Since antiquity, Piper betel. Linn, commonly known as betel vine, has been used as a religious, recreational and medicinal plant in Southeast Asia. The leaves, which are the most commonly used plant part, are pungent with aromatic flavor and are widely consumed as a mouth freshener. It is carminative, stimulant, astringent and is effective against parasitic worms. Experimental studies have shown that it possess diverse biological and pharmacological effects, which includes antibacterial, antifungal, larvicidal, antiprotozal, anticaries, gastroprotective effects, free radical scavenging, antioxidant, anti-inflammatory hepatoprotective, immunomodulatory, antiulcer and chemopreventive activities. The active principles hydroxychavicol, allylpyrocatechol and eugenol with their plethora of pharmacological properties may also have the potential to develop as bioactive lead molecule. In this review, an attempt is made to summarize the religious, traditional uses, phytochemical composition and experimentally validated pharmacological properties of Piper betel. Emphasis is also placed on aspects warranting detail studies for it to be of pharmaceutical/clinical use to humans.
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Rai MP, Thilakchand KR, Palatty PL, Rao P, Rao S, Bhat HP, et al. Piper betel Linn (betel vine), the maligned Southeast Asian medicinal plant possesses cancer preventive effects: time to reconsider the wronged opinion. Asian Pac J Cancer Prev 2011;12:2149–2156.
Kumar N, Misra P, Dube A, Bhattacharya S, Dikshit M, Ranade S. Piper betle Linn., a maligned Pan-Asiatic plant with an array of pharmacological activities and prospects for drug discovery. Curr Sci 2010;99:922–932.
Pradhan D, Suri KA, Pradhan DK, Biswasroy P. Golden heart of the nature: Piper betle L. J Pharmacog Phytochem 2013;1:147–167.
Kirtikar KR, Basu BD. Indian medicinal plants. Vol. III. 2nd ed. Bishen Singh Mahendra Pal Singh: Dehradun, India; 1998:2131–2133.
Satyavati GV, Raina MK, Sharma M, eds. Medicinal plants of India. Vol. 1. New Delhi: Indian Council of Medical Research 1987.
Guha P. Betel leaf: the neglected green gold of India. J Hum Ecol 2006;19:87–93.
Rao MD. “Auspicious trees and plants”, hidden treasure of vastu shilpa shastra and Indian traditions.S.B.S. Publishers, Bangalore, india. 1995;178–180.
IARC. Betel-quid and areca nut chewing and some arecanutderived nitrosamines. In: IARC monographs. Vol. 85. 2004. International Agency for Research on Cancer, WHO, Lyon, France. Available from http://monographs.iarc.fr/ENG/Monographs/vol85/volume85.pdf
Bissa S, Songara D, Bohra A. Traditions in oral hygiene: Chewing of betel (Piper betel L.) leaves. Curr Sci 2007;92:26–28.
Rastogi RP, Mehrotra BN. Compendium of Indian medicinal plants. Vol. 3. New Delhi: Publications and Information Directorate; 1993:502–503.
Parmar VS, Jain SC, Gupta S, Talwar S, Rajwanshi VK, Kumar R, et al. Polyphenols and alkaloids from Piper species. Phytochemistry 1998;49:1069–1078.
Amonkar AJ, Nagabhushan M, D’Souza AV, Bhide SV. Hydroxychavicol: a new phenolic antimutagen from betel leaf. Food Chem Toxicol 1986;24:1321–1324.
Nagabhushan M, Amonkar AJ, D’Souza AV, Bhide SV. Hydroxycahvicol: a new anti-nitrosating phenolic compound from betel leaf. Mutagenesis 1989;4:200–204.
Sankar CR, Sridevi D, Babu MK. Studies on essential oil and oil constituents of betel vine cultivars. Andhra Agri J 1996;43:24–26.
Saeed SA, Farnaz S, Simjee RU, Malik A. Triterpenes and β-sitosterol from Piper betel: isolation, antiplatelet and antiinfl ammatory effects. Bio Soc Transac 1993;21:462–465.
Ghosh K, Bhattacharya TK. Chemical constituents of Piper betel Linn. (Piperaceae) roots. Molecules 2005;10:798–802
Huang X, Yin Y, Huang W, Sun K, Cheng C, Bai L, Dai Y. Alkaloids and lignans from stems of Piper betle. Chin J Mater Med (Chin) 2010;35:2285–2288.
