Anti-inflammatory Potential of Persea americana (Avocado) Leaves: A Systematic Review of Mechanisms and Preclinical Evidence

Dewa Ayu Kintan Nindya Kartika, Ni Nyoman Wahyu Udayani, Rr. Asih Juanita

Abstract


Chronic inflammation contributes to major degenerative diseases such as diabetes, cancer, and cardiovascular disorders, while conventional anti-inflammatory therapies often pose toxicity risks. Avocado leaves (Persea americana Mill.) are traditionally used to manage inflammatory conditions, yet their molecular mechanisms remain underexplored. This systematic review aimed to evaluate the anti-inflammatory activity of avocado leaves and synthesize current evidence on their underlying mechanisms. A systematic literature search was conducted in Google Scholar, PubMed, and ScienceDirect from May 2015 to May 2025 following PRISMA guidelines. Studies were screened based on predefined inclusion and exclusion criteria, and risk of bias was assessed using appropriate tools. From an initial 286 records, five preclinical studies met the eligibility criteria and were included in the final analysis. Avocado leaves contain flavonoids such as quercetin, catechin, and epicatechin and demonstrate anti-inflammatory effects through multiple pathways, including inhibition of NF-κB signalling and activation of Nrf2-mediated antioxidant responses. Preclinical models have demonstrated beneficial effects in carrageenan-induced edema, radioprotection, wound healing, and toxin-induced oxidative stress models, although clinical evidence remains absent. Overall, avocado leaves show promise as a multi-target anti-inflammatory candidate; however, well-designed clinical trials and standardized extract characterization are required to establish their therapeutic potential.


Keywords


Avocado leaves; Persea americana; Anti-inflammatory; NF-κB; Nrf2; COX-2

Full Text:

PDF

References


H. S. Semis, C. Gur, M. Ileriturk, O. Kaynar, and F. M. Kandemir, “Investigation of the anti-inflammatory effects of caffeic acid phenethyl ester in a model of λ-carrageenan–induced paw edema in rats,” Human & Experimental Toxicology, vol. 40, no. 12_suppl, pp. S721–S738, Dec. 2021. [Online]. Available: https://doi.org/10.1177/09603271211054436

D. W. Rousdy, E. R. P. Wardoyo, and S. Ifadatin, “Anti-inflammatory activity of Spatholobus littoralis Hassk. (bajakah) stem ethanolic extract in carrageenan-induced paw edema mice,” Jurnal Biodjati, vol. 7, no. 1, pp. 66–74, May 2022. [Online]. Available: https://doi.org/10.15575/biodjati.v7i1.14126

B. Hasyim, I. Yudhawan, H. Ekowati, and E. P. N. Rachmani, “Anti-inflammatory activity of a combination of ethanol extracts of ginger (Zingiber officinale) and bangle (Zingiber cassumunar) in carrageenan-induced rats,” Acta Pharmaciae Indonesia (Acta Pharm Indo), vol. 11, no. 2, p. 11548, Apr. 2024. [Online]. Available: https://doi.org/10.20884/1.api.2023.11.2.11548

K. Aleksandrova, L. Koelman, and C. E. Rodrigues, “Dietary patterns and biomarkers of oxidative stress and inflammation: A systematic review of observational and intervention studies,” Redox Biology, vol. 42, Jun. 2021. [Online]. Available: https://doi.org/10.1016/j.redox.2021.101869

H. J. Forman and H. Zhang, “Targeting oxidative stress in disease: Promise and limitations of antioxidant therapy,” 2021. [Online]. Available: https://doi.org/10.1038/s41573-021-00233-1

K. Lu, C. Y. Yang, and Z. H. Yan, “Analgesic and anti-inflammatory activity of Cotinus coggygria Scop. extracts in vivo,” Asian Pacific Journal of Tropical Biomedicine, vol. 14, no. 6, pp. 225–235, Jun. 2024. [Online]. Available: https://doi.org/10.4103/apjtb.apjtb_132_24

A. Alqudah, E. Y. Qnais, O. Gammoh, Y. Bseiso, and M. Wedyan, “Potential anti-inflammatory activity of the Salvia fruticosa Mill. essential oil,” Journal of Pharmacy & Pharmacognosy Research, vol. 12, no. 1, pp. 14–26, Jan. 2024. [Online]. Available: https://doi.org/10.56499/jppres23.1724_12.1.14

