Review Article | Volume: 13, issue: 5, May, 2023

A comprehensive review of the ethnobotanical, phytochemical, and pharmacological properties of the genus Bambusa

Mohammad Amil Zulhilmi Benjamin Fiffy Hanisdah Saikim Shean Yeaw Ng Nor Azizun Rusdi   

Open Access   

Published:  May 04, 2023

DOI: 10.7324/JAPS.2023.98082
Abstract

Throughout Africa, China, India, and other parts of the world for ages, the genus Bambusa (Poaceae) has been utilized in folk medicine. Various studies have concentrated on the ethnobotany, phytochemistry, and pharmacology of Bambusa spp. in recent years. This scoping study employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline to analyze articles published from 2003 to 2021 on Bambusa spp. The articles were also retrieved from the Scopus database. As a result, 97 articles were selected based on the criteria given: 50 articles for the ethnobotanical aspect, 11 articles for the phytochemical aspect, and 44 articles for the pharmacological aspects (including 8 similar articles from other aspects). A large variety of pharmacological activities, including antioxidant, anti-inflammatory, antibacterial, antifungal, antimalarial, anticancer, antidiabetic, abortifacient, and cytotoxicity activities, were found in the crude extracts and purified bioactive components of Bambusa spp. Alkaloids, flavonoids, phenolics, terpenoids, and other compounds have all been isolated and named from Bambusa spp. Bambusa spp. have a sizable worldwide marketplace due to their outstanding medicinal benefits and minimal toxicity, which has sparked increased attention from academics. Nevertheless, there is no available review article that has compiled all the information regarding the utilization and properties of Bambusa spp. Hence, this review aims to identify and reveal the widely used Bambusa spp. that have grown worldwide. The review mainly summarizes the phytoconstituents and their corresponding pharmacological properties, which are significant in providing a collective scientific evaluation of Bambusa spp. for the development and utilization of a potential novel ethnomedicine.




Citation:

Benjamin MAZ, Saikim FH, Ng SY, Rusdi NA. A comprehensive review of the ethnobotanical, phytochemical, and pharmacological properties of the genus Bambusa. J Appl Pharm Sci, 2023; 13(05):001–022. https://doi.org/10.7324/JAPS.2023.98082

Copyright: © The Author(s). This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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INTRODUCTION

Naturally occurring substances have been used as another option, instead of conventional treatments, for several ailments because of their respectable effectiveness and reduced toxicity (Ijaz et al., 2017). Biologically active compounds from natural resources have received exceptional interest among scientists working on different diseases (Krishnakumar et al., 2013). To date, several modern pharmaceutical products derived from plants or plant-based medicine have been utilized in treating various conditions (Antony et al., 2017; Gajalakshmi et al., 2012; Himaja and Neelufar Shama, 2015; Sanusi et al., 2017). Due to their extraordinary curative powers and fewer side effects, traditional medicines continue to be used as alternatives or supplemental therapies despite the increasing global acceptance of contemporary drugs (Divya et al., 2017; Monton et al., 2014).

One of the biggest genera of woody bamboos, with over 100 species, Bambusa Schreber is a member of the subtribe Bambusinae J. S. Presl, with its subfamily being known as Bambusoideae Kunth ex Ascherson and Graebner (Ohrnberger, 1999). Bambusa spp. can be identified by its dominant primary branch with several secondary branches, thick-walled culms, and erect triangular blades of the culm sheaths (Dransfield, 1992; Dransfield and Widjaja, 1995). They possess unique sheathing structures, a spreading architecture, petiolate foliage, a highly effective rhizome network, hollowed woody stems, and tree-like characteristics from a physiological perspective (Banik, 2015). This genus is located between southern Asia and the Pacific Rim in the tropics and subtropics, and many species are arboreal in Africa, India, China, and Brazil, with widespread utility and economic value (Bahru and Ding, 2021; Pereira and Beraldo, 2007; Tewari et al., 2019; Wu et al., 2009). Due to its several applications, this plant also plays a significant financial and socioeconomic part in the lives of the locals in some Asian nations including China, India, Japan, and the countries of Southeast Asia, especially in rural regions (Cho et al., 2011; Khairi et al., 2020; Ruiz-Sanchez et al., 2019). They are present in about 1,500 consumer products (Li and Kobayashi, 2004), that are used in a variety of contexts, including musical instruments, food profiles, and building supplies (Cho et al., 2011) to the production of paper pulp, fencing, basketry (Pearson et al., 1994), water pipes, utensils (Liu et al., 2008), bridges (Xiao et al., 2010), and low-rise housing (Chung and Yu, 2002).

