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Review
School of Pharmacy, Institut Teknologi Bandung (ITB), Jl Ganesha 10, Bandung 40116, Indonesia and Department
of Pharmaceutical Biology, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
b Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Antonius Deusinglaan 1,
9713 AV Groningen, The Netherlands
c Technische Biochemie, Technische Universitt Dortmund, Emil-Figge-Strasse 66, 44227 Dortmund, Germany
a r t i c l e
i n f o
a b s t r a c t
Article history:
Jamu is the Indonesian traditional herbal medicine that has been practised for many cen-
turies in the Indonesian community to maintain good health and to treat diseases. Although
9 October 2013
still very popular in rural as well as in urban areas. Based on its traditional use jamu is
being developed into a rational form of therapy, by herbal practitioners and in the form of
phytopharmaceuticals. Jamu has acquired a potential benet, both economically and clinically. We surveyed the most frequently used plants in jamu that have also been investigated
Keywords:
regarding their constituents and pharmacological effects. The Indonesian government has
Jamu
divided the preparation of medicinal plants into three categories, i.e. jamu, standardized
Phytomedicine
jamu is largely based on empirical data, more research is needed to scientically prove
Pharmacological activity
efcacy and to assure safety. In the further development of jamu, ethical issues such as
intellectual property rights, benet sharing, biodiversity and conservation need to be considered. This paper aims to review the current status of jamu and to give comprehensive
views that can be used in its future development for the further improvement of its utility
in curing illnesses and maintaining good health.
2014 Elsevier GmbH. All rights reserved.
Contents
1.
2.
3.
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Indonesian medicinal plants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.1. Biodiversity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.2. Recent research development and research communities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.3. Economical prospective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Corresponding author at: Technische Biochemie, Emil-Figge-Strasse 66, 44227 Dortmund, Germany. Tel.: +49 231 7557 487;
fax: +49 231 7557 489.
E-mail address: oliver.kayser@bci.tu-dortmund.de (O. Kayser).
2210-8033/$ see front matter 2014 Elsevier GmbH. All rights reserved.
http://dx.doi.org/10.1016/j.hermed.2014.01.002
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4.
5.
6.
7.
1.
j o u r n a l o f h e r b a l m e d i c i n e 4 ( 2 0 1 4 ) 5173
Introduction
2.
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Methodology
3.
3.1.
Biodiversity
j o u r n a l o f h e r b a l m e d i c i n e 4 ( 2 0 1 4 ) 5173
Indonesian Country Study on Biodiversity (ICSBD 1993) estimates the number of owering plants species in Indonesia to
be between 25,000 and 30,000. Some 40 million Indonesians
have historically used the herbal medicines for protection
and the treatment of diseases and the Indonesian community
makes use of around 6000 plant species. Data of the number
of medicinal plants also vary. PT Eisei (1995) published the Dictionary of Indonesian Medicinal Herbs containing more than 2500
plant species which principally can be developed for medicinal purposes, while Zuhud et al. (2001) identied 1845 species
with medicinal potential in the forests of Indonesia. These
numbers are potentially to be updated due to the continuing inventory and investigation of yet unidentied species.
According to the National Agency of Drug and Food Control
(NADFC/BPOM), 283 plant species have been ofcially registered for their medicinal use; the larger remainder is used
traditionally.
To facilitate the activities on the conservation and sustainable use of biodiversity of Indonesian medicinal plants
as medicines and functional foods, the Indonesian Government, through the National Development Planning Agency
(BAPPENAS), has launched the Indonesian Biodiversity Strategy and Action Plan 20032020 (IBSAP). IBSAP is based on
the evaluation of the previous action plan from 1993 called
BAPI (Biodiversity Action Plan for Indonesia), formulated in
collaboration between the Indonesian Government (BAPPENAS), the Ministry of Environment, research institutes and
non-governmental stakeholders with the support of the international development institutions.
3.2.
Recent research development and research
communities
Evaluation of jamu as a rational phytotherapy has to cover
different areas of research including social, cultural, economic, and ethical viewpoints. Preclinical pharmacological
studies have been carried out with extracts and isolated
compounds, and even a few clinical studies are available.
However, jamu is still largely not evidence-based from a
clinical perspective. The results from in vitro and in vivo preclinical studies support the traditional use of many jamu
products.