Shitut S, Pandit V, Mehta BK. The antimicrobial efficiency of Piper betel Linn leaf (stalk) against human pathogenic bacteria and phytopathogenic fungi. Cent Eur J Public Health 1999;7:137–139.
Bandyopadhyay S, Pal B, Bhattacharya S, Ray M, Roy KC. Use of betel leaf extract to induce IFN-gamma production from human peripheral blood T cells and as a Th1 type immunomodulator. United States Patent 2006;7045157.
Nair R, Chanda S. Antimicrobial activity of Terminalia catappa, Manilkara zapota and Piper betel leaf extract. Ind J Pharma Sci 2008;70:390–393.
Chatchawanchonteera A, Kampanawarawan W, Pansri Y, Poosri C, Pimsiri K, Maikaew U, et al. Inhibition effect of Piper betel extract on clinical isolated Pseudomonas aeruginosa from animals. KKU Vet J 2005;15:152–158.
Urasopon N, Tongngok P, Wattanakul W, Wangmaneerat A, Salarngam I. A study of the antimicrobial activity of Thai herbs on Enteropathogenic Escherichia coli. J Thai Vet Med Assoc 2003;54:27–38.
Urasopon N, Tongngok P, Wattanakul W, Wangmaneerat A, Salarngam I. A study of the antimicrobial activity of thai herbs on Enteropathogenic Escherichia coli. J Thai Vet Med Assoc 2003;54:27–38.
Pongpech P, Prasertsilpe V. The study of antimicrobial activity of piper betel cream and gel against some fungi, yeast and bacteria. J Nat Res Council; 1993:19.
Ramakrishna Y, Goda H, Baliga MS, Munshi AK. Decreasing cariogenic bacteria with a natural, alternative prevention therapy utilizing phytochemistry (plant extracts). J Clin Pediatr Dent 2011;36:55–63.
Fathilah AR, Rahim ZHA. The anti-adherence effect of Piper betel and Psidium guajava extracts on the adhesion of early settlers in dental plaque to saliva-coated glass surfaces. J Oral Sci 2003;45:201–206.
Nalina T, Rahim ZHA. Effect of Piper betel. L extract on the virulence activity of streptococcus mutans—An in vitro study. Pakistan J Biolo Sci 2006;9:1470–1475.
Nalina T, Rahim ZHA. The crude aqueous extract of Piper betel L. and its antibacterial effect towards streptococcus mutans. Am J Biotechnol Biochem 2007;3:10–15.
Fathilah AR, Rahim ZHA, Othman Y, Yusoff M. Bacteriostatic effect of Piper betel and Psidium guajava extracts on dental plaque bacteria. Pak J Biol Sci 2009;12:518–521.
Rahim ZH, Thurairajah N. Scanning electron microscopic study of Piper betle L. leaves extract effect against streptococcus mutans ATCC 25175. J Appl Oral Sci 2011;19:137–146.
Sharma S, Khan IA, Ali I, Ali F, Kumar M, Kumar A, et al. Evaluation of the antimicrobial, antioxidant, and antiinflammatory activities of hydroxychavicol for its potential use as an oral care agent. Antimicr Agents Chemother 2009;53:216–222.
Ramji N, Ramji N, Iyer R, Chandrasekaran S. Phenolic antibacterials from Piper betel in the prevention of halitosis. J Ethnopharmacol 2002;83:149–152.
Chou CC, Yu RC. Effect of Piper betel L. and its extracts on the growth and aflatoxin production by Aspergillus parasiticus. Proceedings of the National Science Council, Republic of China. Part B. Life Sci 1984;8:30–35.
Trakranrungsie N, Chatchawanchonteera A, Khunkitti W. Ethnoveterinary study for antidermatophytic activity of Piper betel, Alpinia galanga and Allium ascalonicum extracts in vitro. Res Vet Sci 2008;84:80–84.
Prakash B, Shukla R, Singh P, Kumar A, Mishra PK, Dubey NK. Efficacy of chemically characterized Piper betle L. essential oil against fungal and afl atoxin contamination of some edible commodities and its antioxidant activity. Int J Food Microbiol 2010;142:114–119.
Ali I, Khan FG, Suri KA, Gupta BD, Satti NK, Dutt P, et al. In vitro antifungal activity of hydroxychavicol isolated from Piper betle L. Ann Clin Microbiol Antimicrob 2010;3:7–12.
