Table 2.
Herbal medicines tested against Helicobacter pylori
| Herb | Study type | Result | Observation | Active principle | Mechanism of action | Ref. |
| Garlic | In vivo clinical trial | No improved eradication (consult Table 1) | NA | NA | NA | [111,112] |
| Pelargonium sidoides roots (eps) 7630 | In vitro using AGS cells and in situ using biopsies | Inhibit H. pylori growth and cell adhesion | South African herbal remedy | NA | Anti-adhesive activity | [114,115] |
| Cranberry juice | In vitro using immobilized human mucus and erythrocytes | Inhibit H. pylori cell adhesion | NA | NA | Anti-adhesive activity (sialic acid-specific adhesion) | [116,117] |
| Oregano and cranberry | In vitro agar difusion assay | Inhibition zones on agar plate | NA | Phenolic compounds | Urease inhibition; disruption of energy production inhibiting proline dehydrogenase at the plasma membrane | [93] |
| Magnolia officinalis Rehd. Et Wils. (Magnoliaceae) and Cassia obtusifolia L. (Leguminosae) | Compounds tested against Jack bean urease | Inhibit urease | Chinese medicinal herbs | Hydroxamic acids, phosphoramidates, urea derivatives, quinones, and heterocyclic compounds | Inhibit urease | [118] |
| Camellia sinensis | In vitro test against H. pylori, urease activity assay | Inhibit urease; reduction of H. pylori population | Tea leaves | Polyphenolic compounds and catechin contents (epicatechin, epigallocatechin, epicatechin gallate, epigallocatechin gallate) | Inhibit urease | [94] |
| Apple peel polyphenols | Compounds tested against Jack bean urease; in vitro test against H. pylori; in vitro test using hela cells; in vivo test using C57BL6/J mice | Inhibit urease; prevented vacuolation in hela cells; antiadhesive effect; anti-inflammatory effect | NA | Polyphenols | Inhibit urease; anti-adhesive activity | [78,95] |
| Calophyllum brasiliense Camb. (Clusiaceae) | In vitro disk diffusion; in vivo using Wistar rats infected with H. pylori | Dose-dependent reduction of ulcerated area; decreased number of urease-positive animals; partial anti-H. pylori inhibition | Large tree widely distributed in Latin America known in Brazil as "guanandi" | Mixture of chromanone acids | Inhibit urease; modulation of endogenous antioxidant systems | [86,87] |
| Mouriri elliptica Martius (Melastomataceae) | In vivo Swiss albino mice and male Wistar albino rats animal | Gastric protective action without antisecretory effect; anti-H. pylori action | Brazilian fruit-bearing plant of known as “coroa-de-frade” | Acid derivatives, acylglycoflavonoids and condensed tannins | Inhibit NO production by macrophages; stimulating proliferation factors (PCNA), COX-2 | [119] |
| Hancornia speciosa Gomez (Mangaba) | In vivo Swiss albino mice and male Wistar albino rats animal | Antiulcer activity | Medium-sized tree (3–10 m) from central Brazil, known as “mangaba”, “mangabeira” or “mangava” | Polymeric proanthocyanidins | Increase pH and decrease acid output of gastric juice, stimulate mucus synthesis and produce antisecretory effect | [120] |
| Byrsonima fagifolia Nied. (Malpighiaceae) | In vivo Swiss albino mice and male Wistar albino rats animal In vitro disc diffusion technique | Gastric protective action; anti-inflammatory effect; anti-H. pylori action | Brazilian herb known as "murici" or "murici-do-mato" | Phenolic compounds, flavonoids, gallic acid derivatives | Antioxidant properties | [97] |
| Alchornea triplinervia | In vivo mouse model | Antisecretory property; anti-H. pylori effect; gastroprotective action | Medicinal plant from Brazil | Flavonoids | Antisecretory action, increase of gastric mucosa prostaglandin E(2) levels | [96] |
| Amphipterygium adstringens (Schltdl.) Standl. (Anacardiaceae) | In vitro killing assay | Exhibits potent dose-dependent anti-H. pylori activity | Mexican folk medicine | Anacardic acids mixture | NA | [121] |
| Extract of Japanese rice also | In vivo Mongolian gerbil model | Anti-H. pylori activity; anti-inflammatory effect | NA | NA | NA | [122] |
| 16 Mexican plants1 | In vitro broth microdilution method | Anti-H. pylori activity | Mexican folk medicine | NA | NA | [123] |
| Bacopa monniera | In vitro broth microdilution method | Anti-H. pylori activity | In Ayurveda, (ancient medicine of India) known as medhya rasayana or "brahmi" | NA | Augmentation of defensive mucosal: mucin secretion, life span of mucosal cells, and gastric antioxidant | [124] |