Bamboos have drawn interest from all around the world and are essential to the drug and food industry sectors due to their nutritional and medicinal capabilities (Nirmala et al., 2018). Thus, Bambusa spp. harbor many pharmaceutical compounds, such as steroids, terpenoids, tannins, flavonoids, polyphenols, alkaloids, glycosides, phytosterols, ginsenosides, and fatty acids (Carey et al., 2009; Jawaid et al., 2015; Lodhi et al., 2016; Saducos, 2021; Thamizharasan et al., 2015; Yakubu and Bukoye, 2009; Zihad et al., 2018). For centuries, Bambusa spp. have been used in folk medicines for the treatment and prevention of various diseases (Esakkimuthu et al., 2016; Luo et al., 2020; Prabhu et al., 2021). Pharmacological properties of Bambusa spp. include anti-inflammatory (Carey et al., 2009; Lodhi et al., 2016; Muniappan and Sundararaj, 2003; Vanitha et al., 2016), antifungal (Abiala et al., 2015; Saducos, 2021; Tyagi et al., 2018), antibacterial (Badwaik et al., 2014; Jayarambabu et al., 2021), antimalarial (Esmaeili et al., 2015; Komlaga et al., 2016), antioxidant (Alok et al., 2017; Karnjanapratum et al., 2019; Kong et al., 2020; Sandhiya et al., 2013), anticancer (Jayarambabu et al., 2021; Kalaiarasi et al., 2015), antidiabetic (Dey et al., 2018; Goyal et al., 2017), abortifacient (Yakubu and Bukoye, 2009; Yakubu et al., 2009), and cytotoxicity (Komlaga et al., 2016; Valdés et al., 2010) activities. Resultantly, the bioactive compounds of Bambusa spp. can serve as a fundamental idea for drug development.

In order to promote future investigation into the widespread use and therapeutic application of this medicinal plant, this review presents the existing information on plant ethnobotany, phytochemistry, and the pharmacological activities of Bambusa spp.


MATERIALS AND METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Moher et al., 2009) were used to assist this research on the ethnobotanical, phytochemical, and pharmacological aspects of the genus Bambusa and scoping study methodology (Arksey and O’Malley, 2005) as a systematic approach. The methodological framework for the scoping review consisted of five stages: (1) establishing the research questions; (2) locating relevant studies; (3) study selection; (4) charting the data; (5) compiling, summarizing, and reporting the results. Figure 1 illustrates the PRISMA flow diagram for article selection.

Stage 1: establishing the research questions

The research questions were: (1) What are the beneficial health effects of ethnobotanical and pharmacological properties of Bambusa species? (2) What type of phytochemicals can be found in Bambusa species?

Figure 1. PRISMA flow diagram for article selection process.

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Stage 2: locating relevant studies

The source of data was the Scopus database. Articles published between 2003 and 2021 were considered for the search process. The literature search was conducted using specific keywords, comprising “Bambusa/Poaceae ethnobotany” or “Bambusa/Poaceae traditional knowledge” and “Bambusa/Poaceae phytochemistry” and “Bambusa/Poaceae pharmacology” or “Bambusa/Poaceae medicine” or “Bambusa/Poaceae biological activities”. A total of 2,560 total articles were retrieved from the literature search.

Stage 3: study selection

Studies were considered in regards to inclusion in this study if they satisfied the criteria which follow: (1) emphasizing all species names from the genus Bambusa; (2) reporting single or multiple data of the ethnobotany, phytochemistry, and pharmacology in Bambusa species; (3) showing bioactive compound with its figure and Chemical Abstracts Service Registry Number (CAS RN) that can be found in Bambusa species; (4) highlighting the beneficial health effects of the ethnobotany in Bambusa species; and (5) evaluating the mechanism of each pharmacological property in Bambusa species.

Stage 4: charting the data

The data were presented according to the following: (1) species, local names, diseases or ailments, parts used, preparation and administration, and references for ethnobotanical aspect; (2) compound names, CAS RN, species, pharmacological activities, and references for phytochemical aspect; and (3) pharmacological properties, species, material basis, methods, results, and references for pharmacological aspects.