Kumarasinghe SPW, Karunaweera ND, Ihalamulla RL, Arambewela LSR, Dissanayake RDSCT. Larvicidal effects of mineral turpentine, low aromatic white spirits, aqueous extracts of Cassia alata, and aqueous extracts, ethanolic extracts and essential oil of betel leaf (Piper betle) on Chrysomya megacephala. Ind J Dermat 2002;41:877–880.
Wardhana AH, Kumarasinghe SPW, Arawwawala LDAM, Arambewela LAR. Larvicidal efficacy of essential oil of betel leaf (Piper betle) on the larvae of the Old World screwworm fl y, Chrysomya bezziana in vitro. Ind J Dermat 2007;52:43–47.
Sawangjaroen N, Subhadhirasakul S, Phongpaichit S, Siripanth C, Jamjaroen K, Sawangjaroen K. The in vitro anti-giardial activity of extracts from plants that are used for self-medication by AIDS patients in Southern Thailand. Parasitol Res 2005;95:17–21.
Sarkar A, Sen R, Saha P, Ganguly S, Mandal G, Chatterjee M. An ethanolic extract of leaves of Piper betel (Paan) Linn mediates its antileishmanial activity via apoptosis. Parasitology Res 2008;102:1249–1255.
Sawangjaroen N, Phongpaichit S, Subhadhirasakul S, Visutthi M, Srisuwan N, Thammapalerd N. The anti-amoebic activity of some medicinal plants used by AIDS patients in Southern Thailand. Parasitol Res 2006;98:588–592.
Al-Adhroey AH, Nor ZM, Al-Mekhlafi HM, Amran AA, Mahmud R. Antimalarial activity of methanolic leaf extract of Piper betle L. Molecules 2010;16:107–118.
Singh M, Shakya S, Soni VK, Dangi A, Kumar N, Bhattacharya SM. The n-hexane and chloroform fractions of Piper betel L. trigger different arms of immune responses in BALB/c mice and exhibit antifilarial activity against human lymphatic filarid Brugia malayi. Int Immunopharmacol 2009;9:716–728.
Wirotesangthong M, Inagaki N, Tanaka H, Thanakijcharoenpath W, Nagai H. Inhibitory effects of Piper betel on production of allergic mediators by bone marrow-derived mast cells and lung epithelial cells. Int J Immunopharmacol 2008;8:453–457.
Santhakumari P, Prakasam A, Pugalendi KV. Antihyperglycemic activity of Piper betel leaf on streptozotocininduced diabetic rats. J Med Food 2006;9:108–112.
Saravanan R, Prakasam A, Ramesh B, Pugalendi KV. Influence of Piper betle on hepatic marker enzymes and tissue antioxidant status in ethanol-treated Wistar rats J Med Food 2002;5:197–204.
Young SC, Wang CJ, Lin JJ, Peng PL, Hsu JL, Chou FP. Protection effect of Piper betel leaf extract against carbon tetrachloride-induced liver fibrosis in rats. Arch Toxicol 2007;8:45–55.
Pushpavalli G, Veeramani C, Pugalendi KV. Influence of Piper betel on hepatic marker enzymes and tissue antioxidant status in D-galactosamine-induced hepatotoxic rats. J Basic Clin Physiol Pharmacol 2008;19:131–150.
Prabhu MS, Platel K, Saraswathi G, Srinivasan K. Effect of orally administered betel leaf (Piper betel Linn.) on digestive enzymes of pancreas and intestinal mucosa and on bile production in rats. Ind J Exp Biol 1995;33:752–756.
Bhattacharya S, Chaudhuri SR, Chattopadhyay S, Bandyopadhyay SK. Healing properties of some Indian medicinal plants against indomethacin-induced gastric ulceration of rats. J Clin Biochem Nutri 2007;41:106–114.
Bhattacharya S, Banerjee D, Bauri AK, Chattopadhyay S, Bandyopadhyay SK. Healing property of the Piper betel phenol, allylpyrocatechol against indomethacin-induced stomach ulceration and mechanism of action. World J Gastroenterol 2007;13:3705–3713.
Panda S, Kar A. Dual role of betel leaf extract on thyroid function in male mice. Pharmacol Res 1998;38:493–496.
Adhikary P, Banerji J, Chowdhury D, Das AK, Deb CC, Mukherjee SR, et al. Antifertility effect of Piper betel Linn. extract on ovary and testis of albino rats. Ind J Exp Biol 1989;27:868–870.