Many institutions in Indonesia, especially governmental institutions such as the Ministry of Health, Ministry
of Forestry, Ministry of Environment, Ministry of Agriculture, the National Development Planning Agency (BAPPENAS),
the National Agency of Drug and Food Control (NADFC or
BPOM) are engaged in research directed at the development of medicinal plants. The universities are also actively
involved in plant research through their related faculties
or departments from a variety of different areas such as
medicine, pharmacy, chemistry, biology, agriculture, forestry,
marine, environment and engineering. National research
institutions such as the Indonesian Institute of Science
and the Herbarium Bogoriense, are involved in the development of jamu as well as non-governmental institutions
such as KEHATI (Indonesian Biodiversity Foundation), WALHI,
SKEPHI, and various industrial companies (Bermawie et al.,
2005).
3.3.
53
Economical prospective
3.4.
Ethical considerations in the development of
medicinal plants
Intellectual property rights (IPR), indigenous knowledge, benet sharing, efcacy and safety are issues that must be
considered in the further development of Indonesian medicinal plants. Jamu has been handed down from generation to
generation based on the traditional knowledge and experience of the community. When new plant-derived therapeutics
based on indigenous knowledge are being explored, it is
important that the companies return benets to the native
population and the local governments from which the
research material was obtained (King et al., 1996). When
individuals or institutions from biotechnologically developed
countries wish to obtain indigenous raw material from a
biotechnologically less developed country, an agreement for
the procurement of such material may be negotiated. In article 19.2 of the Rio Convention (1992) there is an agreement
in regard to the handling of biotechnology and distribution
of its benets. It is mentioned that each contracting party
shall take all practicable measures to promote and advance
priority access on a fair and equitable basis by contracting parties, especially developing countries, to the results
and benets arising from biotechnologies based upon genetic
resources provided by those contracting parties. Such access
shall be on mutually agreed terms. Goodwill to maintain
such a ow may be achieved through appropriate scientic
and monetary compensation, both in real time and in longterm sharing of the benets of discovery (Soedjarto, 1996).
Over-harvesting may render medicinal plants into endangered species. Individuals or institutions exploring medicinal
plant material also have responsibilities for their conservation. Most of the current knowledge that jamu can maintain
health and/or cure certain diseases comes from the native
people who have experienced success in curing illness by taking jamu It remains to be proven that jamu fulls the generally
54
Table 1 Examples of jamu products (and composition) from the major Indonesian jamu companies.
Industry name
Jamu name
Ingredients
PT. Phapros
Menstralax
Sakit kencing
Kuku Bima
Fitogas
New Padibu
Fitolac
PT. Deltomed Laboratories
Srongpas Ginseng
Antangin JRG
Hiperten
Diabetin
PT. Mustika Ratu
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Indications/use
Jamu Jago
Pegal linu
Esha
Encok
Sirnakarang
Allus
Nyonya Meneer
Diapet NR
Encok
Irex Max
Diami
PT. Konimex
PT. Tenaga Tani farma
PT. Puspo Internusa
Sentia
Pil Binari
Pacekap diabest
Diamanis
55
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Alleviates rheumatism
Dissolves kidney stones
56
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4.
4.1.
Rational phytotherapy with jamu and
phytomedicine
Jamu, as traditional medicine arising from experiences of the
past and embedded in the culture of society, cannot stand
still but constantly changes and develops. Along with conventional medicine it shares issues in appropriate and rational
use. This includes qualication and licensing of the provider,
proper use of good quality products, good communication
between traditional medicine providers and patients and provision of scientic information and guidance to the public
(WHO, 2002). The WHO encourages the use and development
of traditional medicine as an accessible and affordable means
to provide healthcare for all people (WHO, 2005). Although
the pharmacological effects of some jamu constituents have
been recorded, there is an apparent lack of records or written
data reporting the effectiveness of jamu medicine, especially
jamu gendong. To assure the correct use of such products,
the Indonesian government (NADFC) has divided the medicinal plants into three categories based on the way they are
prepared and based on a judgement of proof of their efcacy; i.e. jamu, standardized herbal medicines, and tofarmaka
(phytomedicines; regulation nr. HK.00.05.4.2411, 2004). All
preparations have to meet basic safety criteria. The therapeutic effects of jamu have to be supported by empirical data. The
efcacy of standardized herbal medicines has to be proved
in preclinical trials and standardization on active ingredients is required, while for the efcacy of tofarmaka, clinical
trials have to be carried out. The Indonesian government
has launched the Centre for Development and Implementation of Traditional Treatment (Sentra P3T) in 1995. The
Centres activities include research on herbal medicines, education and training of human resources as well as service of
herbal medicines based treatment. Other programmes include
selecting, testing, certifying, registration/licensing, inventory,
screening, clinical testing, utilization and evaluation of traditional medicine, and compilation of laws applicable to
traditional treatment.
