Abstract
Libidibia ferrea (Mart. ex Tul.) L. P. Queiroz (jucá) is a plant extensively used in the Brazilian folk medicine for the treatment of the inflammatory process. Primary studies have focused on the verification of these biological activities, highlighting the role of this plant in inflammatory conditions. This systematic review aimed to critically establish which part of the plant and what type of plant extract present the highest evidence of anti-inflammatory activity as in vivo and in vitro experimental models. This study has followed the recommendations by PRISMA and was registered in the PROSPERO database under number CRD42020159934. The literature review was carried out in several medical and scientific databases (Google Scholar, LILACS, ProQuest, PubMed, ScienceDirect, Scopus and Web of Science) in studies published up to February 2020 and updated on March 2021. No language restriction was made to this search. Eligibility criteria were adopted instead. The risk of bias was evaluated through SYRCLE’s RoB tool for the in vivo studies. 609 studies were initiated to identify the whole and the subsequent steps of screening. 13 studies remained in the results (10 in vivo and 3 in vitro). In most studies the risk of bias was low or unclear. The high risk of bias was related to the risk of attrition and reporting bias. The fruit and the aqueous extract were identified as the most used in the studies carried out on the qualitative analysis and the results of the in vivo and in vitro studies were conducive to the anti-inflammatory action, a meta-analysis could not be performed due to heterogeneity between studies and the potential risk of bias to estimate the side effects. Therefore, the implementation of in vivo studies following the international guidelines could collaborate with analyses of the anti-inflammatory effect of jucá.
Highlights
In view of the systematic organization and analysis of scientific evidence of the anti-inflammatory effects of L. ferrea or Caesalpinia ferrea on in vivo and in vitro studies, we have sought to answer that part of the L. ferrea plant, and which type of extract has the most evident antiinflammatory effects in the experimental models of acute inflammation on in vivo and in vitro studies
The electronic research has identified one systematic review entitled Natural Antimicrobials and Oral Microorganisms: A Systematic Review on Herbal Interventions for the Eradication of Multispecies Oral Biofilms [31], that provide antimicrobial data from various medicinal plants, including Caesalpinia ferrea, the anti-inflammatory activity data were not described in said study
Nine studies [19,20,21,22,23,24,25,26, 30] have obtained the plants in the Northeastern region in Brazil, and four [12, 27, 28, 29] have obtained them in the Northern region which corroborates the Libidibia ferrea anti-inflammatory action on in vivo and in vitro studies: A systematic review literature data, which have demonstrated the wide distribution of this plant throughout Brazil, occurring in Caatinga, Atlantic Forest, and Cerrado domains especially in this area [3] and Northern region (AM, AP, PA, RO, RR) [32]
Summary
This Systematic Review followed the recommendations by Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) [S1 and S2 Tables] and was registered in the Prospective Registry of Systematic Reviews (PROSPERO) database under protocol number CRD42020159934 (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID= 159934). There was no language restriction in the systematic search from which all the references of the included studies were screened for identifying potential additional study. Studies, which attended the eligibility criteria were included for narrative synthesis, a summarization of the collected data and descriptive analysis of the results. In addition to the use of SYRCLE as described above, indirectness domain was used to analyze the quality of evidence, following the GRADE for in vivo studies [14]. Grades of Recommendation, Assessment, Development and Evaluation Working Group Guideline Development Tool (GRADEpro GDT) [15] was used. Extraction and summarized data from in vitro studies were described in Tables 4 and 5. There is an evaluation tool to assess the in vitro toxicity studies using the Science in Risk Assessment and Policy (SCIRAP tool) [18]
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