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Jason M. Peranginangin et al., (2013) Int. J. Res. Phytochem. Pharmacol.

, 3(3), 121-127

ISSN: 2231-010X
Review Article

www.ijrpp.pharmascope.org

Therapeutic potency of Solanum torvum Swartz on benign prostatic hyperplasia


treatment : A review
1

Jason M. Peranginangin* , Andreanus A. Soemardji , Ketut Adnyana I , Diah Dhianawaty D

Faculty of Pharmacy, Setia Budi University, Surakarta, Indonesia


Departmen of Clinical Pharmacology, School of Pharmacy, Institute Technology of Bandung, Bandung, Indonesia
3
Department of Biochemistry, Faculty of Medicine, Padjadjaran, Bandung, Indonesia

ABSTRACT
Solanum torvum is a commonly used herb in traditional medicine and have been widely used for the treatment of
large number of human ailments. This review paper support updated information on its phytochemical and
pharmacological activities and scientific approach about the potential role of S. torvum on BPH treatment. The
chemical compound of this plant has been used as antihypertensive, antioxidant, cardiovascular, anti-platelet
agregation, antimicrobial, sedative, digestive, hemostatics, diuretic, analgesic and antiinflammatory. S. torvum has
been widely used by the people of Indonesia to overcome prostate disorders. However, the literature search
showed that pharmacological study of S. torvum against BPH has never been reported previously. This review
attempt to find relationship between traditional concept and scientiffically proved activities, especially role of S.
torvum on BPH treatment. S. torvum have therapeutic potential for the treatment of BPH because its antiinflammatory, imunomadulator and antioxidant activity. S. torvum is a promising medicinal plant for treatment of
BPH. The possibly beneficial role of S. torvum in BPH has not been suggested. Thus, further research can be
designed to prove this hypothesis.
Keywords: Solanum torvum; Benign Prostatic Hyperplasia; antiinflammatory; Immunomodulatory; antioxidant
INTRODUCTION
Benign Prostatic Hyperplasia (BPH) is a non-malignat
growth and uncontrolled cells and stroma of the
prostate gland that causes urinary difficulties, become
the most frequent cause of lower urinary tract
symptoms (LUTS) in men over 50 years, its frequency
increases with age (Molina et al., 2007). The recent
estimates mentioned the incidence of BPH in men aged
51-60, 61-70, and 81-90 years, respectively 42, 70 and
90% (Nickel, 2008). In Indonesia, BPH is a second
urologic disorders after urinary tract stones were
found in the urology clinic and an estimated 50% in
men aged over 50 years (Pakasi, 2009). With the
improvement of development will give the effect of
rising life expectancy, the number of patients with BPH
will increasingly.
Although the pathogenesis of BPH is not fully
understood, an important role is attributed to
hormonal changes that occur in older men, such as
prostate increased conversion of testosterone (T) to
dihydrotestosterone (DHT) which is a more active
metabolites that bind to androgen receptors and
* Corresponding Author
Email: [email protected]
Contact: +62-8122643987
Received on: 12-05-2013
Revised on: 17-06-2013
Accepted on: 18-07-2013

increases the release of different growth factors ,


reaction catalyzed by 5-reductase enzyme. Excessive
accumulation of DHT in the prostate leads to BPH
(Carson and Rittmaster, 2002). Therefore 5-reductase
inhibitors are the first choice for treating BPH, reducing
enlarged prostate (Sandhu and Te, 2004). In the past
selective treatment for enlarged prostate is primarily
surgery. Currently, drug therapy has been used to treat
early-stage prostate disorders (Lund et al., 2004).
Because surgery and drug therapy is expensive and
there is also the possibility of side effects, it is
necessary to make a therapeutic agent that is cheap
and safe. Phytotherapy for BPH is very common in
many countries. Natural product that seems to have
limited side effects become more important in the
treatment of BPH (Mohammady et al., 2011).
Some extracts of certain herbs can be used to improve
symptoms caused by prostatic obstruction, but
pharmacologic data concerning the active substances
that support the drug action mechanism of
phytotherapy not known with certainty until now.
Phytotherapy possibility to work as an anti-estrogen,
anti-androgens, lowering the levels of sex hormone
binding globulin (SHBG), inhibition of basic fibroblast
growth factor (bFGF) and epidermal growth factor
(EGF), disrupt the metabolism of prostaglandins,
antiinflammation effect, reduce outflow resistance,
and decrease the volume of the prostate. Among the
many marketed phytotherapy are Pygeum africanum,

