Anti-inflammatory and antioxidant activity of Varronia curassavica’s extracts
in preclinical studies: a systematic review
Cordia verbenacea; extract; inflammation.
Varronia curassavica Jacq. is a native and non-endemic species of Brazil, and plant derivatives
obtained from the species are popularly used for the treatment of inflammatory diseases in
general. In Brazil, there is a phytotherapeutic medicine registered with ANVISA that has the
essential oil of the species as an active ingredient. It is known that extracts and essential oils
are plant derivatives; however, they have different chemical compositions. Within this context,
the anti-inflammatory pharmacological effect of the essential oil obtained from the leaves
cannot be extrapolated to other plant derivatives obtained, for example, with water and ethanol.
Therefore, it is justified to conduct a systematic review with the species to assess whether there
is preclinical evidence that proves the efficacy, safety, and quality of plant derivatives obtained
with organic solvents and water. Therefore, the objective of this study was to evaluate the
antioxidant and anti-inflammatory capacity of Varronia curassavica (erva-baleeira) in
preclinical models through a systematic review of the literature. To conduct this systematic
review, the checklist contained in the Preferred Reporting Framework for Systematic Reviews
and Meta-Analyses (PRISMA) was used as a guide for study selection, screening and eligibility.
The guiding question of this review is “What is the antioxidant and anti-inflammatory capacity
of Varronia curassavica (erva-baleeira) using preclinical models?”. MeSH and non-MeSH
terms were used for the search strategy and the search was conducted in PubMed-Medline,
Scopus, Web of Science and Embase. With the selected studies, data extraction and risk of bias
assessment were performed using the Systematic Review Center for Laboratory Animal
Experimentation (SYRCLE) risk of bias tool. As a result, it was possible to highlight in this
systematic review that the leaves were the part of the plant most used by the studies, being
subjected to maceration c in most cases, with ethanol or 70% ethanol. Six studies conducted
with extracts identified four main substances: rosmarinic acid, artemetin, briquelin, and
cordialin A. The results observed in preclinical studies with animals showed that, administered
orally, the extract was able to decrease the expression of pro-inflammatory cytokines, such as
TNF-α, IL-6, and IL-1β, edema, and increase important antioxidant enzymes, such as catalase
and GSH. In contrast, the essential oil, administered orally, was also able to reduce edema and
TNF-α; however, it did not cause changes in IL-1β and PGE2. The methodological quality of
the studies included in this systematic review was predominantly classified as low risk, since
most of the criteria necessary to assess bias in the study were sufficiently reported. In
conclusion, the results suggest that V. curassavica extracts have anti-inflammatory and
antioxidant potential in preclinical in vivo models. It was observed that the ethanolic and
hydroethanolic extracts obtained by maceration from the leaves of erva-baleeira were capable
of combating inflammation in preclinical models in vivo, using the oral route of administration
as the main route.