| Propolis | In vitro test against H. pylori Test against Recombinant protein (peptide deformylase) | Anti-H. pylori activity | Resinous hive product collected by honeybees | Phenolic compounds, mainly Caffeic acid phenethyl ester (CAPE) | CAPE is a competitive inhibitor of H. pylori peptide deformylase | [107,125] |
| Gosyuyu (Wu-Chu-Yu) and Psoralen (extract from Psoralea corylifolia) | In vitro test against H. pylori | Anti-H. pylori activity | Chinese herbal medicine, namely “buguzhi” | Alkyl methyl quinolone alkaloids | NA | [126] |
| Amu-ru 7, a | In vitro test against H. pylori In vivo Mongolian gerbil | Anti-H. pylori activity Did not cure Mongolian gerbil, but colonization rate diminish | Mongolian folk medicine | Alkyl methyl quinolone alkaloids Rhei rhizome is the most effective component | Inhibited biofilm formation by H. pylori partial inhibition of urease | [127] |
| Agrimonia eupatoria, Hydrastis canadensis, Filipendula ulmaria, and Salvia officinalis | In vitro test against H. pylori | Anti-H. pylori activity | Western herbal medicine | NA | NA | [128] |
| Curcumin diferuloylmethane | In vitro test against H. pylori In vitro using AGS cells In vivo C57BL/6 mice and Male Sprague-Dawley rats | In vitro anti-H. pylori activity; effective in eradication of H. pylori from infected mice and in restoration of H. pylori-induced gastric damage | The major yellow pigment present in the rhizome of turmeric (the perennial herb Curcuma longa) | Diferuloylmethane | Suppressing secretion of metalloproteinases 3 and 9 by gastric cells noncompetitive inhibitor of H. pylori shikimate dehydrogenase, among others decrease nuclear factor-kB (NF-κB) p65 | [76,106,129] |
| Nigella sativa (Ranunculaceae) | In vivo adult patients | Administrated with omeprazole had a eradication rate similar to triple therapy (consult Table 1) | Grows in the Middle East, Eastern Europe, and Eastern and Middle Asia | Thymoquinone, dihydrothymoquinone and terpenes | Disrupting the lipid structure of the cell membrane | [89] |
| Methanol extract of the leaf of Allium ascalonicum | In vitro test against H. pylori | Anti-H. pylori activity | Known as garlic | Alkaloids, cardiac glycosides and saponins | Decrease urease activity | [130] |
| Leaves of Piper carpunya Ruiz and Pav. (syn Piper lenticellosum C.D.C.) (Piperaceae) | In vitro test against H. pylori In vitro against rat peritoneal leukocytes | Anti-inflammatory; anti-ulcer action | Widely used in folk medicine in tropical and subtropical South American | Flavonoids | Inhibition of H+, K+-ATPase activity | [98,99] |
| Apium graveolens seeds | In vitro test against H. pylori | Anti-H. pylori activity | Used in Ayurvedic medicine | Compound with anti-Helicobacter activity, an asymmetric phthalide dimer | Induces morphologic changes in H. pylori and inhibits protein and DNA synthesis | [131] |
| Davilla elliptica and Davilla nitida | In vivo Swiss albino mice and male Wistar albino rats animal In vitro disc diffusion technique | Anti-H. pylori activity; gastric protection action | Brazil folk medicine | Phenolic acid derivatives, acylglycoflavonoids, and condensed tannins | Stimulats moderate levels of H2O2, trigger moderation of the oxidative burst and consequently the immune response | [132] |
| Resveratrol | In vitro test against H. pylori In vitro using MKN-45 cells | Inhibit urease, anti-inflammatory and anti-cancer activity cardioprotective and neuroprotective properties | highly abundant in red grapes | Polyphenol | Modulation of interleukin (IL)-6, NF-κB, and mitogen-activated protein kinases; modulatory effects on H. pylori-induced IL-8 secretion, reactive oxygen species production, and morphological changes | [102,103,133, 134-136] |
| Anisomeles indica | In vitro test against H. pylori In vitro using AGS cells | Anti-H. pylori activity; anti-inflammatory properties | From Southeast Asia and Australia | Ovatodiolide | Attenuated the inflammatory response by decreasing NF-κB activation and IL-8 secretion, inhibit lipopolysaccharide-induced inflammation in macrophages (including the secretion of the pro-inflammatory cytokine tumor necrosis factor-α, and nitric oxide (NO) production, and protein expressions of inducible NO synthase and cyclooxygenase-2 (COX-2) | [75] |
