Piper betel a traditional green gold to the world of medicine

It reached Madagascar and East Africa much later, and was also introduced into the West Indies. 

Written Chinese sources from the period of the Tang dynasty (A.D. 618-907) described South-East Asia as a region of betel users. 

Betel chewing was widespread in South India and South China when the first Europeans arrived in the 15th Century.

SCIENTIFIC CLASSIFICATION

Kingdom:Plantae

Clade:Tracheophytes

Clade:Angiosperms

Clade:Magnoliids

Order:Piperales

Family:Piperaceae

Genus:Piper

Species:P. betle 

ELEMENTAL COMPOSITION

Photo credit: Deenanath jhade

https://www.researchgate.net/figure/Elemental-Composition-of-Piper-betle-Linn_tbl1_305425617

TRADITIONAL USES

• Betel leaf has been described from ancient times as an aromatic, stimulo-carminative
• astringent and aphrodisiac 
• The leaves are credited with wound healing property
• The Indian traditional system of medicine has identified the leaves with digestive and pancreatic lipase stimulant activities
• Betel leaf is traditionally known to be useful for the treatment of various diseases like bad breath, boils and abscesses, conjunctivitis, constipation, headache, itches, mastitis, mastoiditis, leucorrhoea, otorrhoea, swelling of gum, rheumatism, cuts and injuries
• Fresh juice of betel leaves is used in many ayurvedic preparations
•  Leaves considered being useful in treating bronchitis and dyspnea
• The leaves were chewed by singers to improve their voice
• The fruit of Piper betel employed with honey as a remedy for cough
• The fresh betel leaves possess antimicrobial, ringworm, antifungal, antiseptic and antihelminthic effects
• Leaves are used in eye drops for eye injury/infection as a baby lotion for the new born, for coughs, asthma, constipation and to arrest milk secretion
• Essential oil from leaves of this plant has been used for the treatment of respiratory catarrhs and antiseptic
• Leaf extract is reported to inhibit male reproductive competence
• The leaves possess antifertility on male rats and anti-motility effects on washed human spermatozoa
• In folk medicine root is used as long lasting female oral contraceptive.
•  The users believe that chewing the ‘paan’ improves their efficiency and stamina
• Piper betel showed hypotensive, cardio tonic, smooth and skeletal muscles relaxant actions

MEDICINAL VALUES 

• Cytotoxic or Anticancer Potential

Study evaluated an aqueous extract of leaves to cytotoxicity studies on Hep-2 cell line. The mean CTC50 was 96.25 ug/ml suggesting potent cytotoxicity and probable anticancer property. Piper betle leaf extract showed significant LC50 values of >100 µg/mL towards A.salina. The presence of cytotoxic compounds also suggests potential antitumor or anticancer property.

Anti cancer activity of piper betal

Photo credit :Sushma R. Gundala, and Ritu Aneja Cancer Prev Res 2014;7:477-486 ( American Association for Cancer Research)

• Antimalarial/Antioxidant

Study evaluated the phytochemical and antioxidant potentials of a crude extract for possible antimalarial effects. Phytochemical screening yielded antiplasmodial chemical constituents. The extract exhibited potent ability to scavenge free radicals and demonstrated significant schizonticidal activity in all three antimalarial evaluation models.

Photo credit: https://www.lybrate.com

• PotentialAnti-Diabetic/Leaves

Study evaluated the possibility of P. betle as a neutraceutical for diabetes mellitus patients. Patients were treated with either P. betle or triphal (an herbal antidiabetic drug). Results demonstrated the ability of P.betle capsules made from spray dried powder of betel hot water extract as a potential treatment for type 2 diabetes patients.

Photo credit: https://doi.org/10.1016/j.bionut.2014.07.009 

• Antioxidant/Antiproliferative

An ethyl acetate extract showed the highest ferric reducing activity and radical scavenging activities against DPPH, superoxide anion and NO radicals, which was attributed to its high phenolic content. Analyses yielded catechin, morin, and quercetin in the leaves. The plant extract also showed highest inhibitory effect against proliferation of MCF-7 cells, with increased activities of catalase and superoxide dismutase.