4.2.
Preparation of jamu
Original jamu (jamu gendong) is prepared in the form of a decoction and is sold by ladies carrying jamu on their back. Jamu
gendong is produced by cottage industries using traditional
methods. Traditional jamu makers are aware of issues relating
to hygiene, sanitation and chemical contaminations from biological or non-biological sources (such as bacterial and fungal
toxins, heavy metals).
They try to protect raw plant materials and products from
contamination, although this is unlikely to comply with international industrial standards. The methods of preparation
are often different from producer to producer, and production steps like selection of raw materials, sorting, grating,
4.3.
Legislative aspects of jamu and phytomedicines in
Indonesia
The Indonesian government, through the Ministry of Health
and NADFC, is regulating jamu and phytomedicines (tofarmaka). The regulations are aimed at developing safe
herbal medicinal products and to monitor the quality of the
products including efcacy and efciency by pharmacovigilance reports. For the production of traditional medicine
in Indonesia, the jamu gendong and small-scale industries
have to refer to good manufacturing practice guidelines for
traditional medicine, called CPOTB (Cara Pembuatan Obat Tradisional yang Baik). CPOTB is regulated by the Ministry of
Health (regulation nr. 659/MENKES/SK/X/1991). This regulation was renewed by BPOM in 2005 with regulation nr.
HK.00.05.4.1380. CPOTB and includes all aspects of production such as raw material, production process, quality
control, factory building, workers, management, instrumentation, and sanitation. CPOTB is also to be applied to
manufacturers producing standardized herbal medicines and
phytomedicine.
The traditional medicine manufacturers (IOT and IKOT)
as well as the jamu products have to be registered
in the BPOM (246/MENKES/Per/V/90 and HK.00.05.41.1384,
2005). Using this regulation, the production and distribution of traditional medicine can be controlled to full
the requirements according CPOTB. Traditional medicines
are produced in a range of formulations including powders, pills, capsules, crude extracts, tablets and liquids.
These medicinal products have to be produced according to the description published in regulation number
661/MENKES/SK/VII/1994. To develop the traditional jamu
medicines, the Indonesian government has established
the Centre for Development of Traditional Medicine (Sentra P3T). The Centre is supported by regulation number
0584/MENKES/SK/VI/1995.
Table 2 Review of published literature relating to selected medicinal plants used in jamu.
Plant name
Curcuma domestica
Plant part
Rhizomes
Zingiber ofcinale
Ethanol
Rhizomes
Zingiber aromatica
Kaemferia pandurata
Alpinia galanga
Ethanol
Rhizomes
Rhizomes
Major compound(s)
or group of
compounds
Curcumin
Xanthorrhizol
Results
In vitro IC50 = 40 M
In vitro and in vivo
EC50 = 6.16 g/ml
In vitro, in vivo,
IC50 = 40.6 g/ml
Ethanol
Gingerol, paradol
Ethanol
Zerumbone
Hexane
Pinostrobin
Chloroform
Hydroxypanduratin A
Panduratin A
Oil
Aqueous
acetone
In vitro, in vivo,
IC50 = 20.2 g/ml
In vitro 10100 g/ml
In vivo 2 mg/kg BW
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Curcuma xanthorrhiza
Type of extract
57
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Table 2 (Continued)
Plant name
Rheum palmatum
Cymbopogon citrates
Plant part
Root
