A Review Medicinal Benefits of Betel Leaf

Abstract

Betel leaf (Piper betel L.), an evergreen perennial climber that belongs to the Piperaceae family, is valued for its medicinal, cultural, and economic use in South and Southeast Asia. In Ayurvedic and traditional medicine, its leaves have long been chewed in a number of ways due to their stimulatory and restorative qualities. Among its many pharmacological properties are antibacterial, antioxidant, anticancer, anti-inflammatory, and gastroprotective actions. Despite its historic significance, cultivation has decreased because of financial limitations and contemporary consumption patterns. Betel leaf is grown in many tropical and subtropical nations, such as Bangladesh, Malaysia, Sri Lanka, and India. It is a fragrant shrub with heart-shaped leaves that is dioecious. It is especially important from a religious, cultural, and therapeutic perspective in traditional Indian systems like Ayurveda. It has been utilized for over two millennia and continues to be an essential part of traditional healing systems and rituals. Literature research and an evaluation of the pharmacological and phytochemical properties of Piper betel leaves were part of the study. The leaves were harvested from Bangladesh's Jahangirnagar University, examined by the National Herbarium, and extracted in a number of ways. A number of procedures, such as disc diffusion, DPPH radical scavenging, and GC-MS analysis, were used to examine the makeup of essential oils, antioxidants, an antimicrobial. The antibacterial, antioxidant, gastroprotective, anti-inflammatory, and anticancer properties of betel leaf (pyres betel) are just a few of its many therapeutic benefits. It may take into account both traditional formulations and drug development. Abuse of betel quid, however, can have detrimental health implications, especially when mixed with tobacco. To guarantee sustainable use, it is important to keep it economically relevant, promote its health benefits, and discourage harmful consumption habits.

Keywords

Antioxidant, antibacterial, gastroprotective, anti-inflammatory, Ayurvedic, traditional, ethnobotanical, and piper betel Phytochemistry and Quid Betel.

Introduction

4.1 Distribution

The story of Piper betel begins in Indochina, which includes modern-day countries like Vietnam, Cambodia, Laos, Thailand, and Myanmar. It also stretches to Peninsular Malaysia, East Timor, and the Lesser Sunda Islands in Southeast Asia. As people migrated and traded, the plant found its way to new places, reaching Papua New Guinea, Malaysia, Micronesia, South Asia, the Maldives, Mauritius, Réunion Island, and even Madagascar. Interestingly, during the colonial era, it made its way to the Caribbean as well.(24).

4.2 AYURVEDIC USE

1. Scanty or Obstructed Urination: Diuretic qualities are attributed to betel leaf juice. Urine transit is made easier by its juice, which is mildly sweetened and combined with diluted milk.
2. Respiratory disorder: Betel leaves are beneficial. In lung diseases that occur in both youth and elderly life. When the leaves are warmed and soaked in mustard oil, they can be applied to the chest to ease coughing or breathing difficulties.(25,26)

4.3 Dental Health and Beetle Nuts

In the Indian subcontinent, betel quid—often referred to as paan—is a traditional chew made by wrapping various ingredients in a betel leaf. Typically, it includes areca nut, slaked lime, and the nut from the Areca catechu palm, with some variations adding tobacco. The areca nut is derived from the endosperm of the fruit of the Areca catechu palm. People usually place the quid in their mouth, chewing it for about 10 to 15 minutes before either swallowing or spitting it out. This practice can happen several times a day, sometimes as many as six times. The main attraction of chewing betel nut is its euphoric effects. (27)

5. PHARMACOLOGICAL ACTIVITY

Numerous natural products are used in traditional medicine in a number of nations to treat a wide range of illnesses. Piper betel is a member of the Piperaceae family, which includes more than 2000 species. This plant is native to India. Although the exact processes underlying the effectiveness of piper betel leaves against several human infections remain unclear, they have been demonstrated to be effective. Because of its vital qualities, which include anti-oxidant, anti-cancer, and anti-allergic capabilities, extracts of piper betel have been used for centuries to cure a variety of illnesses.(28)

5.1 Platelet Inhibition Activity

We conducted experiments to see how hydroxychavicol (HC) affects platelet aggregation. The findings showed that HC is a strong inhibitor of cyclooxygenase activity, helps reduce reactive oxygen species, disrupts platelet calcium signaling, and lowers thromboxane B2 production, which in turn limits platelet aggregation. These characteristics indicate that HC could be a promising option for treating and preventing cardiovascular issues, including conditions like osteoarthritis. Notably, it provides antiplatelet and anti-inflammatory benefits without interfering with normal blood clotting functions.(29)