Sarkar M, Gangopadhyay P, Basak B, Chakrabarty K, Banerji J, Adhikary P, et al. The reversible antifertility effect of Piper betle Linn. on Swiss albino male mice. Contraception 2000;62:271–274.
Tewari PV, Chaturvedi C, Dixit SN. Antifertility effect of betel leaf stalk (Tambul patrabrint): a preliminary experimental study. J Res Edu Ind Med 1970;4:143–151.
Sharma JD, Sharma L, Yadav P. Antifertility efficacy of Piper betel Linn. (Petiole) on female albino rats. Asian J Exp Sci 2007;21:145–150.
Pushpavalli G, Veeramani C, Pugalendi KV. Effect of Piper betel on plasma antioxidant status and lipid profile against D-galactosamine-induced hepatitis in rats. Redox Report 2009;14:7–12.
Arya DS, Arora S, Malik S, Nepal S, Kumari S, Ojha S. Effect of Piper betel on cardiac function, marker enzymes, and oxidative stress in isoproterenol-induced cardiotoxicity in rats. Toxicol Mech Methods 2010;20:564–571.
Lei D, Chan CP, Wang YJ, Wang TM, Lin BR, Huang CH, et al. Antioxidative and antiplatelet effects of aqueous inflorescence Piper betel extract. J Agri Food Chem 2003;51:2083–2088.
Kanjwani DG, Marathe TP, Chiplunkar SV, Sathaye SS. Evaluation of immunomodulatory activity of methanolic extract of Piper betel. Scan J Immunol 2008;67:589–593.
Nair S, Nagar R, Gupta R. Antioxidant phenolics and flavonoids in common Indian foods. J Asso Physic India 1998;46:708–710.
Murata K, Nakao K, Hirata N, Namba K, Nomi T, Kitamura Y, et al. Hydroxychavicol: a potent xanthine oxidase inhibitor obtained from the leaves of betel Piper betle. J Nat Med 2009;63:355–359.
Rathee JS, Patro BS, Mula S, Gamre S, Chattopadhyay S. Antioxidant activity of Piper betel leaf extract and its constituents. J Agri Food Chem 2006;54:9046–9054.
Jagetia GC, Baliga MS. The evaluation of nitric oxide scavenging activity of certain Indian medicinal plants in vitro: a preliminary study. J Med Food 2004;7:343–348.
Choudhary D, Kale RK. Antioxidant and non-toxic properties of Piper betel leaf extract: in vitro and in vivo studies. Phyto Res 2002;16:461–466.
Ganguly S, Mula S, Chattopadhyay S, Chatterjee M. An ethanol extract of Piper betle Linn. mediates its antiinfl ammatory activity via down regulation of nitric oxide. J Pharm Pharmacol 2007;59:711–718.
Lee YY, Hung SL, Pai SF, Lee YH, Yang SF. Eugenol suppressed the expression of lipopolysaccharide-induced proinflammatory mediators in human macrophages. J Endodont 2007;33:698–702.
Lee YY, Yang SF, Ho WH, Lee YH, Hung SL. Eugenol modulates cyclooxygenase-2 expression through the activation of nuclear factor kappa B in human osteoblasts. J Endodont 2007;33:1177–1182.
Dohi T, Terada H, Anamura S, Okamoto H, Tsujimoto A. The anti-inflammatory effects of phenolic dental medicaments as determined by mouse ear edema assay. Jap J Pharmacol 1989;49:535–539.
Kim SS, Oh OJ, Min HY, Park EJ, Kim Y, Park HJ, et al. Eugenol suppresses cyclooxygenase-2 expression in lipopolysaccharide-stimulated mouse macrophage RAW264.7 cells. Life Sci 2003;73:337–348.
Sarkar D, Saha P, Gamre S, Bhattacharjee S, Hariharan C, Ganguly S, et al. Anti-inflammatory effect of allylpyrocatechol in LPS-induced macrophages is mediated by suppression of iNOS and COX-2 via the NF-kappaB pathway. Int Immunopharmacol 2008;8:1264–1271.
Pandey A, Bani S, Dutt P, Suri KA. Modulation of Th1/Th2 cytokines and infl ammatory mediators by hydroxychavicol in adjuvant induced arthritic tissues. Cytokine 2010;49:114–121.
