J. Pharm. Pharmacogn. Res., vol. 12, no. 3, pp. 391-413, May-Jun 2024.

DOI: https://doi.org/10.56499/jppres23.1832_12.3.391

Review

An evidence-based review of Morinda citrifolia L. (Rubiaceae) fruits on animal models, human studies, and case reports

[Una revisión basada en la evidencia de los frutos de Morinda citrifolia L. (Rubiaceae) en modelos animales, estudios en humanos e informes de casos]

Asman Sadino^1,2*, Jutti Levita^3*, Nyi Mekar Saptarini⁴, Adryan Fristiohady⁵

¹Department of Pharmacology and Clinical Pharmacy, Faculty of Mathematics and Natural Sciences, Garut University, Garut 44112, Indonesia.

²Student at the Doctoral Program in Pharmacy, Faculty of Pharmacy, Padjadjaran University, Sumedang 45363, Indonesia.

³Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Padjadjaran University, Sumedang 45363, Indonesia.

⁴Department of Pharmaceutical Analysis and Medicinal Chemistry, Faculty of Pharmacy, Padjadjaran University, Sumedang 45363, Indonesia.

⁵Faculty of Pharmacy, Halu Oleo University, Kendari 93132, Indonesia.

*E-mail: jutti.levita@unpad.ac.id

Abstract

Context: Morinda citrifolia L. (Rubiaceae), commonly known as noni, is widely used as a complementary and alternative therapy in many countries due to its numerous beneficial effects on health.

Aims: To thoroughly analyze the efficacy and safety of M. citrifolia fruit across all reported areas.

Methods: The articles were explored on the PubMed and Cochrane Library databases using a combination of keywords: Morinda citrifolia AND human studies; Morinda citrifolia AND pharmacological activities using PRISMA guidelines.

Results: Studies in animal models revealed its activity as anti-dyslipidemia, anti-lipogenesis, anti‑fungal, hepatoprotective, hypotensive, immunostimulatory, anti-alopecia, photoprotective, antitumor, antiviral, anticancer, antidopaminergic, and antimicrobial. Based on the clinical and efficacy evidence, it is apparent that M. citrifolia is a potentially valuable medicinal plant whose status should be upgraded from laboratory bench to bedside. The safety of M. citrifolia has been confirmed and proven by no occurrence of AEs or only mild gastrointestinal discomforts. However, five cases of male and female patients aged from 14 to 63 years old reported different symptoms, such as fatigue, headache, vomiting, pigmentation, or acute hepatitis, after a high-dose daily use of this supplement.

Conclusions: Taking everything into consideration, M. citrifolia, despite its mild adverse events, has a beneficial efficacy and safety as an antioxidant; nevertheless, caution and therapy drug monitoring is required if this plant is to be taken in a long-term period.

Keywords: adjunctive therapy; antioxidants; Morinda citrifolia; noni fruit; plant-based therapy.

Resumen

Contexto: La Morinda citrifolia L. (Rubiaceae), comúnmente conocida como noni, se utiliza ampliamente como terapia complementaria y alternativa en muchos países debido a sus numerosos efectos beneficiosos para la salud.

Objetivos: Analizar exhaustivamente la eficacia y seguridad del fruto de M. citrifolia en todas las áreas reportadas.

Métodos: Los artículos se exploraron en las bases de datos PubMed y Cochrane Library utilizando una combinación de palabras clave: Morinda citrifolia AND human studies; Morinda citrifolia AND pharmacological activities utilizando las guías de PRISMA.

Resultados: Los estudios en modelos animales revelaron su actividad como antidislipidémica, antilipogénica, antifúngica, hepatoprotectora, hipotensora, inmunoestimuladora, antialopecia, fotoprotectora, antitumoral, antiviral, anticancerígena, antidopaminérgica y antimicrobiana. Basándose en las pruebas clínicas y de eficacia, es evidente que la M. citrifolia es una planta medicinal potencialmente valiosa cuyo estatus debería elevarse de la mesa de laboratorio a la cabecera del enfermo. La inocuidad de la M. citrifolia ha sido confirmada y demostrada por la ausencia de EA o por la aparición de molestias gastrointestinales leves. Sin embargo, cinco casos de pacientes de ambos sexos con edades comprendidas entre los 14 y los 63 años informaron de diferentes síntomas, como fatiga, dolor de cabeza, vómitos, pigmentación o hepatitis aguda, tras el uso diario de este suplemento en dosis altas.

Conclusiones: Tomando todo en consideración, la M. citrifolia, a pesar de sus leves efectos adversos, tiene una eficacia y seguridad beneficiosas como antioxidante; no obstante, se requiere precaución y seguimiento farmacológico de la terapia si se va a tomar esta planta a largo plazo.

Palabras Clave: antioxidantes; fruto del noni; Morinda citrifolia; terapia basada en plantas; terapia coadyuvante.

Citation Format: Sadino A, Levita J, Saptarini NM, Fristiohady A (2024) An evidence-based review of Morinda citrifolia L. (Rubiaceae) fruits on animal models, human studies, and case reports. J Pharm Pharmacogn Res 12(3): 391–413. https://doi.org/10.56499/jppres23.1832_12.3.391

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