Stage 5: compiling, summarizing, and reporting the results

The findings of the genus Bambusa were presented systematically in the form of tables for ethnobotanical and pharmacological aspects, whereas both tables and figures were utilized for the phytochemical aspect.


ETHNOBOTANICAL ASPECT

Bambusa spp. (Fig. 2) have been used to cure a variety of diseases in folk medicine. For instance, the people of Subhartipuram in India prescribed the leaves of Bambusa vulgaris for the treatment of rheumatism (Singh et al., 2020). Additionally, B. vulgaris is prescribed to cure malaria, heart problems, and clean-out dilation. Kani tribals consume the seeds of B. arundinacea as a paste to cure rheumatism (Ayyanar and Ignacimuthu, 2011). The paste of B. bambos seeds is used to treat rheumatism (Silambarasan and Ayyanar, 2015). Traditional healers in Kanyakumari apply a paste made from the entire plant, turmeric, and Areca catechu to cure bruising and reduce swelling (Sukumaran et al., 2014). The people of the Rakhain tribe used the leaves and roots of B. multiplex to cure fever and skin itches in Bangladesh (Hanif et al., 2009), whereas the root of B. arundinacea is used in treating joint pains (Sharkar et al., 2013).

Bambusa arundinacea and B. vulgaris are the two most utilized species in traditional medicine. Hence, the medical applications of Bambusa spp. are detailed in Table 1.


PHYTOCHEMICAL ASPECT

The phytochemical analyses of ethanol extract from B. vulgaris yielded positive results for carbohydrates, flavonoids, glycosides, proteins, tannins, and terpenoids. The extraction of aqueous and ethyl acetate fractions was found to be 1.82% w/w and 1.13% w/w, respectively (Lodhi et al., 2016). The phytochemical analysis of B. arundinacea leaves revealed the presence of amino acids, carbohydrates, flavonoids, proteins, and steroids in the crude extract (Jawaid et al., 2015). Furthermore, the presence of phytoconstituents such as alkaloids, flavonols, and phenolics in B. arundinacea was attributed to the laxative properties found in the shoot (Zihad et al., 2018). Bambusa blumeana (known as Kawayang Tinik) extracts of whole plants contain phytochemicals such as alkaloids, flavonoids, phenolics, sterols, and tannins. Hence, more research is crucial to discover the compounds responsible for the antifungal properties (Saducos, 2021). This study of B. arundinacea seed extracts showed the presence of flavonoids, phenolics, quinines, steroids, and tannins (Thamizharasan et al., 2015). Additionally, early phytochemical testing of a fluid extract of B. vulgaris foliage revealed the presence of alkaloids, anthraquinones, flavonoids, glycosides, phenolics, saponins, and tannins. However, terpenes, steroids, and chalcones were not identified. Alkaloids made up the majority of the B. vulgaris leaves’ aqueous extract, whereas flavonoids made up the least amount of the phytochemicals (Yakubu and Bukoye, 2009). The early phytochemical screening of B. vulgaris methanol extract revealed the presence of alkaloids, carbohydrates, flavonoids, glycosides, and proteins (Carey et al., 2009).

Figure 2. Example of Bambusa spp.

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The phytochemistry of Bambusa spp. including B. balcooa, B. nutans, and B. textilis has been investigated in detail and classified into certain chemical compounds (Table 2). In Figures 314, the structural properties of these compounds (1-49) are also depicted (Liu et al., 2016; Pande et al., 2018; Sarkar et al., 2020; Soumya et al., 2014).


PHARMACOLOGICAL ASPECTS

Table 3 shows a variety of pharmaceutical activities of Bambusa spp. that exhibit clinically relevant biological activities.

