Therapeutic potentials associated with biological properties of Juniper berry oil (Juniperus communis L.) and its therapeutic use in several diseases – A Review

Abstract

Juniperus communis L. is a plant that belongs to the Cupressaceae family. It grows as either a shrub or small tree and is widely distributed across the Northern Hemisphere, including northern Europe, Asia, and America. The berries are an efficient source of several bioactive structures. This review article will focus on the current status of the therapeutic use of juniper berry essential oil, which is presently indicated as a herbal medicinal treatment for dyspepsia. Interest in plant-based medicinal products is growing, and therefore it is important that accessible, up-to-date research is available to patients. Many plants are a natural source of therapeutic structures and can therefore often provide an alternative to synthetic pharmacology. A main constituent of juniper berry oil is α-pinene, a highly active structure which has been shown in in vitro and in vivo studies to possess several biological activities. This review sums up the available reports and indications which describe the function and value of juniper berry essential oil and especially, the constituent α-pinene as a potential candidate in several disorders and inflammatory conditions.Keywords: Juniperus communis, dyspepsia, juniper berry oil, Antioxidant activity, Antibacterial activity, Anti-inflammatory activity

Full text

Bioactive Compounds in Health and Disease 2022; 5(9): 174-185 BCHD Page 174 of 185
Review Article Open Access
Therapeutic potentials associated with biological properties of
Juniper berry oil (Juniperus communis L.) and its therapeutic use
in several diseases – A Review
Albrecht, Uwe1*, Madisch, Ahmed2
1 Mediconomics GmbH, Misburger Strasse 81B, 30625 Hannover, Germany2
; Centrum Gastroenterologie Bethanien,
Agaplesion Krankenhaus Bethanien, Im Prüfling 23, 60389 Frankfurt, Germany
*Corresponding author Uwe Albrecht, Mediconomics GmbH, Misburger Strasse 81B, 30625 Hannover, Germany
Submission Date: August 31st, 2022; Acceptance Date: September 22nd, 2022; Publication Date: September 29th, 2022
Please cite this article as: Uwe A., Ahmed M. Therapeutic potentials associated with biological properties of Juniper berry
oil (Juniperus communis L.) and its therapeutic use in several diseases – A Review. Bioactive Compounds in Health and
Disease 2022; 5(9):174-185. DOI: https://www.doi.org/10.31989/bchd.v5i9.999
ABSTRACT
Juniperus communis L. is a plant that belongs to the Cupressaceae family. It grows as either a shrub or small
tree and is widely distributed across the Northern Hemisphere, including northern Europe, Asia, and
America. The berries are an efficient source of several bioactive structures. This review article will focus on
the current status of the therapeutic use of juniper berry essential oil, which is presently indicated as a
herbal medicinal treatment for dyspepsia. Interest in plant-based medicinal products is growing, and
therefore it is important that accessible, up-to-date research is available to patients. Many plants are a
natural source of therapeutic structures and can therefore often provide an alternative to synthetic
pharmacology. A main constituent of juniper berry oil is α-pinene, a highly active structure which has been
shown in in vitro and in vivo studies to possess several biological activities. This review sums up the available

Bioactive Compounds in Health and Disease 2022; 5(9): 174-185 BCHD Page 175 of 185
reports and indications which describe the function and value of juniper berry essential oil and especially,
the constituent α-pinene as a potential candidate in several disorders and inflammatory conditions.
Keywords: Juniperus communis, dyspepsia, juniper berry oil, Antioxidant activity, Antibacterial activity,
Anti-inflammatory activity
©FFC 2022. This is an Open Access article distributed under the terms of the Creative Commons Attribution
4.0 License (http://creativecommons.org/licenses/by/4.0)
INTRODUCTION: Naturally occurring compounds have
always been an essential source of therapeutic
compounds, both directly and indirectly. The range of
ailments treated by natural remedies can vary from mild
stress or mood disorders to more severe asthma
conditions and digestive problems [1-2]. The process of
extracting different structures from plants and
employing them in chemical synthesis has been a
distinctive approach in drug discovery as well [3-4].
Furthermore, it has been demonstrated that the
complex mixture of essential oils (EOs) synthesized by
plants play an important role in the defense mechanisms
against microorganisms and herbivores [5-6]. Herbal
medicines, including essential oils have been applied in
various biological conditions since ancient times due to
their spasmolytic, anti-inflammatory, antioxidant, and

