurenoic
acid.6,7 According to Silva et al16, the results of their research
demonstrated a significant decrease in tumor necrosis factor
α(TNF-α) and Interleukin-1 (IL-1) expression and myeloper-
oxidase (MPO) activity at the T1/T2 time point.
In the results reported by other studies with copaiba oil,
there are uses of copaiba oil as a vehicle for administration of
medicaments, for topical and oral treatment28,29,infood
technology30, dental procedures30, and cardiorespiratory pro-
cesses.9Here we can observe a positive result in the use of
copaiba oil of 78% according to ►Table 4. This can demonstrate
versatility in the use of copaiba oil for different purposes.
In the studiesusing copaiba oil with a focus on its antitumor
action, the results were promising. Of the 4 studies published
in the database that were collected for the present meta-
analysis, 100% of the results showed a decrease in tumor
activity in the presence of copaiba oil in any form of
Table 4 The results with significance, evaluated
2014 2015 2016 2017 Total %
Positive Negative Positive Negative Positive Negative Positive Negative Positive Negative
Cancer –– 2–––2–100.0 –
Infections and
inflammation
3 1 10 1 3 1 5 1 84.0 19.0
Others –1–22–3–62.5 37.5
Healing –– –11–1 1 50.0 50.0
Total 3 2 12 4 6 1 11 2 78.0 22.0
Table 5 Publication types
2014 2015 2016 2017 Total %
In vitro 1 10 6 4 21 50.0
In vitro
animal
37161740.4
In vitro
human
–––112.4
Review –––112.4
Others 1 ––124.8
Journal of Morphological Sciences Vol. 35 No. 3/2018
Meta-analysis on Copaiba Oil Ferro et al.164
administration, whether oral, topical or in vitro. Although we
have found few studies on antitumor activity in our present
study, the use of copaiba oil in cancer therapies have
shown great results. Further clinical studies with copaiba oil
in humans are required for future development of dosages,
toxicity, and pharmacokinetic and pharmacodynamic
activities.
Interestingly, differently from the results on antitumor
activity, the percentages presented with respect to the
healing properties of copaiba oil were different than
expected, with only 50% of positive results found. Consider-
ing the empirical use of local people in the use of copaiba oil
as a healing agent, this result was a surprise. However, we
cannot fail to report that the studies found on the healing
properties of copaiba did not involve its application oil on
the skin exclusively. Yasoshima et al26 used copaiba oil via
gavage in rats that underwent hernia repair with Vicryl
mesh. According to the authors, there were no significant
results in the postoperative healing process when compared
with the control group. Wagner et al12 used copaiba oil in
local ulcers in the mouth of rats and did not obtain
significant results.
Conclusion
The proposed administration of copaiba oil in pathological
processes seems promising. The results presented in this
meta-analysis show that copaiba oil is an interesting alter-
native for treatments in pathologies such as chronic inflam-
mation, infectious processes, various type of cancer,
autoimmune diseases, and as a vehicle for the absorption
of other drugs. However, more studies on copaiba oil would
bring a great contribution to the medical community in the
search for alternative treatments. We have not found studies
related to age-fighting properties of copaiba oil. Therefore,
there is an open gap here.
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