Antioxidant activity

The antioxidant activity of Bambusa spp. has been extensively investigated. The methanolic extract of B. arundinacea as one of the ingredients in the Ayurvedic formula of Drakshavaleha (DKV) had a maximum DPPH (1,1-diphenyl-2-picrylhydrazyl) radical scavenging activity of 68.24% at 100 μg/ml. Furthermore, at 100 μg/ml, the maximum DPPH radical scavenging activity of marketed DKV formulations (DKV-1, DKV-2, and DKV-3) was 67.90%, 68.35%, and 68.40%, respectively (Alok et al., 2017). The ethyl acetate and hexane extracts of fresh B. balcooa did not show instant radical scavenging capacity as the second oxidation wave was delayed (Boruah et al., 2012). DPPH radical scavenging activity was 8.57%, 14.31%, and 17.85% for biscuits merged with 5%, 10%, and 15% of B. balcooa levels, respectively. Meanwhile, the value for the control was 3.50%, depicting improved functional and nutraceutical properties for biscuit preparation and other food products (Choudhury et al., 2015). By absorbing hydrogen peroxide and DPPH radicals, both acetone and the aqueous extracts of B. vulgaris demonstrated their antioxidant properties in a manner dependent on dosage (Goyal et al., 2013).

Table 1. List of Bambusa spp. used as medicinal plant worldwide.

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The maximum scavenging of DPPH radicals was seen in the methanolic extract from B. balcooa, which was followed by the aqueous extract. However, the B. balcooa extract in acetonic form had the least amount of action. The maximum ferric reducing antioxidant power (FRAP) result was seen in the aqueous extract of B. balcooa (0.217), followed by the acetonic extract (0.027), and the methanolic extract (0.079) when compared to ascorbic acid (0.041) as a reference at a concentration of 200 μg/ml. Therefore, it can be inferred that aqueous extract contains in vitro antioxidant effect (Goyal et al., 2017). The fiber hydrolysate from B. vulgaris shoots displayed ABTS [2,2’-azinobis-(3-ethylbenzothiazoline-6-sulfonate)] radical scavenging activities, DPPH, FRAP, and oxygen radical absorbance capacity. Bambusa vulgaris can thus be successfully synthesized via enzymatic hydrolysis with antioxidant activity and is appropriate for application in fortified fiber products (Karnjanapratum et al., 2019).

Table 2. Phytoconstituents isolated from Bambusa spp.

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Figure 3. Chemical structures (1-7) isolated from B. nutans and B. textilis.

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Anti-inflammatory activity

All experimental models, including acetic acid-induced vascular permeability, carrageenan-induced peritonitis, cotton pellet granuloma, formaldehyde-induced paw edema, and estimation of plasma malondialdehyde (MDA), were significantly and dose-dependently inhibited (p < 0.01) by B. vulgaris (100 mg/kg, 200 mg/kg, and 400 mg/kg, p.o.). The results indicated that B. vulgaris significantly contains anti-inflammatory properties, which are reflected in the use of this traditional plant for treating painful and inflammatory conditions (Carey et al., 2009). The inhibitory activities of paw edema were significantly decreased by increasing the amounts of ethyl acetate and aqueous fractions from B. vulgaris, which contains anti-inflammatory properties (Lodhi et al., 2016). When compared to the usual medications recognized as ulcerogenic, the methanolic extract of B. arundinacea leaves against immunologically generated paw edema and carrageenan-induced edema was shown to be better (Muniappan and Sundararaj, 2003). Additionally, by stabilizing the membrane of human red blood cells and using the protein denaturation technique, the hydroalcoholic extract of B. arundinacea shows potent anti-inflammatory properties (Vanitha et al., 2016).

Figure 4. Chemical structures (8-9) isolated from B. nutans.

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Figure 5. Chemical structure (10) isolated from B. balcooa, B. nutans, and B. textilis.

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Figure 6. Chemical structure (11) isolated from B. nutans and B. textilis.

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Antibacterial activity

At doses ranging from 2.5 mg/ml to > 80 mg/ml, both aqueous and ethanolic extracts of B. vulgaris demonstrated bactericidal action against at least one of the test pathogens, as analyzed by Minimum Bactericidal Concentration and Minimum Inhibitory Concentration (MIC) (Bolou et al., 2011). In contrast to the ethanolic leaf extract, which lacked antibacterial activity against Salmonella typhi and Streptococcus faecalis, fresh leaf extracts of B. tuldoides from sorghum liquors and fermented maize at a concentration of 20 g/100 ml demonstrated antibacterial activity against all of the bacteria tested. Higher concentrations (20 g/40 ml) of both fresh and dried extracts of B. tuldoides demonstrated greater antibacterial activity than sorghum liquors and fermented maize (Oluwahenyinmi et al., 2014). For increasing concentrations (25, 50, 100, and 150 μl) of ethanolic extract of B. arundinacea, the inhibition zone for Staphylococcus aureus was 14, 16, 17, and 19 mm, whereas that of Bacillus subtilis was 12, 14, 15, and 17 mm, respectively (Jayarambabu et al., 2021). Following the use of the agar well diffusion method, B. vulgaris extracts may include compounds with antibacterial activities that can be incorporated into novel antimicrobial medicines (Sandhiya et al., 2013).