5.2 Antioxidant Activity

A Research has revealed that aqueous extracts from three different types of Piper betel leaves show impressive antioxidant properties when tested through various in vitro methods, including DPPH radical scavenging, superoxide radical neutralization, hydroxyl radical inhibition, and protection against lipid peroxidation [51]. Additionally, the ethanolic extract of betel leaves has been studied in experimental animals, particularly rabbits, using concentrations of 5%, 10%, and 15%. In this experiment, burns were created by applying heated metal plates to the shaved backs of the rabbits, which caused damage to the dermis and subcutaneous tissues, leading to blister formation. The rabbits received topical treatment with the betel leaf extract once a day for a week. The healing process was monitored visually and compared to Bioplacenton, which acted as a positive control. The findings indicated that the ethanolic extracts of Piper betel at all tested concentrations effectively promoted the healing of burn wounds in the rabbits (Oryctolagus cuniculus).

The phytochemical composition of betel leaves is notably abundant in flavonoids, phenolic compounds, and essential minerals, all of which enhance their antioxidant capabilities. These bioactive elements play a crucial role in shielding body cells from oxidative stress and damage caused by free radicals. Consequently, regular consumption of betel leaves has been associated with the prevention of various chronic diseases and the promotion of overall health and well- being.(30)

5.3 Radio Protective Activity

When exposed to radiation, mammalian systems can suffer negative consequences that include cell death and a higher risk of degenerative disorders. P. betel leaf ethanolic extract’s radioprotective qualities have recently been investigated as a low-cost substitute for synthetic radioprotectants, which are said to be harmful. To determine how the extract works as a radioprotector, its ability to stop g-ray-induced lipid-peroxidation and DNA damage in rat liver mitochondria was measured and analyzed.(31)

5.4 Antibacterial Activity

The antibacterial properties of dried Piper betel leaves were evaluated using the disc diffusion method. To prepare the leaves, they were blended, extracted in water, and then heated to 90 °C for 15 minutes before testing. The study focused on bacterial strains like Staphylococcus aureus, Staphylococcus epidermidis, and Escherichia coli, with ampicillin–sulbactam used as the positive control. The findings showed that extracts from betel leaves effectively inhibited both Gram-positive and Gram-negative bacteria, as evidenced by the inhibition zones observed. Phytochemical analysis indicated that betel leaves are rich in terpenoids, glycosides, alkaloids, phenolics, flavonoids, tannins, saponins, and essential oils. The essential oil's major components included 5-(2-propenyl)-1,3-benzodioxole (25.67%), eugenol (18.27%), and 2-methoxy-4-(2-propenyl) acetate-phenol (8.00%). The antibacterial effects are primarily linked to the oxygenated terpenoids found in these oils. These bioactive compounds are recognized for their ability to combat oral pathogens that lead to dental caries, plaque accumulation, tooth decay, and bad breath. Traditionally, betel leaves have also been used to alleviate toothaches, gum inflammation, swelling, and oral infections. Eating a small amount of betel leaf paste after meals is thought to aid digestion, enhance gut health, and help reduce bad breath.(32,33)

5.5 Antimicrobial Activity

The antibacterial properties of betel leaf (Piper betel) ethanol extract were evaluated using the disc diffusion method. Previous studies on betel leaf powder have confirmed the presence of various compounds, including carbohydrates, flavonoids, alkaloids, and a significant amount of antioxidants. The antioxidant activity of the ethanol extract was assessed through the DPPH assay, which revealed impressive free radical scavenging abilities. These results indicate that the extract has considerable antimicrobial effects against several bacterial strains, such as Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus vulgaris, and Staphylococcus aureus. Further research has shown that different solvent extracts of Piper betel leaves—like water, methanol, ethyl acetate, and petroleum ether—also displayed antibacterial activity against a range of pathogenic bacteria, including Streptococcus pyogenes, Staphylococcus aureus, Proteus vulgaris, and Escherichia coli. Additionally, the essential oils derived from betel leaves exhibited inhibitory effects on Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli. The antibacterial effectiveness of betel leaf is linked to its rich array of phytochemicals and phenolic compounds, which help combat both Gram-positive and Gram- negative bacteria. (34,35).

