Anticancer Activity of Asiatic Acid from Centella Asiatica: A Comprehensive Systematic Review of In Vitro and In Vivo Studies
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Abstract
Abstract—Centella asiatica, containing asiatic acid (AsA), represents one such candidate demonstrating promising anticancer effects. This study aims to comprehensively review the anticancer activity of AsA in published in vitro and in vivo studies. A systematic review method was employed and several databases, including Scopus, PubMed, ScienceDirect, and Google Scholar, were used to conduct a comprehensive and systematic search of the literature based in vitro and in vivo studies in November 2023 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thirty-three articles were included, distributed across twenty-five in vitro studies, three in vivo studies, and five both in vitro and in vivo studies. Based on the findings in the reviewed articles, we report that AsA, a triterpene derived from C. asiatica, exhibits anticancer effects demonstrated both in various cancer cell lines and in cancer cell-induced animal model, through several mechanisms, including anti-inflammatory effects, antioxidant effects, inhibition of cell proliferation, inhibition of invasion and migration, and induction of apoptosis and autophagy. Conclusions based on findings in in vitro and in vivo studies, AsA has strong potential to be used and developed as an inhibitor of various types of cancer cells.
Keywords: anticancer, asiatic acid, cancer, centella asiatica, herbal
Abstrak—Centella asiatica, yang mengandung asam asiatik (AsA), mewakili salah satu kandidat yang menunjukkan efek antikanker yang menjanjikan. Penelitian ini bertujuan untuk meninjau secara komprehensif aktivitas antikanker AsA dalam studi in vitro dan in vivo. Metode yang digunakan adalah tinjauan sistematis pada beberapa basis data, termasuk Scopus, PubMed, ScienceDirect, dan Google Scholar, untuk melakukan pencarian literatur yang komprehensif dan sistematis berdasarkan studi in vitro dan in vivo yang dilakukan pada November 2023 dan mengikuti pedoman Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Tiga puluh tiga artikel diinklusikan, terdiri dari dua puluh lima studi in vitro, tiga studi in vivo, dan lima studi in vitro dan in vivo. Berdasarkan temuan dalam artikel yang ditinjau, kami melaporkan bahwa AsA, triterpen yang berasal dari C. asiatica, menunjukkan efek antikanker baik di berbagai sel kanker maupun pada model hewan yang diinduksi sel kanker, melalui beberapa mekanisme, termasuk efek antiinflamasi, efek antioksidan, penghambatan proliferasi sel, penghambatan invasi dan migrasi, serta induksi apoptosis dan autofagi. Kesimpulan berdasarkan temuan dalam studi in vitro dan in vivo, AsA memiliki potensi yang kuat untuk digunakan dan dikembangkan sebagai penghambat berbagai jenis sel kanker.
Kata kunci: antikanker, asam asiatik, kanker, centella asiatica, herbal
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References
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7. Gopal S, Achenbach CJ, Yanik EL, Dittmer DP, Eron JJ, Engels EA (2014) Moving Forward in HIV-Associated Cancer. JCO 32:876–880
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9. Kratz CP, Achatz MI, Brugières L, et al (2017) Cancer Screening Recommendations for Individuals with Li-Fraumeni Syndrome. Clinical Cancer Research 23:e38–e45
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12. Mirecka A, Paszkowska-Szczur K, Scott RJ, et al (2014) Common variants of xeroderma pigmentosum genes and prostate cancer risk. Gene 546:156–161
13. Suh S, Kim K-W (2019) Diabetes and Cancer: Cancer Should Be Screened in Routine Diabetes Assessment. Diabetes Metab J 43:733
14. Singh N, Baby D, Rajguru J, Patil P, Thakkannavar S, Pujari V (2019) Inflammation and cancer. Ann Afr Med 18:121
15. Nikolaos Tzenios (2023) Obesity as a risk factor for cancer. EPRA 101–104
16. Bahrami H, Tafrihi M (2023) Global trends of cancer: The role of diet, lifestyle, and environmental factors. Cancer Innovation 2:290–301
17. Abbas Z, Rehman S (2018) An Overview of Cancer Treatment Modalities. Neoplasm. https://doi.org/10.5772/intechopen.76558