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121

Jason M. Peranginangin et al., (2013) Int. J. Res. Phytochem. Pharmacol., 3(3), 121-127

Table 1: Pharmacological activities of Solanum torvum Swartz


Pharmacological
activity
Antibacterial

Extract/plants
S.
torvum
aqueous and
solvent
leaf
extract

In vivo/ in vitro
screening model
Tested
against
Xanthomonas
campestris
pv
oryzae by cup
diffusion method
Tested
againts
Fusarium sacchari
by poisoned food
technique.

Antifungal

S. torvum
leaf extract

Antiviral

S. torvum
methanolic
fruits extract

Tested
againts
herpes
simplex
virus type 1

Anti-ulcerogenic

S.
torvum
aqueous and
methanol
extracts
of
leaves

Investigated
against ethanol,
indomethacin,
Pylorus ligation
and cold-restraint
stress-induced
gastric ulcer in rat

Antioxidant

S. torvum
fruit extract

Scavenging free
radical potential
was
evaluated
againts ethanolic
solution of DPPH
and
hydrogen
peroxide

Antihypertensive
and
metaboliccorrection activity

S. torvum
fruit extract

Wistar
rats
maintained on a
high fructose diet
developed high
systolic
blood
pressure
and
increase in body
weight,
Serum
insulin, glucose,
triglycerides,
cholesterol and
uric acid levels

122

Result of study

Reference

Methanolic
and
ethanolic
extracts showed the activity
against
Xanthomonas
campestris pv oryzae at
different concentrations
Extract was fungicidal at 0.5
ml/ml dose, since no further
revival of growth was observed
in inoculated plates even after
incubation for 6 days after
inoculation.
The
extract
required minimally 5 min to kill
the test fungus at its MIC
A new C4 - sulfated isoflavonoid
(torvanol A) and steroidal
glycoside
(torvoside
H)
together with torvoside A were
isolated
from
methanolic
extract of S. torvum fruits
exhibited antiviral activity with
IC50 values of 9.6, 23.2 and 17.4
g/ml
Revealed the presence of
flavanoids,
sterols
and
triterpens which may be
responsible
for
anti-ulcer
property. It strength the
mucosal barrier through the
increase of the mucus and
bicarbonate production and
reducing the volume of gastric
acid secretion or by simply
neutralising the gastric activity
Phenol
and
flavonoid
compounds of S. torvum
extract was the most potent as
it
exhibited
outstanding
reducing power, scavenging
activity against DPPH and
hydrogen peroxide. Good corelation was observed with
radical scavenging activity of
extracts and total phenolics
Ethanolic extract (100 and 300
mg/kg/day, p.o.) significantly
reduced
SBP
and
all
biochemical parameters in
fructose-fed animals.
Also have the 5-HT and
adrenergic 1-receptor blocking
activity on isolated tissue
preparation.
Aqueous
and
methanolic
extract
also
possess
hypotensive activity which may

Lalitha et al.,
2010; Bari et al.,
2010

Gupta
and
Tripathi, 2011

Arthan et al., 2002

Nguelefack et al.,
2008; Antonio et
al., 2004

Waghulde et al.,
2011; Gyamfi et
al., 1999

Mohan et al.,
2009; Jaiswal and
Mohan,
2012;
Nguelefack et al.,
2008

JK Welfare & Pharmascope Foundation | International Journal of Research in Phytochemistry & Pharmacology

Jason M. Peranginangin et al., (2013) Int. J. Res. Phytochem. Pharmacol., 3(3), 121-127