5.6 Gastro Protective Activity

It has long been known that piper betel linn can cure stomach ulcers. It also possesses gastroprotective properties. Hot aqueous extracts (HAE) and cold ethanolic extracts (CEE) from its leaves can offer significant protection against ethanol-induced stomach injury when taken orally. Both extracts exhibit stronger efficacy against gastrointestinal injury at the greatest dosages. HAE prevents the volume of stomach acid from increasing as well. It is also believed to make the stomach mucosa more mucus-rich. HAE and CEE hence have strong gastroprotective properties.(36)

5.7 Anti Allergic Activity

Researchers have been looking into how Piper betel might help reduce the production of allergy- related substances in lung cells and mast cells derived from bone marrow. They tested an ethanolic extract of Piper betel in the lab, focusing on its effects on the human lung epithelial cell line BEAS- 2B, particularly regarding the release of exotoxins and interleukin-8 (IL-8). Additionally, they examined how it influenced histamine release and the production of granulocyte–macrophage colony-stimulating factor (GM-CSF) in mouse bone marrow mast cells (BMMCs). The findings showed that the extract effectively inhibited the release of exotoxins and IL-8 during allergic reactions triggered by TNF-α and IL-4. Moreover, it significantly lowered histamine and GM-CSF levels in responses related to IgE-mediated hypersensitivity. These results indicate that Piper betel may have the potential to help manage allergic conditions by limiting the production of crucial mediators involved in allergies.(37).

5.8 Anticancer Activity

Anti-cancer drugs that contain antioxidants may work by balancing reactive oxygen species (ROS), which prevents cancer cells from proliferating when apoptosis is prevented (Abrahim et al., 2012). Experimental and clinical studies have shown that chronic inflammation is the primary cause of many human diseases, including cancer and tumors (Kangralkar and Kulkarni,2013). Traditionally, the betel leaf was used as a folk remedy to treat oral irritation. In Southeast Asia, where smoking and cigarette use are prevalent, 90% of cases of mouth cancer occur, making it one of the top ten most common cancers (Jiang et al., 2019). One of the first research (Toprani and Patel, 2013) found that hamsters’ oral cancer caused by pinene was prevented by topical therapy with leaf extracts.(38)

5.9 Antimalarial Activity

More protection against Anopheles stephensi and Culex fatgans mosquito bites was offered by EO in comparison to the well-known insect repellent citronella oil. Citronella oil only offered 2.2 and 2.6 hours of protection against Anopheles stephensi and Culex fatgans, respectively, but the oil offered almost 4 hours when sprayed at a rate of 20 liters per centimeter 2. Paan’s ability to fend against mosquitoes has thus been demonstrated (Pal and Chandrashekar, 2010; Ibrahim et al., 2017; Cang et al., 2020). (39)

5.10 Anti Nociceptive Activity

Piper betel contains anti-nociceptive properties, according to a 2011 study by Arambewela LS et al. The licking time in the early and late stages of the formalin test was significantly decreased by dosages of Piper betel extract of around 200 and 300 mg/kg, as shown by a bell- shaped dose- response curve. Histamine and bradykinin are examples of inflammatory mediators that cause pain in the late phase of the formalin test, whereas formalin directly stimulates sensory nerve fibers, causing pain in the early phase. According to reports, NSAIDs decrease the formalin test’s two phases. The betel extracts also caused disruptions in both test phases, which may indicate that sensory transmission and the release of inflammatory mediators are impaired.(40)

5.11 Anti Diabetes Activity

According to numerous studies, betel leaf powder helps lower blood sugar levels in people with type 2 diabetes who have just received a diagnosis. A potent antioxidant, betel leaf aids in the treatment of diabetes by lowering inflammation brought on by uncontrolled blood sugar and combating oxidative stress. (41)

6. TRADITIONAL USE

Secondary metabolites found in the plant betel (Piper betel) can be used as a foundation for conventional medicine. Originating in central and eastern Malesia, this betel plant was first cultivated some 2,500 years ago throughout tropical Asia, Madagascar, and East Africa. In the fifteenth century, Europeans introduced this variety of betel to South China and India, where it now grows and spreads. (42)

7. DISEASE

Collar rot,” “foot rot,” “leaf spot,” (and powdery mildew are the main diseases that have an impact on betel vines.