Antifungal activity

The extracts (sequentially ethanol, ethyl acetate, hexane, and water) acquired from B. vulgaris boiled shoots exhibited a higher antifungal effect (MIC: 0.01–2.50 mg/ml) compared to antibacterial effect (MIC: 0.31–2.50 mg/ml) (Kong et al., 2020). Class III chitinase cDNA (BoChi3-1) was cloned from suspension-cultured bamboo (B. oldhamii) cells and then produced in yeast by using a cDNA library (Pichia pastoris X-33). Both recombinant BoChi3-1 isoforms inhibited Scolecobasidium longiphorum growth (Kuo et al., 2008). At a concentration of 1 mg/ml, all Kawayang Tinik (B. blumeana) extracts showed a statistically equivalent zone of inhibition (ZOI) against Aspergillus niger, whereas ethanolic leaf and root extracts produced a wider ZOI against Penicillium chrysogenum than other B. blumeana extracts. In addition, antifungal assay findings demonstrated that B. blumeana extracts have a comparable antifungal effect to fluconazole, an FDA-approved antifungal agent at 1 mg/ml concentration (Saducos, 2021).

Antimalarial activity

Plasmodium berghei was evaluated for in vivo antimalarial efficacy against B. arundinacea methanolic extract, and it demonstrated 26.0%, showing excellent antimalarial potential (Esmaeili et al., 2015). The organic solvent fractions of B. vulgaris exhibited antimalarial activity with ethyl acetate and petroleum ether fractions, displaying an IC50 below 1 μg/ml against the Plasmodium falciparum 3D7 strain (Komlaga et al., 2016). Bambusa vulgaris hydroalcoholic extract also demonstrated the most specific and potent antimalarial property (IC50 = 4.7 μg/ml, SI = 28.9) (Valdés et al., 2010).

Antidiabetic activity

Treatment of streptozotocin-induced diabetic rats with Qurs Tabasheer (including B. arundinacea) for 28 days significantly reduced serum glucose, cholesterol, fructose-1-6-biphosphatase, glucose-6-phosphatase, and triglycerides, whereas the magnitude of hexokinase and high-density lipoprotein cholesterol was amplified (Ahmed et al., 2013). Compared to diabetic animals, the animals given B. tulda leaves showed a gain in body weight. Hence, hydromethanolic extract proved that B. tulda leaves possess antidiabetic activity. Although the effect was significant, B. tulda leaves could be utilized in managing diabetic levels (Dey et al., 2018). While plasma insulin levels were raised relative to diabetic control, the aqueous extract of B. balcooa at 100 mg/kg and 200 mg/kg effectively reduced fasting blood glucose and glycated hemoglobin in alloxan-induced diabetic rats. Both dosages of glibenclamide (standard antidiabetic agent) were efficient against diabetic rats (Goyal et al., 2017). The hypoglycemic effect of B. arundinacea aqueous extract was statistically significant and equivalent to that of glibenclamide at 0.9 mg/kg in euglycemic rats at 30 minutes and 1,000 mg/kg in hyperglycemic rats at 3 hours with an oral dose of 500 mg/kg (Joshi et al., 2009).

Figure 7. Chemical structures (12-15) isolated from B. textilis.

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Figure 8. Chemical structures (16-19) isolated from B. nutans.

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Figure 9. Chemical structure (20) isolated from B. balcooa.

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Figure 10. Chemical structures (21-29) isolated from B. balcooa.

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Figure 11. Chemical structure (30) isolated from B. bambos and B. textilis.