A. P. Malino, B. J. Kepel, F. D. H. Budiarso, F. Fatimawali, A. E. Manampiring, and W. Bodhi, “In vitro test of antioxidant activity of Clerodendrum minahassae (leilem) leaf ethanol extract using DPPH and FRAP methods,” Heca Journal of Applied Sciences, vol. 2, no. 1, pp. 27–34, Mar. 2024. [Online]. Available: https://doi.org/10.60084/hjas.v2i1.135

K. B. Megha, X. Joseph, V. Akhil, and P. V. Mohanan, “Cascade of immune mechanism and consequences of inflammatory disorders,” 2021. [Online]. Available: https://doi.org/10.1016/j.phymed.2021.153712

V. Mayakrishnan et al., “Chemical composition analysis and assessment of antioxidant and anti-inflammatory activities of crude extract of Flueggea leucopyrus on carrageenan-induced paw edema in Wistar albino rats,” Antioxidants, vol. 13, no. 8, Aug. 2024. [Online]. Available: https://doi.org/10.3390/antiox13080976

M. Cordaro et al., “Cashew (Anacardium occidentale L.) nuts counteract oxidative stress and inflammation in an acute experimental model of carrageenan-induced paw edema,” Antioxidants, vol. 9, no. 8, pp. 1–19, Aug. 2020. [Online]. Available: https://doi.org/10.3390/antiox9080660

A. Sinniah, S. Yazid, and R. J. Flower, “From NSAIDs to glucocorticoids and beyond,” Cells, vol. 10, no. 12, Art. 3524, Dec. 2021. [Online]. Available: https://doi.org/10.3390/cells10123524

S. Bindu, S. Mazumder, and U. Bandyopadhyay, “Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective,” Biochemical Pharmacology, vol. 180, 114147, Oct. 2020. [Online]. Available: https://doi.org/10.1016/j.bcp.2020.114147

S. N. Oktavia, I. Ifora, and F. Fauziah, “Anti-inflammatory, analgesic, and antipyretic potential of Azadirachta indica: A review,” Journal of Drug Delivery and Therapeutics, vol. 12, no. 3-S, pp. 245–254, Jun. 2022. [Online]. Available: https://doi.org/10.22270/jddt.v12i3-s.5502

A. Singh, U. Soni, P. K. Varadwaj, K. Misra, and S. I. Rizvi, “Anti-inflammatory effect of curcumin in an accelerated senescence model of Wistar rat: An in vivo and in-silico study,” Journal of Biomolecular Structure and Dynamics, vol. 43, no. 3, pp. 1459–1470, 2025. [Online]. Available: https://doi.org/10.1080/07391102.2023.2291832

J. M. Al-Khayri, G. R. Sahana, P. Nagella, B. V. Joseph, F. M. Alessa, and M. Q. Al-Mssallem, “Flavonoids as potential anti-inflammatory molecules: A review,” Molecules, vol. 27, no. 9, Art. 2901, 2022. [Online]. Available: https://doi.org/10.3390/molecules27092901

N. N. W. Udayani, N. L. A. M. Ratnasari, and I. D. A. A. Y. Nida, “Determination of phytochemical compounds (alkaloids, flavonoids, and tannins) in ethanol extract of black turmeric (Curcuma caesia Roxb.) rhizome,” Jurnal Pendidikan Tambusai, vol. 6, no. 1, 2022. [Online]. Available: https://doi.org/10.31004/jptam.v6i1.3256

S. Sebayang, R. Rayendra, I. Wientarsih, and B. P. Priosoeryanto, “The potential of avocado plant (Persea americana Mill.) in dermatology,” Jurnal Veteriner dan Biomedis, vol. 2, no. 2, pp. 79–85, 2024. [Online]. Available: https://doi.org/10.29244/jvetbiomed.2.2.79-85

R. K. Upadhyay, “Anti-arthritic potential of plant natural products; its use in joint pain medications and anti-inflammatory drug formulations,” International Journal of Green Pharmacy, vol. 10, no. 3, 2016. [Online]. Available: https://doi.org/10.22377/ijgp.v10i3.698