• Antifertility effect

Ethanolic extract of Piper betle Petiole given to female albino rats at a dose level of 100 mg/kg caused antiestrogenic effects . Extract treatment caused reduction in reproductive organ weights, circulating level of estrogen, fertility, number of litters, serum glucose concentration, enzyme activity of acid phosphatase, SGOT and SGPT Whereas, the concentration of cholesterol and ascorbic acid increased. This is needed to be investigated whether cholesterol is increased due to non-utilization of it or by de novo synthesis.

• Anti-Ulcer/Wound Healing

Betel leaves therapeutic qualities consists of healing of wounds as well as infection. Crush a couple of leaves, extract the juice, and use it on the wound or even infection. Then place a betel leaf on top of it and wrap it using a bandage. The wound will certainly heal within 2 days since it helps prevent the development of destructive microbes. 

Photo credit:  https://doi.org/10.1186/s41038-015-0023-7

Research done on rat about wound healing properties of piper betal

• Antihistaminic Activity

Study evaluated the antihistaminic activity of P. betle. Results showed antihistamine activity, with a right shift of dose response curve of histamine and disturbed histamine induced bronchoconstriction in whole guinea pig. Chlorpheniramine was used as reference.

• Glucose Lowering/Analgesic

Antihyperglycemic activity evaluation of methanol extract of leaves in glucose-loaded Swiss albino mice showed dose-dependent and significant lowering of blood sugar. Antinociceptive evaluation in gastric pain models in mice showed significant and dose-dependent reduction in the number of gastric writhing in gastric pain-induced mice.

• Anticariogenic Effect/Action on Salivary pH

Study on the anticariogenic efficacy of Piper betle showed efficacy in resisting salivary pH change comparable to 0.05% sodium fluoride. Piper betle showed an anticariogenic effect through effective inhibition of acid production by salivary bacteria.

• Antifungal

Hydroxychavicol, isolated from the chloroform extraction of the aqueous extract of P. betle, was investigated for antifungal activity against 124 strains of selected fungi.Hydroxychavicol exhibited inhibitory effects on fungal species of clinical significance. It also exhibited an extended post antifungal effect for Candida species and suppression of mutant emergence. Results suggest a potential antifungal agent for topical applications, as well as a gargle for oral candida infections.

• Antitumor

Study evaluated a methanolic extract of Piper betle leaves and fractions for antitumor activity against Ehrlich ascites carcinoma in Swiss albino mice. Results showed significant antitumor activity, which may be attributed to augmentation of endogenous antioxidant potential.

• Antimicrobial

Antimicrobial screening of essential oil showed antibacterial activity against E. coli, Streptococcus pyogenes, and S. aureus and antifungal activity against Colletotrichum sp., Fusarium oxysporium sp., Corynospora cassicola, and Rigidoporous sp.Larvicidal on Screwworm Fly (Chrysomya bezziana)

Essential Oil/Leaves: Study of essential oil of Piper betle showed effective larvicidal activity for first and second instar larvae in vitro, suggesting a potential for a natural and novel larvicide. Study evaluated the radioprotective activity of Piper betle

• Anti-Cholinesterase Inhibitory Activity

Study evaluated three leaf varieties Kaliganga, Meetha, and Haldi—for acetylcholinesterase inhibitory properties.Aqueous extracts of both fresh and dry leaves of all varieties inhibited acetylcholinesterase activity in a dose dependent manner. The AChE inhibitory property of P. betle may have a beneficial effect on memory function.

• Gastroprotective

Study evaluated the gastroprotective activity of allylpyrocatechol (APC), the major antioxidant constituent of Piper betle, against indomethacin-induced stomach ulceration in a rat model. Results showed both APC and misoprostol effectively healed stomach ulceration. The protective activity was attributed to antioxidant activity and the enhancement of mucin content of gastric tissues.