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Anticancer activity

Bambusa arundinacea-derived zinc oxide nanoparticles (ZnO NPs) demonstrated anticancer activity against MCF-7 cell lines. These results indicate that biosynthesized ZnO NPs may have therapeutic properties (Jayarambabu et al., 2021). Kalaiarasi et al. (2015) examined the antitumor effectiveness of in vitro-grown B. arundinacea (Ba) and B. nutans (Bn) leaf samples for the formation of metallic silver nanoparticles (AgNPs) from silver ions against human prostate cancer cell lines (PC-3). BaAgNPs and BnAgNPs had IC50 values for PC3 cancer cells of 73.57 μg/ml and 84.88 μg/ml, respectively, while Vero cells had IC50 values of 93.58 μg/ml and 96.41 μg/ml, respectively. For BaAgNPs and BnAgNPs, the percentages of apoptotic bodies as measured by acridine orange/ethidium bromide staining were 76% and 62%, respectively. The observations clearly suggest that synthesized BaAgNPs may have anticancer activity against human PC-3 cell lines in contrast to BnAgNPs.

Figure 12. Chemical structures (31-34) isolated from B. textilis.

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Figure 13. Chemical structures (35-45) isolated from B. balcooa.

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Figure 14. Chemical structures (46-49) isolated from B. bambos.

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Table 3. Pharmacological properties of Bambusa spp.

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Abortifacient activity

Aqueous extracts of B. vulgaris leaves were tested for their toxicity at 250 mg/kg and 500 mg/kg body weight in a pregnant Dutch rabbit test. The extract increased kidney gamma-glutamyl transferase (GGT) at a dose of 250 mg/kg. Contrarily, kidney GGT activity decreased at 500 mg/kg while the 250 mg/kg dose did not affect the liver and serum GGT. Furthermore, the extract increased the levels of total and conjugated bilirubin, bicarbonate ions, creatinine, potassium, sodium, and uric acid in the blood. The alteration of biochemical markers by the aqueous extract of B. vulgaris leaves suggests a negative impact on the excretory, secretory, synthetic, and reabsorptive functions of the liver and kidney in animals (Yakubu et al., 2009). Yakubu and Bukoye (2009) also showed B. vulgaris aqueous extract to be an abortifacient. The dosage of the extract at 250 mg/kg and 500 mg/kg decreased the fetus survival rate to 29% and 0%, correspondingly, while the same levels resulted in 60% and 100% more abortions, accordingly. The implantation index and preimplantation loss were evaluated in relation to the control. Both dosages resulted in an increase in the post-implantation loss and resorption index. The extract also decreased serum progesterone, luteinizing hormone, and follicle-stimulating hormone levels. These results verified the abortifacient properties of the aqueous extract of B. vulgaris leaves.

Cytotoxic effect

Methanolic extract of B. arundinacea was screened for cytotoxicity effect on Madin-Darby bovine kidney cells and showed no IC50 (Esmaeili et al., 2015). Nevertheless, the aqueous extract of B. vulgaris showed CC50 > 100 μg/ml when tested for cytotoxicity against human umbilical vein endothelial cells, supporting its classical usage in Ghana as a malaria therapy (Komlaga et al., 2016). A hydroalcoholic extract of B. vulgaris over human cell line MRC-5 to examine cytotoxicity showed CC50 of 136.7 μg/ml, thereby reflecting that the extract could possess cytotoxicity activity (Valdés et al., 2010).


SUMMARY AND OUTLOOK

This review has elucidated the significance of Bambusa spp. as a medicinal plant with diverse pharmacological spectra. Bambusa spp. contain a variety of phytochemical constituents that are responsible for their diverse ethnomedicinal and pharmacological properties. Developing novel clinical therapeutics from Bambusa spp. requires additional investigation of the current data. Given that this review compiled vital information on various aspects of this medicinal plant, it provides an excellent opportunity for future research.


ACKNOWLEDGMENTS

Sincere appreciation is extended to Sabah Parks and Sabah Biodiversity Centre for giving access permission [JKM/MBS.1000-2/2 JLD.12 (89)].


AUTHOR CONTRIBUTIONS

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work. All the authors are eligible to be an author as per the international committee of medical journal editors (ICMJE) requirements/guidelines.


FINANCIAL SUPPORT

The authors would like to thank Universiti Malaysia Sabah for the financial support provided by the Postgraduate Research Grant (UMSGreat) [GUG0507-2/2020] throughout the research period.


CONFLICTS OF INTEREST

The authors report no financial or any other conflicts of interest in this work.


ETHICAL APPROVALS

This study does not involve experiments on animals or human subjects.


DATA AVAILABILITY

All data generated and analyzed are included in this research article.


PUBLISHER’S NOTE

This journal remains neutral with regard to jurisdictional claims in published institutional affiliation.


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