| Glycyrrhiza glabra | In vitro test against H. pylori In vitro using AGS cells In vivo adult patients | Anti-H. pylori activity; anti-inflammatory properties (consult Table 1) | Legume known as licorice from southern Europe and parts of Asia | Flavenoid, main component glycyrrhetinic acid | Inhibition H. pylori of DNA gyrase, protein synthesis and dihydrofolate reductase enzyme; anti-inflammatory activity likely through inhibition of COX and lipoxygenase pathways | [88,100] |
| Cistus laurifolius | In vitro test against H. pylori | Anti-H. pylori activity | Folk medicine in Anatolia | Flavenoid, most active is quercetin 3-methyl ether (isorhamnetin) | NA | [137] |
| Sclerocarya birrea | In vitro test against H. pylori | Anti-H. pylori activity | Medicinal plant used by Zulus, Vhavendas, Xhosas and Sothos of South Africa | Essential oils: terpinen-4-ol (35.83%), pyrrolidine (32.15%), aromadendrene (13.63%) and α-gurjunene (8.77%) | NA | [138] |
| Phyllanthus urinaria | In vitro test against H. pylori In vitro using AGS cells | Anti-H. pylori activity; anti-inflammatory properties | Tropical and subtropical countries (Taiwan) | Phyllanthin, phyltetralin, trimethyl-3,4-dehydrochebulate, methyl gallate, rhamnocitrin, methyl brevifolincarboxylate, β-sitosterol-3-O-β-d-glucopyranoside, quercitrin and rutin | Inhibits AGS cells adhesion and invasion; decreases NF-κB activation and IL-8 secretion | [139,140] |
| Artemisia douglasiana Besser (Asteraceae) | In vitro test against H. pylori | Anti-H. pylori activity | Folk medicine in Argentina known as "matico" | Dehydroleucodine, a sesquiterpene lactone of the guaianolide type | Potent inhibitors of the transcription factor NF-κB | [141,142] |
| Geranium wilfordii | In vitro test against H. pylori | Anti-H. pylori activity | Herb from China | Corilagin (1), and 1,2,3,6-tetra-O-galloyl-β-D-glucose | NA | [143] |
| HZJW, composed of 12 medicinal herbs | In vitro test against H. pylori In vivo Balb/c mice | Anti-H. pylori activity; reduction of ulcerative lesion; eradicate H. pylori in mice | Chinese herbal formula composed of 12 herbs listed in (91) | Protoberberine alkaloids palmatine, coptisine and aporphine alkaloid of magnoflorine | NA | [91] |
| Cratoxylum arborescens (Vahl) Blume | In vitro test against H. pylori In vivo Balb/c mice | Anti-H. pylori activity, anti-inflammatory activity; reduced ulcer area, higher mucus content | Asian herbal medicine | α-mangostin (AM), is a prenylated xanthone | Anti-COX-2 and anti-NO activities | [144] |
| Chenopodium ambrosioides L. And Adina pilulifera. Chenopodium ambrosioides L. | In vitro test against H. pylori | Anti-H. pylori activity | Jinghua Weikang Capsule (Chinese patent drug for peptic ulcer | NA | NA | [145] |
| Momordica cochinchinensis Springer (Cucurbitaceae) | In vivo mice | Gastroprotective effect | Momordica saponin I | NA | [146] | |
| Sangre de grado (Croton lecheleri and Croton palanostigma) | In vitro test against H. pylori In vivo C57BL/6 mice | Anti-H. pylori activity No bactericidal effect in mice | Sangre de grado is a red, viscous latex from the cortex of trees used in Peruvian medicine | NA | Mice with higher hepatic metallothionein levels | [147] |
| Polygonum tinctorium Lour | In vitro test against H. pylori In vivo Mongolian gerbil | Anti-H. pylori activity; anti-inflammatory effect; decreased bacterial load in Mongolian gerbil | Known as indigo | Tryptanthrin and kaempferol (flavenoid) | Inhibition of nitric oxide production, and the transcription of cyclooxygenase | [80] |
| Artocarpus obtusus Jarret | In vitro test against H. pylori In vivo Mongolian gerbil | Anti-H. pylori activity; gastroprotective effect; increased mucus content | Endemic species of Borneo known as “pala tupai” | Pyranocycloartobiloxanthone A, a xanthone | Free radical scavenging effect, induction of HSP70, via anti-apoptotic property (down regulate bax gene), inhibits Cox-2 enzyme | [148] |
| Punica granatum and Juglans regia | In vitro test against H. pylori | Anti-H. pylori activity | Iranian plants | NA | NA | [149] |
1
Castella tortuosa, Amphipterygium adstringens, Ibervillea sonorae, Pscalium decompositum, Krameria erecta, Selaginella lepidophylla, Pimpinella anisum, Marrubium vulgare, Ambrosia confertiflora, Couterea latiflora, Byophyllum pinnatum, Tecoma stans linnaeus, Kohleria deppena, Jatropha cuneata, Chenopodium ambrosoides, and Taxodium macronatum. NA: Not applicable; H. pylori: Helicobacter pylori.