Review
Psidium guajava: A review of its traditional uses, phytochemistry and pharmacology

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Abstract

Psidium guajava, is an important food crop and medicinal plant in tropical and subtropical countries is widely used like food and in folk medicine around of the world. This aims a comprehensive of the chemical constituents, pharmacological, and clinical uses. Different pharmacological experiments in a number of in vitro and in vivo models have been carried out. Also have been identified the medicinally important phyto-constituents. A number of metabolites in good yield and some have been shown to possess useful biological activities belonging mainly to phenolic, flavonoid, carotenoid, terpenoid and triterpene. Extracts and metabolites of this plant, particularly those from leaves and fruits possess useful pharmacological activities. A survey of the literature shows P. guajava is mainly known for its antispasmodic and antimicrobial properties in the treatment of diarrhoea and dysentery. Has also been used extensively as a hypoglycaemic agent. Many pharmacological studies have demonstrated the ability of this plant to exhibit antioxidant, hepatoprotection, anti-allergy, antimicrobial, antigenotoxic, antiplasmodial, cytotoxic, antispasmodic, cardioactive, anticough, antidiabetic, antiinflamatory and antinociceptive activities, supporting its traditional uses. Suggest a wide range of clinical applications for the treatment of infantile rotaviral enteritis, diarrhoea and diabetes.

Introduction

Psidium guajava, which is considered a native to Mexico (Rios et al., 1977) extends throughout the South America, European, Africa and Asia. Based on archaeological evidence. It has been used widely and known in Peru since pre-Columbian times. It grows in all the tropical and subtropical areas of the world, adapts to different climatic conditions but prefers dry climates (Stone, 1970). The main traditional use known is as an anti-diarrhoeal. Other reported uses include gastroenteritis, dysentery, stomach, antibacterial colic pathogenic germs of the intestine.

Its medicinal usage has been reported in indigenous system of medicines in America more than elsewhere. Psidium guajava Linn. (family Myrtaceae), is commonly called guave, goyave or goyavier in French; guave, Guavenbaum, Guayave in German; banjiro in Japanese; goiaba, goiabeiro in Portugal; araçá-goiaba, araçá-guaçú, guaiaba in Brazil; guayaba, guayabo in Español and guava in English (Killion, 2000). Psidium guajava is a small tree which is 10 m high with thin, smooth, patchy, peeling bark. Leaves are opposite, short-petiolate, the blade oval with prominent pinnate veins, 5–15 cm long. Flowers are somewhat showy, petals whitish up to 2 cm long, stamens numerous (Stone, 1970). Fruit are fleshy yellow globose to ovoid berry about 5 cm in diameter with an edible pink mesocarp containing numerous small hard white seeds. There has been a tremendous interest in this plant as evidenced by the voluminous work. Therefore, we aimed to compile an up to date and comprehensive review of Psidium guajava that covers its traditional and folk medicine uses, phytochemistry and pharmacology.

More recent ethnopharmacological studies show that Psidium guajava is used in many parts of the world for the treatment of a number of diseases, e.g. as an anti-inflammatory, for diabetes, hypertension, caries, wounds, pain relief and reducing fever (Table 1). Some of the countries with a long history of traditional medicinal use of guava include Mexico and other Central American countries including the Caribbean, Africa and Asia. Some of these uses will be outlined here.

Medicinal plants are an important element of the indigenous medical systems in Mexico (Lara and Marquez, 1996). These resources are part of their traditional knowledge. The Popoluca Indians of Veracruz rely on medicinal plants for their health care. They appear to have developed a system whereby they select and continue to use plants that they find the most effective for health care purposes. The folk use of guava has been documented in the indigenous groups of Mexican Indians, Maya, Nahuatl, Zapotec and Popoluca. A decoction of the leaves is used to cure cough. According to communities of Nahuatl and Maya origin and Popoluca of the region of the Tuxtlas, Veracruz, they use a guava leaf decoction to treat digestive suffering associated with severe diarrhoea. This is a frequent disease in rainy weather (Heinrich et al., 1998).

P guajava (Myrtaceae) is widely used in Mexico to treat gastrointestinal and respiratory disturbances and is used as an anti-inflammatory medicine (Aguilar et al., 1994). Commonly roots, bark, leaves and immature fruits, are used in the treatment of gastroenteritis, diarrhoea and dysentery. Leaves are applied on wounds, ulcers and for rheumatic pain, while they are chewed to relieve toothache (Heinrich et al., 1998). A decoction of the new shoots is taken as a febrifuge. A combined decoction of leaves and bark is given to expel the placenta after childbirth (Martínez and Barajas, 1991). A water leaf extract is used to reduce blood glucose level in diabetics. This hot tea was very common among the local people of Veracruz (Aguilar et al., 1994).

The leaf of Psidium guajava is used traditionally in South African folk medicine to manage, control, and/or treat a plethora of human ailments, including diabetes mellitus and hypertension (Ojewole, 2005, Oh et al., 2005).

Guava has been used widely in the traditional medicine of Latin America and the Caribbean in the treatment of diarrhoea and stomach-aches due to indigestion (Mejía and Rengifo, 2000, Mitchell and Ahmad, 2006a, Mitchell and Ahmad, 2006b). Treatment usually involves a decoction of the leaves, roots, and bark of the plant. It also has been used for dysentery in Panama and as an astringent in Venezuela. A decoction of the bark and leaves is also reported to be used as a bath to treat skin ailments. In Uruguay, a decoction of the leaves is used as a vaginal and uterine wash, especially in leucorrhoea (Conway, 2002). In Costa Rica, a decoction of the flower buds is considered an effective anti-inflammatory remedy (Pardo, 1999).