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antimicrobial activities [6-7]. Moreover, the usage of EOs
is increasing in industrial areas such as cosmetic,
perfume, pharmaceutical and food industries [6-9]. After
years of predominantly synthetic preservatives for foods
and cosmetics or the usage of synthetic drugs,
consumers and patients are becoming more concerned
about the ingredients of these products. In the same
token, a renewing interest in plant-based essential oils
as preservatives or treatment has been reported in the
population [6], [10-14]. Juniper oil is one possible
candidate, as it is categorized as Generally Recognized as
Safe (GRAS) by the US Federal Regulation (U.S. Code of
Federal Regulations, 2017). Juniperus communis L. is an
example of a promising medicinal plant due to its high
content of pharmacologically valuable essential oils
(EOs). Of particular interest is α-pinene from the group
of monoterpenes, which was categorized as a “molecule
of interest” due to its biological activities, its therapeutic
potential [15], and the high amount found in essential
oils gained from Juniperus species [15-16]. This review
aims to provide an overview of the evidence for the
biological and potential therapeutic effects of Juniperus
communis L. essential oil. Literature was searched
employing PubMed
(http://www.pubmed.ncbi.nlm.nih.gov), ScienceDirect
(http://www.sciencedirect.com), Scientific Electronic
Library Online (SciELO) (http://www.scielo.org) and
Google Scholar (http://www.googlescholar.com).
Publications from between 1998 and 2021 included over
20 in vitro and in vivo studies highlighting the
pharmaceutical potential of juniper berry essential oil.
While the historical use of juniper in a therapeutic
context has been thoroughly reviewed by previous
published works such as Al-Snafi (2018) [17], the current
review aims to highlight the potential of juniper berry
essential oil to recent studies for drug discovery and for
therapeutically application.
Plant background and uses:Juniperus communis L.
(Cupressaceae Rich. ex Bartl.) belongs to the genus
family of Juniperus L., which includes around 70 species
widely spread worldwide. The broad range of its habitat
distribution has resulted in diverse ecological
adaptations [18]. It grows over an extensive area in the
cold Northern Hemisphere, including the northern
regions of Europe, Asia, and North America (Figure 1)
[19]. In addition to its use in the pharmaceutical
industry, juniper berries are also used as a spice or as a
natural ingredient in the cosmetics and food industries,
especially in the traditional production of gin [6]. In
traditional medicine, the berries were associated with
stomachic, diuretic, antiseptic and anti-rheumatic
properties and have been applied in the treatment of
various inflammatory diseases [6], [20-21].

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Figure 1: Picture of Juniperus communis plant © Dr. Uwe
Albrecht
Chemical composition: Juniper oil, which is described in
several Pharmacopoeias (e.g. Ph. Eur. 8, [6]), is typically
extracted from juniper berries. The Berries are carefully
collected to ensure a harvest of high quality [22]. The
volatile compounds are then extracted from the
aromatic berries via steam distillation, as this shows the
highest efficiency among available methods [23]. These
compounds include α-pinene, β-myrcene, sabinene, and
δ-limonene as the most significant and are identified
through GC/FID and GC/MS methods (Figure 2) [24].
Figure 2: Chemical structures of compounds present in J. communis essential oil © Fatema Salamah
Reported separation methods by studies mentioned in
this review differ between authors. According to the
European Pharmacopoeia 10th Edition (Ph. Eur. 10), the
colorless or yellowish juniper berry essential oil is
identified through GC/FID method, using helium as the
carrier gas and fused silica as the column material. The
composition of the oil is specified as being: 20-50%
α-pinene, <20% sabinene, 2-12% limonene, 1-12%
β-pinene, 1-35% β-myrcene, <1% α-phellandrene,
0.5-10% terpinen-4-ol, <2% bornyl acetate and <7%
β-caryophyllene. Among the different monoterpene
hydrocarbons, α-pinene is considered the predominant
active component of J. communis [23], [25]. In fact,
antibacterial, antifungal, neuroprotective,
gastroprotective, and several other biological activities
have been shown to be related to the presence of
α-pinene in juniper species, which was termed
"molecule of interest” [15]. Moreover, α-pinene has
shown anti-inflammatory, spasmolytic, antitumor, and
other pharmacological effects [15], [26].
Biological activities:There is extensive research
available regarding the non-clinical and pre-clinical
potentials of juniper berry oil.
Antioxidant additive in dry fermented sausages: A
former study demonstrated the activity of J. communis
essential oil (JEO) in inhibiting lipid oxidation and
bacterial growth of cooked pork sausages. The following
research was carried out to investigate the antioxidant