Leaves
Type of extract
Methanol
Oil
Major compound(s)
or group of
compounds
Geranial, neral,
myrcene, -pinene
Plumeria bicolour
Bark
Methanol
Plumieride
Alstonia scholaris
Stem bark
Ethanol
Echitamine
Cuminum cyminum
Andrographis paniculata
Seeds
Aqueous,
ethanol
Ethanol
Fruits
Aerial part
Ethanol
Alkaloid
Essential oil
Andrographolide
Clinical 5 mg/kg
bodyweight (BW)
In vivo 1.5 mg/kg BW
In vitro IC50 = 4 g/ml
Results
Inhibition of -hexosaminidase, as a
marker of antigen-IgE-mediated
degranulation (Matsuda et al., 2003a,b)
Inhibition of the growth HeLa
epithelioid and BT-20 human breast
carcinoma cells (Kubo et al., 1992)
Inhibition of -glucosidase activity
(Kubo et al., 1991)
Induction of glutatione S-transferase
(GST) (Zheng et al., 1993)
Growth inhibition of Plasmodium
berghei 86.6% (Tchoumbougnang et al.,
2005)
Inhibition of the growth RIF tumour
cell lines (Dobhal et al., 2004)
Increase of the killing effect of
berberine against tumour on Ehrlich
ascites carcinoma (EAC)-bearing mice
(Jagetia and Baliga, 2004)
Cytotoxic effect in HeLa cell (Jagetia
and Baliga, 2005)
Stimulation of non specic immune
response (Iwo et al., 2000)
Increase of GST activity, inhibit
hepatocarcinogenesis (Aruna and
Sivaramakrishnan, 1998)
Exhibition of anticonvulsant activity
in both PTZ- and MES-induced
seizures (Sayyah et al., 2002)
Exhibition of the cytotoxic activity
against human T-47D cell line (Tan
et al., 2005)
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Pulmatin and
chrysophanein
physcionin
4 -O-methylpiceid and
rhapontin
d-Limonene and
geraniol
Roots
Chloroform
Xanthone
Ethanol
Andrograpanin
In vivo 30 mg/kg
In vitro 3 M
Arcangelisia ava
Whole part
Berberine
In vitro, 25 M
Ardisia compressa
Leaves
Aqueous
Phenolic compounds
Phyllanthus species
Whole plants
Aqueous
Alkaloids, avonoids,
lignans and terpenoids,
tannins
Piper sarmentosum
Berries
Methanol
Piper caba
Aqueous
acetone
Sarmentine, 1-piperetyl
pyrrolidine
Piperine, piperanine,
pipernonaline
Piper longum
Ethanol
Piperine
Isobutyleicosatrienamide,
trachyone,
pergumidiene
Isoliquiritigenin
In vitro 1 g/ml
Liquiritin apioside,
liquritin and
liquiritigenin
In vivo 30 mg/kg BW
Piper nigrum
Glycyrrhiza glabra
Roots
Ethanol
Cough, asthma
Diaphoretic, oedema lowering blood
pressure diaphoretic, dyspnoea
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Leaves
Rheumatic
59
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Table 2 (Continued)
Plant name
Plant part
Type of extract
Eurycoma lancifolia
Roots
Methanol
Anacardium occidentale
Stem barks
Aqueous
Stigmast-4-en-3-ol and
stigmast-4-en-3-one
Anacardic acid
Aerial parts
Buthanol
Myricetin
Aloe vera
Leaves
Ethanol
Centella asiatica
Aerial parts
Aqueous
Asiaticoside
In vivo 10 mg/kg BW
Polysaccharide
Pimarane-type
diterpenes,
neoorthosiphols A and B
Methylripariochromene
A
Terpenoids
Coriandrum sativum
Leaves
Fruits
Aqueous
Essential oil
Eurycomanone
7-methoxy--carboline1-propionic
acid
Abelmoschus moschatus
Orthoshipon aristatus
Results
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Hexane
Major compound(s)
or group of
compounds
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5.
Biological activity of the most common
plants in jamu
The biological activities of the most common plants used in
jamu as reported in the literature are summarized in Table 2.
These are discussed in more detail in the following sections.
5.1.