In Peru, it is used for gastroenteritis, dysentery, stomach pain (by acting on the pathogenic microorganisms of the intestine), indigestion, inflammations of the mouth and throat in the form of gargles (Cabieses, 1993). In some tribes of the forest (Tipis), the tender leaves are chewed to control toothaches by their weak sedative effect. Tikuna Indians use the decocted leaves or bark of guava for diseases of the gastrointestinal tract. It is also employed by the Indians of the Amazons for dysentery, sore throats, vomiting, stomach upsets, vertigo, and to regulate menstrual periods, mouth sores, bleeding gums, or used as a douche for vaginal discharge and to tighten and tone vaginal walls after childbirth. Flowers are also mashed and applied to painful eye conditions such as sun strain, conjunctivitis or eye injuries (Smith and Nigel, 1992). Guava jelly is tonic to the heart and constipation (Conway, 2002).

In the Philippines the astringent unripe fruit, the leaves, the cortex of the bark and the roots are used for washing ulcers and wounds, as an astringent, vulnerary, and for diarrhoea. Leaves and shoots are used by West Indians in febrifuge and antispasmodic baths; the dust of the leaves is used in the treatment of rheumatism, epilepsy and cholera; and guava leaves tincture is given to children suffering from convulsions (Morton, 1987).

In Latin America, Central and West Africa, and Southeast Asia, guava is considered an astringent, drying agent and a diuretic. A decoction is also recommended as a gargle for sore throats, laryngitis and swelling of the mouth, and it is used externally for skin ulcers, vaginal irritation and discharge (Mejía and Rengifo, 2000). In Mozambique, the decoction of leaves is mixed with the leaves of Abacateira cajueiro, to alleviate the flu, cough and pressed chest. In Mozambique, Argentina, Mexico and Nicaragua, guava leaves are applied externally for inflammatory diseases (Jansen and Méndez, 1990).

The use of medicinal plants by the general Chinese population is an old and still widespread practice. Psidium guajava leaves are example of the plant commonly used as popular medicine for diarrhoea which is also used as an antiseptic (Teixeira et al., 2003).

In Brazil the fruit and leaves are considered for anorexia, cholera, diarrhoea, digestive problems, dysentery, gastric insufficiency, inflamed mucous membranes, laryngitis, mouth (swelling), skin problems, sore throat, ulcers, vaginal discharge (Holetz et al., 2002). In USA guava leaf extracts that are used in various herbal formulas for a myriad of purposes; from herbal antibiotic and diarrhoea formulas to bowel health and weight loss formulas (Smith and Nigel, 1992).

Besides the medicinal uses Psidium guayava is employed as food, in carpentry, in construction of houses and in the manufacture of toys (Table 2).

Section snippets

Fruits

These are characterized by a low content of carbohydrates (13.2%), fats (0.53%), and proteins (0.88%) and by a high-water content (84.9%), (Medina and Pagano, 2003). Food value per 100 g is: Calories 36–50 kcal, moisture 77–86 g, crude fibre 2.8–5.5 g, ash 0.43–0.7 g, calcium 9.1–17 mg, phosphorus (Conway, 2002), 17.8–30 mg, iron 0.30–0.70 mg (Iwu, 1993), vitamin A 200–400 I.U., thiamine 0.046 mg, riboflavin 0.03–0.04 mg, niacin 0.6–1.068 mg, ascorbic acid 100 mg, vitamin B3 40 I.U. (Fujita et al., 1985,

Biological activity

Scientific investigations on the medicinal properties of guava dates back to the 1940s. A summary of the findings of these studies performed is presented below.

Toxicology

This toxicologic study was conducted using dry leaves of Psidium guajava L. In this plant material, acute toxicologic study by the following methods: mean lethal dose LD50 test in Swiss mice and alternative toxicology (acute toxic classes) in Wistar rats. We also made the genotoxic of 2 extracts, one of aqueous type, and the other of henaxic type in an in vitro system of short-term somatic segregation induction assay in the Aspergillus nidulans fungus and an in vivo assay of the dry drug in

Infantile rotaviral enteritis

A pilot study was carried out at the Nanfang Hospital, First Military Medical University, and Guangzhou on Psidium guajava (PG) leaf decoction for treating infantile rotaviral enteritis. Sixty-two patients of rotaviral enteritis were randomly divided into the verum group treated with PG and the control group treated with Gegen Qinlian decoction. The time for ceasing diarrhoeal, the content of Na+ in blood, the content of Na+ and glucose in stool, and the rate of negative conversion of human

Summary

Psidium guajava is a well-known medicinal plant that is frequently prescribed in various indigenous systems of medicine especially those of Central America and Africa. Guava extracts, traditionally prepared (infusions, decoctions, tinctures of the barks and leaves and ripe fruit) by many widely separated cultures for eons of time for various uses (Table 1) have, as summarised in this review, been shown by the application of modern scientific methods to indeed possess multiple disease

Conclusion

The pharmacological studies conducted on Psidium guajava indicate the immense potential of this plant in the treatment of conditions such as diarrhoeal, gastroenteritis and rotavirus enteritis, wounds, acne, dental plaque, malaria, allergies, coughs, diabetes, cardiovascular disorder, degenerative muscular diseases, inflammatory ailments including rheumatism and menstrual pain, liver diseases, cancer, etc. Not surprisingly, guava also exhibits antioxidant and anti-inflammatory effects as

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