Bioactive Compounds in Health and Disease 2022; 5(9): 174-185 BCHD Page 178 of 185
behavior in dry fermented sausages. Results obtained
encourage further consideration of utilizing JEO as a
healthier substitute for Sodium Nitrite in dry fermented
sausages [27].
Water disinfectant: An in vitro study demonstrated
JEO's role in suppressing biofilm development of
Mycobacterium avium, and which proposed utilizing it in
sterilized natural water as an effective disinfectant [28].
Antioxidant activity: In vitro assays were carried out to
explore the antioxidant activity of aqueous and
ethanolic extracts of juniper berries. Results confirm the
strong ability of both extracts to scavenge superoxide
and hydrogen peroxide radicals, as well as the presence
of a metal chelating activity [29]. Following these
results, in vitro and in vivo analyses were conducted on
juniper essential oil, showing antioxidant behaviors that
correlated with the concentrations utilized [30].
Moreover, Caenorhabditis elegans worms were
employed to discover the anti-aging effects and
antioxidant potential of JEO. The in vivo assay revealed a
higher survival ratio in worms treated with JEO, in
comparison to the control [31].
Antifungal activity: J. communis berry oil has been
investigated for antifungal activity and studies have
confirmed synergistic effects between the essential oil
components against some tested fungi [32]. The
antifungal potential was adapted for extended in vivo
analysis against dermatophytes yeasts. Subsequently,
the essential oil of J. communis has shown the desired
efficiency as an antifungal agent [33].
Antibacterial activity: Approximately 25000 patients in
Europe die each year due to multidrug-resistant bacteria
infections [34]. Selection among bacteria for
anti-bacterial resistance is accelerated by the overuse of
antibiotics. Therefore, it is critical that alternatives to
antibiotic treatment are identified. Different compounds
of the JEO have previously displayed bacterial growth
inhibition of S. aureus (gram-positive) and A. baumani
(gram-negative) [32]. Another assay confirmed
antibacterial activity against S. aureus, in addition to E.
coli bacterium [35]. A specific mechanism of
antibacterial action was earlier identified as biofilm
formation limiting activity. This study was conducted on
Campylobacter jejuni (C. jejuni), revealing the ability of
JEO to control and suppress the spread of
campylobacters, especially in the food industry [36].
Furthermore, specifically α-pinene was under
investigation to study the modulation of antibiotic
resistance in C. jejuni [34], [37].
Anti-inflammatory activity: Juniper oil is known to
exhibit anti-inflammatory activity, although several
mechanisms for this action have been proposed.
Studies suggest that the proficiency of JEO in inhibiting
the formation of pro-inflammatory cytokines reduces
inflammation [35]. In addition, it has been shown in
studies by Rufino et al. (2014) that Juniperus essential oil
and its major component α-pinene is able to prevent
pro-inflammatory pathway activation upon
IL-1β-stimulation [34], [38]. Moreover, studies by Kim et
al. (2015) demonstrated the effect of α-pinene to reduce
pro-inflammatory cytokine levels of IL-6 and TNF-αin
macrophages [34], [39]. A different study confirms this
anti-inflammatory activity of JEO through in vivo
discoveries in inflammatory settings of human skin cells.
The results obtained suggest therapeutic
anti-inflammatory benefits of J. communis essential oil
within dermal fibroblasts [40].