A. P. Adesola, M. S. Abiodun, and I. O. Steve, “Nutritional, phytochemical and functional properties of avocado (Persea americana Mill.) leaf: Evaluation of its derivative extraction,” Food Chemistry Advances, vol. 6, Mar. 2025. [Online]. Available: https://doi.org/10.1016/j.focha.2024.100869

A. H. Mahmoud, M. N. Samy, A. S. Wanas, and M. S. Kamel, “Gas chromatography–mass spectrometry profiling and analgesic, anti-inflammatory, antipyretic, and antihyperglycemic potentials of Persea americana,” Iranian Journal of Basic Medical Sciences, vol. 24, no. 5, pp. 641–649, May 2021. [Online]. Available: https://doi.org/10.22038/ijbms.2021.53390.12016

I. W. Lutfiah, T. Lestari, and N. L. Dwi, “Anti-inflammatory activity test of ethanolic extract of avocado (Persea americana Mill.) leaves in male Wistar rats,” 2023. Accessed: Jul. 19, 2025. [Online]. Available: https://ejurnal.universitas-bth.ac.id/index.php/PSNDPV3/article/view/1141

N. Cruz-Martins, “Molecular mechanisms of anti-inflammatory phytochemicals 2.0,” International Journal of Molecular Sciences, vol. 24, no. 24, Art. 17443, Dec. 2023. [Online]. Available: https://doi.org/10.3390/ijms242417443

V. Sharma, R. K. Tiwari, S. S. Shukla, and R. K. Pandey, “Current and future molecular mechanism in inflammation and arthritis,” Journal of Pharmacopuncture, vol. 23, no. 2, pp. 54–61, Jun. 2020. [Online]. Available: https://doi.org/10.3831/KPI.2020.23.009

S. Chen, A. F. U. H. Saeed, Q. Liu, Q. Jiang, H. Xu, G. G. Xiao, L. Rao, and Y. Duo, “Macrophages in immunoregulation and therapeutics,” Signal Transduction and Targeted Therapy, vol. 8, Art. 207, Dec. 2023. [Online]. Available: https://doi.org/10.1038/s41392-023-01452-1

P. Santoso, N. N. W. Udayani, I. N. G. T. Sutrisna, and K. A. Adrianta, “Effectiveness of leaf extract in reducing inflammatory reaction in hypercholesterolemic rats,” Journal of Health Sciences and Medicine, vol. 1, no. 1, pp. 12–15, Feb. 2017. [Online]. Available: https://doi.org/10.24843/JHSM.2017.v01.i01.p04

P. Pandey et al., “Therapeutic targeting of inflammation and virus simultaneously ameliorates influenza pneumonia and protects from morbidity and mortality,” Viruses, vol. 15, no. 2, Feb. 2023. [Online]. Available: https://doi.org/10.3390/v15020318

S. Sohrabi, S. Alipour, Z. Ghahramanipour, J. Masoumi, and B. Baradaran, “STAT signaling pathways in immune cells and their associated mechanisms in cancer pathogenesis,” 2025. [Online]. Available: https://doi.org/10.34172/bi.30030

F. Ayustaningwarno, G. Anjani, A. M. Ayu, and V. Fogliano, “A critical review of ginger’s (Zingiber officinale) antioxidant, anti-inflammatory, and immunomodulatory activities,” 2024. [Online]. Available: https://doi.org/10.3389/fnut.2024.1364836

N. N. W. Udayani, H. Meriyani, and K. A. Adrianta, “Effectiveness of ylang-ylang (Cananga odorata) flowers as a hepatoprotective agent in white rats (Rattus norvegicus),” Jurnal Ilmiah Medicamento, vol. 3, no. 2, 2017. [Online]. Available: https://doi.org/10.36733/medicamento.v3i2.902

A. Charlton, J. Garzarella, K. A. M. Jandeleit-Dahm, and J. C. Jha, “Oxidative stress and inflammation in renal and cardiovascular complications of diabetes,” 2021. [Online]. Available: https://doi.org/10.3390/biology10010018

A. Kumar, R. Kumarchandra, R. Rai, and G. Sanjeev, “Anticlastogenic, radiation antagonistic, and anti-inflammatory activities of Persea americana in an albino Wistar rat model,” Research in Pharmaceutical Sciences, vol. 12, no. 6, pp. 488–499, Dec. 2017. [Online]. Available: https://doi.org/10.4103/1735-5362.217429