Anticancer
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O
HO
H3CO
OCH3
HO
HO
OH
3
HO
HO
HO
2
1
R3O
OR1
HO
OR2
4. R1 = R2 = R3 = H
5. R1 = R2 = H, R3 = CH3
OH
HOH2C
BzO
BzO
R2O
O
OH
OAc
R1O
N
HHO
8. R1 = OH, R2 = Ac
9. R1 = Ac, R2 = OH
CO2CH3
+
N CH3
10
CO2CH3
O
O
HO
HO
COOR4
CO2CH3 O
HO
OH
OH
HO
HOH2C
O
OCH3
OH
OH
O
HO
OH
O
O
O
H3CO
OH
HO
O
O
O
HO
OR1
COOR3
OR2
HO
OH
OH
11. R1 = R2 = CH3, R3 = R4 = X
12. R1 = H, R2 = CH3, R3 = R4 = X
13. R1 = R2 = R3 = CH3, R4 = X
14. R1 = R2 = CH3, R3 = X, R4 = CH3
15. R1 = H, R2 = CH3, R3 = R4 = X
OH
16. R1 = CH3, R2 = H, R3 = X, R4 = CH3
X=
OH
CO2CH3 OH
Fig. 1 Chemical structure of several active compounds from plants used in jamu; andrographolide (1),
14-deoxyandrographolide (2) (Andrographiis paniculata), curcumin (3) (Curcuma domestica), hydroxypanduratin A (4),
panduratin A (5) (Kaempferia pandurata), asiaticoside (6) (Centela asiatica), methylripariochromene A (7), orthosiphol A and B
(8 and 9) (Orthoshipon aristatus), echitamine (10) (Alstonia scholaris), helicterins AF (1116) (Helicteres isora).
j o u r n a l o f h e r b a l m e d i c i n e 4 ( 2 0 1 4 ) 5173
5.2.
Antiviral
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5.3.
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5.4.
Anti-inammatory, antirheumatic, antipyretic
and analgesic
5.5.
Hepatoprotective
5.6.
Antidiabetic
Diabetes mellitus is recognized by chronic elevation of the glucose level in the blood and often accompanied by symptoms
of severe thirst, polyuria, weight loss, and stupor. Medicinal plants that are used clinically to treat diabetes have
shown their antidiabetic activity in vitro, in vivo (in animal
models) and in clinical studies. The methanolic and aqueous extracts derived from A. galanga caused highly signicant
reduction in the blood glucose levels of normal rabbits (Akhtar
et al., 2002). The glucosidic compounds 4 -O-methylpiceid
and rhapontin, isolated from kelembak (R. palmatum) roots
that were collected from the market in Indonesia exhibited
moderate -glucosidase inhibitory activity in vitro. The inhibition of -glucosidase activity may be effective in controlling
abnormal levels of blood glucose in metabolic diseases such
as diabetes (Kubo et al., 1991). Hypolipidemic effects have
been shown for aqueous extracts of cumin seeds (Cuminum
cyminum) on alloxan-induced diabetic, triton and cholesterol
fed hyperlipemic rats. Hyperlipidemia is an associated complication of diabetes mellitus. In this study, administering
a cumin extract to diabetic rats signicantly reduced their
blood glucose levels. The mechanism may be a potentiation
of the insulin effect or by increasing the pancreatic secretion
of insulin from the cells (Dhandapani et al., 2002). Guazuma
ulmifolia leaves and Trigonella fonum graceum seeds that are
used clinically against diabetes mellitus have been studied
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5.7.
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5.8.
Gastroprotective
Isolated compounds, 1S-1 -acetoxychavicol acetate and 1S-1 acetoxyeugenol acetate, from A. galanga markedly inhibited
the ethanol-induced gastric mucosal lesions in rats. The
action of 1S-1 -acetoxychavicol was attenuated by pretreatment with indomethacin and N-ethylmalcimide and
signicantly increased the glutathione (GSH) levels of gastric
mucosa in rats. GSH acts as an antioxidant and is important for
maintaining the mucosal integrity in the stomach (Matsuda
et al., 2003a,b). A different mechanism of hepatoprotective
activity was shown by asiaticoside, an active triterpenoid
constituent of leaves of C. asiatica. They were found to promote angiogenesis and stimulate blood vessel formation and
mucosal cell regeneration during the gastric ulcer healing
stage that are important aspects of the wound healing process. Angiogenesis in granulation tissues improves circulation
to the wound site thus providing oxygen and nutrients essential for the healing process (Cheng et al., 2004). The effect
of an ethanolic extract of A. vera on acute gastric mucosal
lesions induced by 0.6 M HCl and acid output was studied in
pylorus ligated and lumen perfused rats, respectively showing
that A. vera has gastric acid anti-secretory activity and thus
66
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could potentially protect the gastric mucosa at low concentrations against injurious agents (Yusuf et al., 2004). Morinda
citrifolia (noni) inhibits gastric emptying in male rats via a
mechanism involving stimulation of cholecystokinin and its
receptor activation. Cholecystokinin is a peptide hormone of
the gastrointestinal system responsible for stimulating the
digestion of fat and protein. It delays gastric emptying and
inhibits gastric acid and plasma gastrin responses (Konturek
et al., 1994; Pu et al., 2004). Ethanol extract and water extract of
Abrus cantoniensis, Saussurea lappa, Eugenia caryophyllata, Magnolia ofcinalis and Ligusticum species strongly inhibited the
growth of Helicobacter pylori which is an important etiologic
impetus leading usually to chronic active gastritis and gastric
ulcer (Li et al., 2005).