Nephroprotective

S. torvum
fruit extract

investigated
against
Doxorubicin
(DOX)
induced
nephrotoxicity in
rats

Cardioprotective

S. torvum
fruit extract

Antidiabetic

S. torvum
fruit extract

Assessed
by
recording changes
in ECG, heart rate
and
measuring
the levels of LDH
and
creatine
phosphokinase
(CK-MB), SOD and
CAT
Streptozotocin
induced diabetic
rats

Analgesic

S. torvum
Leaves
aqueous
extract

Acetic
acidinduced
abdominal
writhing test

Diuretic

S. torvum
Seed and fruit
wall extract

Diuretic activity
evaluated
in
albino rats

Anticancer

S. torvum
Leaves
and
fruit

In vitro study
using
MCF-7
Human mammary
gland
breast
adenocarcinoma
cell lines

partially result from their


bradycardic effect.
Histopathological
changes
showed that DOX caused
significant structural damages
to kidneys like tubular necrosis,
renal lesions and glomerular
congestion
which
were
reversed with S torvum
S. torvum fruit extract has
cardioprotective activity mainly
attributed by its potent
antioxidant property

Methyl caffeate of S. torvum


fruit showed a dose-dependent
(10, 20 and 40 mg/kg)
antidiabetic effect in glucose
fed
hyperglycemic
and
streptozotocin diabetic rats (60
mg/kg iv). Methyl caffeate at
40
mg/kg
significantly
prevented the increase in
blood glucose level after
glucose administration at 60
min in comparison to the
hyperglycemic control group
S. torvum posses analgesic
activity against writhing and
mechanically induced pain in
rat. The pain killing effect of
the plant may be due to
prostaglandin
synthesis
inhibition
The administration of methanol
extracts by oral route at doses;
150,300 and 450 mg/kg. After 5
hour the volume of urine is
measured. Results revealed
that the fruit wall extract
showed significant diuretic
activity comparative to seed
extract and concentrations of
potassium and sodium salts in
urine as compared to standard
drug Furosemide
Extremely effective in the
prevention of cell proliferation
of MCF-7. Anticancer activitiy
of S. torvum was due to its
potential antioxidant effects
especially by the key role of
polyphenols, steroidal saponin
glycoside,
alkaloids
and
flavonoids

JK Welfare & Pharmascope Foundation | International Journal of Research in Phytochemistry & Pharmacology

Mohan
2010

et

al.,

Kamble
2009

et

al.,

Keisuke et al.,
2010; Gandhi et
al., 2011

Atta and Alkofahi,


1997; Ndebia et
al., 2007

Rammohan et al.,
2011

Thenmozhi
Rao, 2011

and

123

Jason M. Peranginangin et al., (2013) Int. J. Res. Phytochem. Pharmacol., 3(3), 121-127

Serenoa repens, Hypoxis rooperi, Urticae radix, and


much more (Lepor and Lowe, 2002).
Medicinal plants play a highly significant role in the
drug discovery and development process. Natural
products are directly or indirectly responsible for
almost 40% of the drug use in modern therapeutics
(Newmann et al., 2003). The family Solanaceae
comprises about 80 genera and 3000 species, from
which 15000 belong to the genus Solanum. This genus
is widespread over the world although it is
concentrated mainly in the tropics and subtropics
(Cronquist, 1981). Solanum torvum Swartz is one of the
plant species that are widespread in almost all regions
of Indonesia, and is widely used as a traditional
medicine in the community (Sirait, 2009). The use of S.
torvum fruit for prostate disorders are widely used by
the people of Indonesia. Zuhud reported that S. torvum
fruit as anti-prostate disorders has been empirically
proven to be effective through his personal experience.
Also based on the experience of the village
communities since the first, consumption of unripe
fruit every day can overcome prostate disorders
(Zuhud, 2012).
SCIENTIFIC CLASSIFICATION (Forest et al., 2003;
Hutapea et al., 2000)
Kingdom: Plantae
Division : Magnoliophyta
Class
: Magnoliopsida
Order
: Solanales
Family
: Solanaceae
Genus
: Solanum
Species : Solanum torvum Swartz
Vernacular name
English : Turkey berry
Indonesia
: Takokak
Central Java
: Terong Cepoka
West Java
: Takokak
Sumatera
: Terong pipit
CONSTITUEN AND PROPERTIES
Phytochemical screening of methanolic extract of S.
torvum fruits gave positive tests for alkaloids,
flavonoids, saponins, tannins, glycosides, fixed oil,
vitamin B group, vitamin C and iron salts (Arif and
Fareed, 2011; Sivapriya and Srinivas, 2007; Koffuor et
al., 2011). S. torvum contains a number of potentially
pharmacologically active chemical like isoflavonoid
sulfate and steroidal glycosides (Yahara et al., 1996;
Arthan et al., 2002), it also contains a number steroidal
glycosides viz. Torvoside A-L (Agrwal et al., 1989;
Yahara et al., 1996; Iida et al., 2005), cholorogenone
{[25R]} - 5a - spirostane - 3,6 dione} and its epimer,
neochlorogenone were extracted from unripe fruits of
S. torvum (Carabot et al., 1991), triacontane derivates
(Mahmood et al., 1985), 22--O-spirostanol
oligoglycosides (Iida et al., 2005), 6-O- -glucosidase
(Arthan et al., 2006).
124