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Renal effects: Diuretic effects of juniper berry have been
explored and were attributed to hydrophilic structures
present in the fruit [41]. However, other studies suggest
that the urine yield increase does not correspond to
electrolytes deficiency when utilizing aqueous solutions
of juniper berries [42].
Gastrointestinal effects: Shifting the focus to
Gastrointestinal (GI) diseases, dyspepsia is a therapeutic
indication of juniper berry oil, according to the
Committee on Herbal Medicinal Products (HMPC)
assessment report in 2010. Furthermore, owing to its
anti-spasmodic, carminative, antibacterial, and digestive
properties, juniper has been reported to treat several
other GI disorders [42]. Additionally, an in vivo study
performed on rats confirmed elevated healing effects of
gastric ulcerations when applying Juniperus communis
extracts. Nevertheless, peptic activity and the pH of the
stomach were not affected. Further applications include
Ascites, Irritable Bowel Syndrome (IBS), and
Hemorrhoids. Effectivity here is believed to be due to
diuretic, carminative and mild astringent activities of JEO
[43].
Antitumor/Cytotoxic effects: Several other papers
confirmed the cytotoxic effects of JEO in cancer cells
through different pathways. For instance, in vivo study
performed on mouse models confirmed the anti-tumor
activity of J. communis extracts against colorectal cancer
cells (CRC), as it was shown to induce cell apoptosis [44].
Another study revealed a potential decrease in colon
tumor development when applying JEO as a chemo
preventive supplement [45]. Furthermore, the addition
of JEO to Doxorubicin (DOX) in human lung
adenocarcinoma A549 cell lines displayed synergistic
anticancer effects [46]. Cytotoxic effects were confirmed
in a study using human cervical cancer (SiHa), human
lung carcinoma (A549), and human skin carcinoma
(A431) cells [47].
Clinical activities: Currently, there are only a few clinical
studies investigating essential oils and more, specifically
on their components such as α-pinene. Especially, on
α-pinene isolated or as ingredient of juniper berries
there is little known so far. However, α-pinene has
shown positive effects in clinical trials with myrtol
(containing 6% α-pinene) as a treatment for respiratory
diseases, such as chronic pulmonary infection [48] or
acute bronchitis [34], [49].
Table 1. Biological activity of Juniper berry essential oil and its dominant constituent α-pinene.
Biological activity
References
Juniper berry essential oil
Antioxidant additive
Alternative for Sodium Nitrite in Dry Fermented Sausages
[27]
Water disinfectant
Limits the biofilm formation of Mycobacterium avium and
Mycobacterium intracellulare on polystyrene in a
temperature-dependent manner
[28]
Antioxidant activity
Strong ability of both extracts to scavenge superoxide and
hydrogen peroxide radicals and the presence of a metal
chelating activity
[29]

Bioactive Compounds in Health and Disease 2022; 5(9): 174-185 BCHD Page 180 of 185
In vitro and in vivo analyses on Juniper essential oil, proving
different antioxidant behaviours
[30]
Caenorhabditis elegans worms were employed to discover the
anti-aging effects of Juniper essential oil
[31]
Antifungal activity
This study estimated the antibacterial and antifungal activity of
three different Juniper berry oils and their main components. All
the micro-organisms used in this experiment were isolated from
patients of Regional Hospital of Gdańsk and some of them
showed resistance against commonly used antibiotics.
[32]
Minimal inhibitory concentration (MIC) and minimal lethal
concentration (MLC) were used to evaluate the antifungal
activity of the oil against dermatophytes (Epidermophyton
floccosum, Microsporum canis, M. gypseum,Trichophyton
mentagrophytes,T. mentagrophytes var. interdigitale,T. rubrum,
T. verrucosum), yeasts (Candida albicans,C. guillermondii, C.
krusei,C. parapsilosis,C. tropicalis, Cryptococcus neoformans)
and Aspergillus species (Aspergillus flavus, A. fumigatus, A.
niger)
[33]
Antibacterial activity
This study estimated the antibacterial and antifungal activity of
three different Juniper berry oils and their main components. All
the micro-organisms used in this experiment were isolated from
patients of Regional Hospital of Gdańsk and some of them
showed resistance against commonly used antibiotics.
[32]
Antibacterial activity against S. aureus in addition to E. coli
bacterium
[35]
This study was conducted on Campylobacter jejuni (C. jejuni),
revealing the ability of Juniper essential oil to control and
suppress the spread of campylobacters, especially in the food
industry
[36]
Anti-inflammatory activity
Proficiency of Juniper essential oil in inhibiting the formation of
pro-inflammatory cytokines
[35]
In vivo discoveries in inflammatory settings of human skin cells
[40]
Renal effects
Time-dependent diuretic response in rats treated with Juniper
berry preparations
[41]
Juniper increases urine output without loss of electrolytes
[42]
Gastrintestinal effects
Juniper has been recorded to treat several gastrointestinal
disorders
[42]
In vivo study performed on rats confirmed elevated healing
effects of gastric ulcerations when applying Juniperus communis
extracts
[43]
Antitumor/Cytotoxic effects