• Anti-Adipogenic/Weight Reducing Potential

Out of 480 herbal extracts, Piper betle and Dolichos biflorus were chosen and evaluated for synergistic anti-adipogenic effects. The herbal formulation LOWAT was significantly better than the individual extracts in terms of adipogenic inhibition. In vitro studies showed inhibition of pre-adipocyte differentiation and potentiation of lipid breakdown in mature adipocytes. In vivo studies showed reduced weight gain with increased serum adiponectin levels in rats on a high fat diet. Results suggest the formulation has potential as a weight management agent.

• Antidepressant

Study evaluated the antidepressant activity of ethanolic extract of P. betle leaves in Swiss albino mice. Results showed significant antidepressant effect as indicated by reduction in duration of immobility. The 100 mg extract dose effect was greater than that of imipramine.

• Anticholesterolemic

Study evaluated the antihypercholesterolemic and antioxidative properties of an ethanolic extract of Piper betle and its active constituent, eugenol, in experimental hypercholesterolemia in Wistar rats. Results showed that eugenol possesses antihyper-cholesterolemic properties.

• Skin Antiseptic

Study evaluated the effectiveness of a 20% Piper betle leaf infusion as an antiseptic solution in pre-surgery cataract patients. Results showed the infusion to have an antiseptic potential. However, the 10% povidone-iodine solution was more effective antiseptic capability.

• Bacteriostatic/Dental Plaque

A study investigating the bacteriostatic effect of Piper betle and P guajava showed both extracts have bacteriostatic effect on the plaque bacteria through suppression of growth and propagation of cells. Results suggest the decoction of plants would be a suitable if used in the control of dental plaque. Results of study showed the crude extract of P betle leaves may exert anticariogenic activities related to a decrease in acid production and changes to the ultrastructure of S mutans.

• Anti-Platelet Aggravating Factory

Evaluation of Piper betle on Platelet Activating Factor (PAF) Receptor Binding Activities: Results showed antagonistic activity towards the PAF (platelet activating factor) in rabbit platelet receptor binding studies.

• Antihyperglycemic

Study evaluated the effect of P.betle on glucose metabolism since it is consumed as betel-quid aftermeals. Results showed that P. betle intake influences glucose metabolism beneficially. 

• Anti-Leishmaniasis

In a comparative in vitro anti-leishmanial activity of methanolic extracts from two landraces of Piper betle.The PB-BM (P betle landrace Bangla Mahoba) selectively inhibited both stages of Leishmania parasites without macrophage cytotoxicity. The efficacy mediated through apoptosis is probably due to higher content of eugenol.

Eugenol  reduced the intracellular proliferation of amastigotes in leishmaniasis

Photo credit: https://doi.org/10.1016/j.actatropica.2016.08.026

REFERENCE 

• https://en.m.wikipedia.org/wiki/Betel

• Shah, S.K. & Garg, G. & Jhade, Deenanath & Patel, N.. (2016). Piper betle: Phytochemical, pharmacological and nutritional value in health management. International Journal of Pharmaceutical Sciences Review and Research. 38. 181-189.
• Verma S, Gupta M.L., Dutta A., Sankhwar S., Shukla S.K. and Flora S.J. Modulation of ionizing radiation induced oxidative imbalance by semi-fractionated extract of Piper betel: an in vitro and in vivo assessment. Oxid. Med. Cell.Longev. 3(1), 2010, 44-52.
• https://www.healthbenefitstimes.com/health-benefits-of-betel-leaf/
• https://uses.plantnet-project.org/en/Piper_betle_(PROSEA) 
• ISSN 2278- 4136, ZDB-Number: 2668735-5IC Journal No: 8192Volume. 1 No. 6 2013 www.phytojournal.com Page | 147, Golden Heart of the Nature: Piper betle L. ByD. Pradhan, Dr. K. A. Suri, Dr. D. K. Pradhan and P. Biswasroy 
• https://www.lybrate.com/topic/betel-leaf-benefits