Shirname LP, Menon MM, Nair J, Bhide SV. Correlation of mutagenicity and tumorigenicity of betel quid and its ingredients. Nutri Cancer 1983;5:87–91
Nagabhushan M, Amonkar AJ, D’Souza AV, Bhide SV. Nonmutagenicity of betel leaf and its antimutagenic action against environmental mutagens. Neoplasma 1987;34:159–167.
Padma PR, Amonkar AJ, Bhide SV. Antimutagenic effects of betel leaf extract against the mutagenicity of two tobaccospecific N-nitrosamines. Mutagenesis 1989;4:154–156.
Bhide SV, Padma PR, Amonkar AJ. Antimutagenic and anticarcinogenic effects of betel leaf extract against the tobacco-specific nitrosamine 4-(N-nitroso methyllamino)-1-(3-pyridyl)-1-butanone (NNK). IARC Sci Pub 1991;105:520–524.
Amonkar AJ, Nagabhushan M, D’Souza AV, Bhide SV. Hydroxychavicol: a new phenolic antimutagen from betel leaf. IARC Sci Pub 1991;105:520–524.
Sukumaran K, Kuttan R. Inhibition of tobacco-induced mutagenesis by eugenol and plant extracts. Mutat Res 1995;343:25–30.
Yin Y, Huang XZ, Wang J, Dai JH, Liang H, Dai Y. Studies on the chemical constituents of the stems of Piper betel. Chin Herb Drug (Chin) 2009;32:887–890.
Trivedi AH, Patel RK, Rawal UM, Adhvaryu SG, Balar DB. Evaluation of chemopreventive effects of betel leaf on the genotoxicity of pan masala. Neoplasma 1994;41:177–181.
Padma PR, Lalitha VS, Amonkar AJ, Bhide SV. Anticarcinogenic effect of betel leaf extract against tobacco carcinogens. Cancer Lett 1989;45:195–202.
Bhide SV, Zariwala MB, Amonkar AJ, Azuine MA. Chemopreventive efficacy of a betel leaf extract against benzo(a)pyrene-induced forestomach tumors in mice. J Ethnopharmacol 1991;34:207–213
Rao AR. Modifying influences of betel quid ingredients on B(a)P-induced carcinogenesis in the buccal pouch of hamster. Int J Cancer 1984;15:581–586.
Azuine MA, Amonkar AJ, Bhide SV. Chemopreventive efficacy of betel leaf extract and its constituents on 7, 12-dimethylbenz(a) anthracene induced carcinogenesis and their effect on drug detoxification system in mouse skin. Ind J Exp Biol 1991;29:346–351.
Rao AR, Sinha A, Selvan RS. Inhibitory action of Piper betel on the initiation of 7,12-dimethylbenz(a) anthraceneinduced mammary carcinogenesis in rats. Cancer Lett 1985;26:207–214.
Bhide SV, Azuine MA, Lahiri M, Telang NT. Chemoprevention of mammary tumor virus-induced and chemical carcinogeninduced rodent mammary tumors by natural plant products. Breast Cancer Res Treat 1994;30:233–242.
Murakami A, Ali AM, Mat-Salleh K, Koshimizu K, Ohigashi H. Screening for the in vitro anti-tumor-promoting activities of edible plants from Malaysia. Biosci Biotec Biochem 2000;64:9–16.
Wagh V, Mishra P, Thakkar A, Shinde V, Sharma S, Padigaru M, et al. Antitumor activity of NPB001-05, an orally active inhibitor of Bcr-Abl tyrosine kinase. Front Biosci 2011;3:1349–1364.
Bhattacharya S, Subramanian M, Roychowdhury S, Bauri AK, Kamat JP, Chattopadhyay S, et al. Radioprotective property of the ethanolic extract of Piper betel Leaf. J Radiat Res 2005;46:165–171.
Verma S, Gupta ML, Dutta A, Sankhwar S, Shukla SK, Flora SJ. Modulation of ionizing radiation induced oxidative imbalance by semi-fractionated extract of Piper betle: an in vitro and in vivo assessment. Oxid Med Cell Longev 2010;3:44–52.
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Fazal, F., Mane, P.P., Rai, M.P. et al. The phytochemistry, traditional uses and pharmacology of Piper Betel. linn (Betel Leaf): A pan-asiatic medicinal plant. Chin. J. Integr. Med. (2014). https://doi.org/10.1007/s11655-013-1334-1