Bioactive Compounds in Health and Disease 2022; 5(9): 174-185 BCHD Page 181 of 185
In vivo study performed on mouse models confirmed the
antitumor activity of J. communis extracts against colorectal
cancer (CRC) by inducing cell apoptosis
[44]
Decrease in colon tumour development when applying Juniper
essential oil as a chemopreventive supplement
[45]
Addition of Juniper essential oil to Doxorubicin (DOX) in human
lung adenocarcinoma A549 cell lines displayed synergistic
anticancer effects
[46]
Cytotoxic effects on human cervical cancer (SiHa), human lung
carcinoma (A549), and human skin carcinoma (A431) cells
[47]
α-pinene
Antibacterial activity
α-pinene was under investigation to study the modulation of
antibiotic resistance in C. jejuni
[37]
Anti-inflammatory activity
Prevention of pro-inflammatory pathway activation in human
chondrocytes upon IL-1β stimulation
[38]
DISCUSSION:The biological and potential therapeutic
effects of Juniperus communis L. oil have been utilized
since the time of ancient medicine, but the renewal of
patient desire for natural alternatives to synthetic
pharmacology, especially in the face of growing bacterial
resistance to antibiotics, has rekindled interest in the oil.
The essential oil obtained by the steam distillation
follows different production protocols depending on
geographical origin, climate, harvesting period or
extraction method [6], [50] leading to variation in
qualitative and quantitative profile [6], [20], [24],
[50-57]. Although showing a wide variation ranging from
13.4% to 77.4%, α-pinene was demonstrated as the
consistent major compound [6]. In like manner, it is also
important to address misleading information concerning
the side effects of this plant. In previous years, Juniperus
communis was alleged to cause kidney irritation.
However, actual evidence on this claim was never
provided. As a matter of fact, recent research published
in 2019 has proven the opposite. The study was
conducted on diabetic rat models, measuring oxidative
stress and kidney function parameters throughout the
experiment. The results obtained confirm enhanced
kidney function associated with protective effects and
promoted antioxidative activity [58], leading to
nephroprotection instead of nephrotoxicity. The other
side effects described in the literature, address the use
of JEO during pregnancy. It is said that the volatile oil of
Juniperus communis could act as a gastrointestinal
irritant, which might stimulate the uterus during
pregnancy and explain why JEO should not be used
during pregnancy [59].
With increased demand of natural compounds
regarding various of pharmacological properties, this
increasing demand represents a risk for high quality
[15], [60]. Previous reports demonstrated adulterations
of essential oils, therefore in the future quality checks of
essential oils are necessary [15], [61-64].
Nevertheless, future clinical trials should
emphasize juniper essential oils or its ingredient,
α-pinene as a potential therapeutic product closing the
gap between pre-clinical study successes and
therapeutic usage.

Bioactive Compounds in Health and Disease 2022; 5(9): 174-185 BCHD Page 182 of 185
CONCLUSION:In this short review, the importance of
essential oils from juniper berries and its major
ingredient α-pinene was highlighted.
Juniper berry essential oil exhibited various promising
biological effects and should be considered for further
therapeutic applications within the pharmaceutical
industry. For instance, JEO could be extra involved in
skincare formulations as a reliable herbal medicine
regarding antiseptic, antimicrobial and anti-aging
properties.
Encouraged by the various biological and
pharmacological potential activities of Juniperus
communis, carrying out clinical studies for further
development is highly appealing. Commercially available
juniper berry oil is marketed as Roleca®, which could be
the main contributor to future clinical trials conducted
within Europe and particularly in Germany.
List of abbreviations used: EO: essential oil; JEO:
Juniperus communis essential oil
Competing Interests: The authors have no financial
interests or conflicts of interest.
Authors’ contribution: All authors contributed to this
manuscript.
Acknowledgement: With respect to the topic of Juniper
communis as a functional food, we like to provide the
information of functional foods being natural or
processed foods that contain biologically active
compounds with effective, but non-toxic amounts and
documented benefits in health.
The authors thank herewith Mrs. Fatema Salamah,
M. Sc. and Mr. Niklas Lonnemann, PhD for the
compilation of the manuscript and review of the
publications which supports all aspects of ensuring
integrity and accuracy. Furthermore, the authors thank
Mrs. Lisa Felix, PhD for reviewing and improving the
quality of the manuscript.
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