5.9.
Cardioprotective
5.10.
Antihypertensive
5.11.
j o u r n a l o f h e r b a l m e d i c i n e 4 ( 2 0 1 4 ) 5173
5.12.
Immunostimulating
5.13.
The essential oil from the fruits of C. cyminum, traditionally used as a stimulant exhibited anticonvulsant activity
in both pentylenetrazole- and maximal electroshock-induced
seizures in male NMRI mice (Sayyah et al., 2002). Antidepressant effects have also been recently reported for curcumin.
It is suggested that this effect may be mediated by actions
in the central monoaminergic neurotransmitter systems (Xu
et al., 2005). G. radix, together with other medicinal plants
such as Bulpleuri radix, Paeoniae radix and Angelicae sinensis radix, have been tested in patients who were exhibiting
tremor, a possible symptom of antipsychotic-induced Parkinsonism. The results concluded that the combination of the
medicinal plants mentioned was effective against tremor from
Parkinsonism (Ishikawa et al., 2000). Methanol leaf extract of
A. macrophylla has been reported to have a CNS depressant
67
activity. It caused a signicant reduction in spontaneous activity, a decrease in exploratory behavioural pattern, a reduction
in muscle relaxant activity and also signicantly potentiated phenobarbital sodium-induced sleeping time in mice
(Chattopadhyay et al., 2004a,b).
5.14.
Others
6.
Known risks and side effects of
medicinal plants used in jamu
It is generally assumed by the public, and also even by
some medical practitioners, that plant drugs are harmless
and therefore are preferable to orthodox medicines. Although
on the whole plant medicines used at the correct dosage
elicit fewer side effects than their orthodox counterparts
their safety and efcacy cannot automatically be assured.
Numerous examples on herb-induced side effects have been
documented (Aronson, 2009).
Data from clinical trials suggest that the most commonly
experienced adverse effects of Panax ginseng for example
are headache, sleep and gastrointestinal disorder. Kavakava (Piper methysticum), currently banned in many European
countries and in the USA may cause tiredness, low energy,
headache, hepatoxicity, skin reactions and gastrointestinal
symptoms. A 52-year-old woman for example, was seen with
papules and plaques on the face and later on her dorsal and
ventral thorax and arms after taking a kava product (type
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7.
Conclusion
Jamu is and will remain an integral part of the Indonesian healthcare system. The in vitro, in vivo and clinical
studies on medicinal plants that are used in jamu have
in part scientically proved their claimed biological activities. Species belonging to the family Zingiberaceae such as
Curcuma, Zingiber, Kaempferia, are the most frequently used
plants in jamu. These species have also been studied intensively for their secondary metabolites and biological activity.
Curcumin and panduratin are typical examples of bioactive
secondary metabolites from these plant species. As members of the Zingiberaceae are generally regarded as safe for
human consumption, these species are excellent candidates
for development as novel standardized jamu products. BPOM
has carried out systematic and comprehensive research on
nine priority plants used in jamu in Indonesia, i.e. ginger
(Z. ofcinale) and king of bitter (A. paniculata) as antineoplasmatics; turmeric (C. domestica), Java turmeric (C. xanthorrhiza)
and bastard cedar G. ulmifolia as antihyperlipidemcs; Java
noni (M. citrifolia), Indonesian bay-leaf Syzygium polyanthum
references
j o u r n a l o f h e r b a l m e d i c i n e 4 ( 2 0 1 4 ) 5173
69
Chi CW, Chang YF, Chao TW, Chiang SH, Peng FK, Lui WY, et al.
Flow-cytometric analysis of the effect of berberine on the
expression of glucocorticoid receptors in human hepatoma
Hepg2 cells. Life Sciences 1994;26:2099107.
Chithra V, Leelamma S. Coriandrum sativum effect on lipid
metabolism in 1,2-dimethyl hydrazine induced colon cancer.
Journal of Ethnopharmacology 2000;71:45763.