1. Foot Root

Phytophthora species are responsible for the most prevalent fungal disease. Foot rot affects the plantaton (Meszka and Michalecka, 2016; Haider et al., 2013). Phytophthora species was identified as P. nicotanae var. parasitca when it was discovered in 1927 (Meng et al., 2014). According to Haider et al. (2013), foot rot caused by P. para-sitca and Phythium vexans de Bery(Phythium piper-inum Dastur) was documented. The petiole of the leaves stays upright, but the lamina gradually starts to drop. This illness is referred to in the region as “Khada Kala,” “Khada Pacha,” or “Madua.” Tegron and Blitox are being sprayed by nearby growers to stop the disease from spreading (Haider et al., 2013).

2. Leaf Spot

Leaf spot disease affecting betel vine, caused by Fusarium semitectum, was first reported by Patra and Pradhan in 2018. Prior to that, Singh and Shanker documented other pathogenic infections, such as Cladosporium pipericola, Drechslera rostrata, Corynespora cassicola, and Cercospora piperis-betel, in Madhya Pradesh and Uttar Pradesh, India, back in 1971. Mait and Sen also made additional observations in 1979. Locally, this disease is often referred to as “Champa Tipa” or “Champa Fulia.” It manifests as small, curling leaf tips, and if the affected leaves aren’t removed quickly, the infection can spread swiftly to the main stem of the vine. Ants and other insects help in transmitting the pathogens from one plant to another, making the situation even worse.

3. Powdery Mildew.

Narasimhan identified the condition in Mysore, India, in 1933. The primary cause of powdery mildew illness is Oidium piperis Uppal (Park et al., 2012). In local parlance, this condition is called “Jhalma.” The infection shows up on the bottom of the leaves as powdery white to light brown patches. At this stage, the upper and bottom parts of the leaves have little white and black particles. This is a highly contagious illness. There is no cure or prevention for this disease. Farmers dust betel vine leaves with a mixture of dried fruit dust and water-diluted Neem tree (Azadirachta indica A. Juss.) leaf juice (Patra and Pradhan 2018).Histopathological and macroscopic analyses. The stomach was quickly taken from both the normal and treated groups, opened along the larger curvature, and then thoroughly cleaned with normal saline. A lengthy piece of gastric tissue was removed from the front of the stomach and preserved in a 10% formalin solution after the stomach ulcers were noted. It was cut into 5-micron slices on a glass slide after being fixed for 24 hours and then embedded in a paraffin block. Hematoxylin-eosin was then used to stain the sections for a histological evaluation of the stomach mucosa. The stomach’s larger curvature was opened, and the gastric antral section was used for biochemical investigations. The portion’s moist weight was also noted.(43).

8. FUTURE STUDIES

Betel leaves are popular for their medicinal benefits; thanks to a range of bioactive compounds they contain. Their low cost and easy availability have made them a favorite not just in India, but around the world (Peddapalli et al., 2020). Traditionally, people have used them as dietary supplements or natural remedies for various ailments, including leprosy, alcoholism, bronchitis, asthma, and indigestion. However, one significant hurdle is their short shelf life, which complicates long-term storage. Consequently, many excess leaves end up being thrown away or fed to cattle. To tackle this problem, it's crucial for researchers to focus on developing effective methods for preserving and storing betel leaves, aiming to extend their freshness and reduce postharvest waste. Given that the production, processing, packaging, handling, transportation, and marketing of betel leaves impact a large segment of the population, both directly and indirectly, collaboration is key. There’s a pressing need for stronger partnerships between federal and state governments to back research efforts and create a dedicated Research and Development Board. These steps would not only help stabilize prices but also boost the economic viability of betel leaf farming.44.

CONCLUSION

Overall, it offers a methodical perspective on Piper betel Linn’s medicinal potential and is most helpful for investigating and developing fundamental pharmaceuticals. People of all ages eat the addictive drug areca nut in many places of the world. It has numerous, varied impacts on practically every organ in the human body, in addition to being carcinogenic to the throat, esophagus, liver, uterine, and oral cavity. Betel vine bioactive compounds should be separated, extracted utilizing both conventional and cutting-edge technologies, and evaluated for further bioactive properties including antibacterial, antioxidant, antidiabetic, anticancer, and so on. The pharmacological activities of piper betel make it one of the most significant plants in human life, with numerous applications, benefits, and medicinal value. People have been using piper betel as a mouth refresher since ancient times.(45,46,47,48,49,50)

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