Y. Rosa et al., “Persea americana leaf extract promotes wound healing by inhibiting NF-κB1,” Journal of Applied Pharmaceutical Science, vol. 15, no. 3, pp. 160–173, 2025. [Online]. Available: https://doi.org/10.7324/JAPS.2025.218012

T. Ogunmoyole, I. Dada, O. A.-C., and others, “Ameliorative potentials of Persea americana leaf extract on toxicant-induced oxidative assault in multiple organs of Wistar albino rats,” 2021. [Online]. Available: https://doi.org/10.1186/S40816-020-00237-1

N. D. Prabowo, K. Mirawati, and S. S. Rahardjo, “Nutraceuticals for cardiovascular risk related to obesity: The role of MUFA in avocado—A scoping review,” [Online]. Available: https://doi.org/10.37287/picnhs.v4i1.1822

N. Chansiw, S. Champakam, P. Chusri, K. Pangjit, and S. Srichairatanakool, “Quercetin-rich ethanolic extract of Polygonum odoratum var. Pakphai leaves decreased gene expression and secretion of pro-inflammatory mediators in LPS-induced RAW264.7 macrophages,” Molecules, vol. 27, no. 12, Jun. 2022. [Online]. Available: https://doi.org/10.3390/molecules27123657

N. N. W. Udayani, I. P. A. Mahendra, I. A. P. Widiasriani, I. M. A. Mahardika, and I. G. A. A. K. Wardani, “Anti-inflammatory activity of Dendrophthoe glabrescens (Blakely) Barlow leaf extract in carrageenan-induced mice (Mus musculus),” Jurnal Ilmiah Medicamento, vol. 11, no. 2, pp. 152–162, Sep. 2025. [Online]. Available: https://doi.org/10.36733/medicamento.v11i2.11434

A. S. Mali, O. Honc, L. Hejnova, and J. Novotny, “Opioids alleviate oxidative stress via the Nrf2/HO-1 pathway in LPS-stimulated microglia,” International Journal of Molecular Sciences, vol. 24, no. 13, Jul. 2023. [Online]. Available: https://doi.org/10.3390/ijms241311089

T. Al-Warhi et al., “The wound-healing potential of Olea europaea L. cv. Arbequina leaves extract: An integrated in vitro, in silico, and in vivo investigation,” Metabolites, vol. 12, no. 9, Sep. 2022. [Online]. Available: https://doi.org/10.3390/metabo12090791

B. Kombate and K. Metowogo, “Pharmacological mechanisms of medicinal plant extracts in the treatment of dermatological diseases: In vitro, in vivo studies and clinical trials,” Journal of Dermatology & Cosmetology, vol. 7, no. 1, pp. 1–7, Jan. 2023. [Online]. Available: https://doi.org/10.15406/jdc.2023.07.00224

M. Heinrich et al., “Reporting guidelines for medicinal plant extracts used in pharmacological and toxicological research: ConPhyMP,” British Journal of Pharmacy, vol. 7, no. 2, Nov. 2022. [Online]. Available: https://doi.org/10.5920/bjpharm.1123

N. N. W. Udayani, I. M. A. Gelgel Wirasuta, D. A. K. Nindya Kartika, and A. P. P. Anggreni, “Sweet potato leaf extract gummy candy as an antioxidant-rich functional food for stunting prevention in children,” Journal Syifa Sciences and Clinical Research, vol. 7, no. 3, pp. 251–264, Aug. 2025. [Online]. Available: https://doi.org/10.37311/jsscr.v7i3.33862

L. Gumustepe, N. Kurt, E. Aydın, and G. Ozkan, “Comparison of ohmic heating- and microwave-assisted extraction techniques for avocado leaves valorization: Optimization and impact on the phenolic compounds and bioactivities,” Food Science & Nutrition, vol. 11, no. 9, pp. 5609–5620, Sep. 2023. [Online]. Available: https://doi.org/10.1002/fsn3.3556




DOI: https://doi.org/10.37311/ijpe.v5i3.33555

Refbacks

  • There are currently no refbacks.


Copyright (c) 2025 Dewa Ayu Kintan Nindya Kartika, Ni Nyoman Wahyu Udayani, Rr. Asih - Juanita

Creative Commons License
Indonesian Journal of Pharmaceutical Education is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.