Choi EM, Hwang JK. Screening of Indonesian medicinal plants for
inhibitor activity on nitric oxide production of RAW264.7 cells
and antioxidant activity. Fitoterapia 2005;76:194203.
Chrubasik S, Pittler MH, Roufogalis BD. Zingiberis rhizome: a
comprehensive review on the ginger effect and efcacy
proles. Phytomedicine 2005;12:684701.
Chularojmontri L, Wattanapitayakul SK, Herunsalee A,
Charuchongkolwongse S, Niumsakul S, Srichairat S.
Antioxidative and cardioprotective effects of Phyllanthus
urinaria L. on doxorubicin-induced cardiotoxicity. Biological
and Pharmaceutical Bulletin 2005;28:116571.
Cragg GM, Newman DJ. Plants as a source of anti-cancer agents.
Journal of Ethnopharmacology 2005;100:729.
Dawkins G, Hewitt H, Wint Y, Obiefuna PCM, Wint B.
Antibacterial effects of Carica papaya fruit on common wound
organisms. West India Medical Journal 2003;52:2902.
De Clercq E. Current lead natural products for the chemotherapy
of human immunodeency virus (HIV) infection. Medicinal
Research Review 2000;20:32349.
De Mejia EG, Ramirez M. Cytotoxicity of Camellia sinensis, Ilex
paraguariensis and Ardisia compressa tea extracts and selected
polyphenols on human hepatoma (HepG2) cancer cells. FASEB
Journal 2004;18:A518.
De Sanctis MT, Belcaro G, Incandela L, Cesarone MR, Grifn M,
Ippolito E, et al. Treatment of edema and increased capillary
ltration in venous hypertension with total triterpenic
fraction of Centella asiatica: a clinical, prospective,
placebo-controlled, randomized, dose-ranging trial. Angiology
2001;52:S559.
Dhandapani S, Subramanian R, Rajagopal S, Namasivayam N.
Hypolipidemic effect of Cuminum cyminum L. on
alloxan-induced diabetic rats. Pharmacological Research
2002;46:2515.
Dobhal MP, Li GL, Gryshuk A, Graham A, Bhatanager AK, Khaja
SD, et al. Structural modications of plumieride isolated from
Plumeria bicolor and the effect of these modications on
in vitro anticancer activity. Journal of Organic Chemistry
2004;69:616572.
Dua VK, Qjha VP, Roy R, Joshi BC, Valecha N, Devi CU, et al.
Anti-malarial activity of some xanthones isolated from the
roots of Andrographis paniculata. Journal of
Ethnopharmacology 2004;95:24751.
Eno AE, Owo OI, Itam EH, Konya RS. Blood pressure depression by
the fruit juice of Carica papaya (L.) in renal and DOCA-induced
hypertension in the rat. Phytotherapy Research 2000;14:2359.
Ernst E, Pittler MH. Risks associated with herbal medicinal
products. Wiener Medizinische Wochenschrift 2002;152:1839.
Ficker CE, Smith ML, Susiarti S, Leaman DJ, Irawati C, Arnason JT.
Inhibition of human pathogenic fungi by members of
Zingiberaceae used by the Kenyah (Indonesian Borneo).
Journal of Ethnopharmacology 2003;85:28993.
Gao YH, Gao H, Chan E, Tang WB, Xu AL, Yang HY, et al.
Antitumor activity and underlying mechanisms of ganopoly,
the rened polysaccharides extracted from Ganoderma
lucidum, in mice. Immunology Investigations 2005;34:17198.
Gnanapragasam A, Ebenezar KK, Sathish V, Govindaraju P, Devaki
T. Protective effect of Centella asiatica on antioxidant tissue
defense system against adriamycin induced cardiomyopathy
in rats. Life Sciences 2004;76:58597.
Goto H, Sasaki Y, Fushimi H, Shibahara N, Shimada Y, Komatsu K.
Effect of Curcuma herbs on vasomotion and hemorheology in
70
j o u r n a l o f h e r b a l m e d i c i n e 4 ( 2 0 1 4 ) 5173
j o u r n a l o f h e r b a l m e d i c i n e 4 ( 2 0 1 4 ) 5173
71
72
j o u r n a l o f h e r b a l m e d i c i n e 4 ( 2 0 1 4 ) 5173
j o u r n a l o f h e r b a l m e d i c i n e 4 ( 2 0 1 4 ) 5173
73