Role of Inflammation in the pathogenesis of BPH


Reviews on the pathogenesis of BPH have provided an
evidence based thesis that strongly suggests a role of
inflammation in the propagation of histological BPH
(Keith and Donna, 2004; Untergasser, et al., 2005;
Kramer and Marberger, 2006). Chronic inflammatory
infiltrates, mainly composed of chronically activated T
cells and macrophages frequently are associated with
BPH nodules (Theyer et al., 1992; Steiner et al., 1994).
These infiltrating cells are responsible for the
production of cytokines (IL-2 and IFN) which may
support fibromuscular growth in BPH (Kramer et al.,
2002). Immigration of T cells into the area is attracted
by increased production of proinflammatory cytokines
such as IL-6, IL-8 and IL-15 (Untergasser et al., 2005;
Lee and Peehl, 2004; Handisurya et al., 2001).
Surrounding cells become targets and are killed,
leaving behind vacant spaces that are replaced by
fibromuscular nodules with a specific pattern of a
Th0/Th3 type of immune response (Steiner et al.,
2003). In-situ studies demonstrated elevated
expression of pro-inflammatory cytokines in BPH. IL-6,
IL-8 and IL-17 may perpetuate chronic immune
response in BPH and induce fibromuscular growth by
an autocrine or paracrine loop (Konig et al., 2004) or
via induction of COX-2 expression (Wang et al., 2004).
Immune reaction may be activated via Toll-like
receptor signalling and mediated by macrophages and
T cells (Konig et al., 2004).
Antiinflammatory activity of S. torvum
Aqueous extract of S. torvum offers analgesic and antiinflammatory effects through inhibition of production
of inflammatory mediators like prostaglandin and
cyclooxygenase. Prostaglandin E2 (PGE2) is a critical
inflammatory mediator that is produced through the
arachidonic acid cascade. The result of study was
showed that S. torvum posses analgesic activity against
writhing and mechanically induced pain in rat (Atta and
Alkofahi, 1997). The antiinflammatory role of S. torvum
is also mediated through own regulation of
cyclooxygenase through suppression of Prostaglandin
E2 activation (Ndebia et al., 2007). Seed and fruit wall
extract of S. torvum evaluated for antiinflammatory
activity by carrageenan induced rat paw edema
method. All text showed significant antiinflammatory
activity, among them seed methanol 500 mg/kg
exhibited superior activity. The activity of extract may
be presence of flavonoids, sterols and saponins
(Rammohan and Reddy, 2010).
Role of immunity on BPH
Enlargement of the prostate gland known as BPH, if the
enlargement involves most of the glandular tissue
called the prostate adenoma. BPH (prostate adenoma)
and PIN (prostatic intraepithelial neoplasia) is believed
to be the most likely precursor to prostate cancer. In
other words, prostate cancer may develope by
background BPH (prostate adenoma) and PIN. Prostatic

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Jason M. Peranginangin et al., (2013) Int. J. Res. Phytochem. Pharmacol., 3(3), 121-127

adenoma can hide the initial period of prostate cancer


(Davidson et al., 1995). BPH and prostate cancer is
currently believed to be caused by a weak immune
response. Different frequencies in peripheral blood
lymphocyte subpopulations of healthy people, BPH
patient and prostate cancer is responsible for the
occurrence and progression of BPH or tumor. Because
the ability of tumor to suppress T cell immune
response, innate immunity cells (NKT and Tregs) may
play an important role in the immunopathogenesis of
BPH and prostate cancer (Sotosek et al., 2011).
Immunomodulatory activity of S. torvum
The aqueous S. torvum extract (75 and 150 mg/kg/day)
significantly enhanced delayed type hypersensitivity
(DTH) response, increased hemagglutinating antibody
(HA) titer and White blood cell (WBC) count (Koffuor et
al., 2011). The methanolic extract of S. torvum seeds
and its ethyl acetate fraction exhibited significant
immunomodulator. Methanolic extract (10, 30 and 100
mg/kg) and ethyl acetate fraction (10 and 30 mg/kg)
produces a significant decrease in paw volume,
significant decrease in total number of leukocyte, and
significant increase in phagocytic index (Attarde and
Mohan, 2010).
Role of antioxidant activity on BPH
Various natural antioxidants available in the cells like
glutathione peroxidase (GPx), glutathione S-transferase
(GST), superoxide dismutase, catalase, vitamin E and
reduced glutathione (GSH) etc. prevents free radical
chain reaction. When these antioxidant defence
system get exhausted or generation of free radicals
exceed to their scavenging capacity, free radical
mediated damage results (Kehrer, 1993).
Srivastava and Mittal (2005) hypothesized that
impaired antioxidant system favors accumulation of
free radical, which may affect the process of
metastasis. They reported oxidant-antioxidant
imbalance may be one of the major factors responsible
for the development of prostate cancer and benign
prostate hyperplasia. The generation of free radicals as
reflected by increased GST activity and the oxidative
damage caused by increased MDA levels in Prostate
cancer and BPH patients could be one of the cause
leading to the development of cancer.
Antioxidant activity of S. torvum
S. torvum extract was the most potent as it exhibited
outstanding reducing power, scavenging activity
against DPPH and hydrogen peroxide. Good corelation
was observed with radical scavenging activity of
extracts and total phenolics. A potent scavenger of free
radicals may serve as a possible preventive
intervention for many diseases as the involvement of
free radicals in the pathogenesis of a large number of
diseases is well known. All the extracts exhibited
different extent of antioxidant activity. This may be

related to the high amounts of flavonoid and phenolic


compounds in the extracts (Waghulde et al., 2011).
Bhuvaneswari et al. have measured the total
antioxidant activity of S. torvum extract using ferric
thiocyanate test which determines the amount of
peroxide produced at the initial stage of lipid
peroxidation. The extent of inhibition of lipid oxidation
is moderate at low (100g/ml) doses of extract.
However, at higher concentrations (800 and
1000g/ml), the plant extract suppressed lipid
oxidation to a considerable extent. S. torvum extract at
higher concentrations inhibits the lipid oxidation
indicating that it has considerable quantities of
phytochemicals responsible for the antioxidant activity.
The chemicals presence namely torvanol A and a
steroidal glycoside, torvoside H may be responsible for
the total antioxidant activity (Bhuvaneswari et al.,
2012).
CONCLUSION
Traditional used by Indonesian people of S. torvum to
overcome prostate disorder and evidence that S.
torvum have antiinflammatory, immunomodulatory
and antioxidant activities will give direction to the
hypothesis S. torvum can be used for BPH treatment.
Furthermore, further research will need to prove and
support the effectiveness of S. torvum in the treatment
of BPH.
Nowaday our research team have being done a study
to approve that fruit of S. torvum can be used for BPH
treatment in animal laboratory.
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