18. Mun EJ, Babiker HM, Weinberg U, Kirson ED, Von Hoff DD (2018) Tumor-Treating Fields: A Fourth Modality in Cancer Treatment. Clinical Cancer Research 24:266–275
19. Ahmad Khan MS, Ahmad I (2019) Herbal Medicine. In: New Look to Phytomedicine. Elsevier, pp 3–13
20. Zahara K, Bibi Y, Tabassum S (2014) Clinical and therapeutic benefits of Centella asiatica. PAB 3:152–159
21. Belwal T, Andola HC, Atanassova MS, Joshi B, Suyal R, Thakur S, Bisht A, Jantwal A, Bhatt ID, Rawal RS (2019) Gotu Kola (Centella asiatica). In: Nonvitamin and Nonmineral Nutritional Supplements. Elsevier, pp 265–275
22. Kunjumon R, Johnson AJ, Baby S (2022) Centella asiatica: Secondary metabolites, biological activities and biomass sources. Phytomedicine Plus 2:100176
23. Sun B, Wu L, Wu Y, Zhang C, Qin L, Hayashi M, Kudo M, Gao M, Liu T (2020) Therapeutic Potential of Centella asiatica and Its Triterpenes: A Review. Front Pharmacol 11:568032
24. Lv J, Sharma A, Zhang T, Wu Y, Ding X (2018) Pharmacological Review on Asiatic Acid and Its Derivatives: A Potential Compound. SLAS Technology 23:111–127
25. Mushtaq Z, Imran M, Hussain M, et al (2023) Asiatic acid: a review on its polypharmacological properties and therapeutic potential against various Maladies. International Journal of Food Properties 26:1244–1263
26. Nagoor Meeran MF, Goyal SN, Suchal K, Sharma C, Patil CR, Ojha SK (2018) Pharmacological Properties, Molecular Mechanisms, and Pharmaceutical Development of Asiatic Acid: A Pentacyclic Triterpenoid of Therapeutic Promise. Front Pharmacol 9:892
27. Lee YS, Jin D-Q, Kwon EJ, Park SH, Lee E-S, Jeong TC, Nam DH, Huh K, Kim J-A (2002) Asiatic acid, a triterpene, induces apoptosis through intracellular Ca2+ release and enhanced expression of p53 in HepG2 human hepatoma cells. Cancer Letters 186:83–91
28. Bunpo P, Kataoka K, Arimochi H, Nakayama H, Kuwahara T, Vinitketkumnuen U, Ohnishi Y (2005) Inhibitory effects of asiatic acid and CPT-11 on growth of HT-29 cells. J Med Invest 52:65–73
29. Hsu Y-L, Kuo P-L, Lin L-T, Lin C-C (2005) Asiatic Acid, a Triterpene, Induces Apoptosis and Cell Cycle Arrest through Activation of Extracellular Signal-Regulated Kinase and p38 Mitogen-Activated Protein Kinase Pathways in Human Breast Cancer Cells. J Pharmacol Exp Ther 313:333–344
30. Park BC, Bosire KO, Lee E-S, Lee YS, Kim J-A (2005) Asiatic acid induces apoptosis in SK-MEL-2 human melanoma cells. Cancer Letters 218:81–90
31. Cho CW, Choi DS, Cardone MH, Kim CW, Sinskey AJ, Rha C (2006) Glioblastoma cell death induced by asiatic acid. Cell Biol Toxicol 22:393–408
32. Tang X-L, Yang X-Y, Jung H-J, Kim S-Y, Jung S-Y, Choi D-Y, Park W-C, Park H (2009) Asiatic Acid Induces Colon Cancer Cell Growth Inhibition and Apoptosis through Mitochondrial Death Cascade. Biological & Pharmaceutical Bulletin 32:1399–1405
33. Zhang J, Ai L, Lv T, Jiang X, Liu F (2013) Asiatic acid, a triterpene, inhibits cell proliferation through regulating the expression of focal adhesion kinase in multiple myeloma cells. Oncology Letters 6:1762–1766
34. Chen J-Y, Xu Q-W, Xu H, Huang Z-H (2014) Asiatic Acid Promotes p21 WAF1/CIP1 Protein Stability through Attenuation of NDR1/2 Dependent Phosphorylation of p21 WAF1/CIP1 in HepG2 Human Hepatoma Cells. Asian Pacific Journal of Cancer Prevention 15:963–967
35. Kim KB, Kim K, Bae S, et al (2014) MicroRNA-1290 promotes asiatic acid-induced apoptosis by decreasing BCL2 protein level in A549 non-small cell lung carcinoma cells. Oncology Reports 32:1029–1036
36. Sarumathi A, Saravanan N (2015) Anti-Proliferative Effect of Asiatic Acid on Hep-G2 Cell Line. Genes Review 1:37–44
37. Wu Q, Lv T, Chen Y, Wen L, Zhang J, Jiang X, Liu F (2015) Apoptosis of HL-60 human leukemia cells induced by Asiatic acid through modulation of B-cell lymphoma 2 family proteins and the mitogen-activated protein kinase signaling pathway. Molecular Medicine Reports 12:1429–1434
38. Lu Y, Liu S, Wang Y, Wang D, Gao J, Zhu L (2016) Asiatic acid uncouples respiration in isolated mouse liver mitochondria and induces HepG2 cells death. European Journal of Pharmacology 786:212–223
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Published
2024-12-31
How to Cite
Ridho, F. M., Fahrudin, P., Syachputra, A. J., Aruan, I. A., Ulfah, K., & Syahri, A. (2024). Anticancer Activity of Asiatic Acid from Centella Asiatica: A Comprehensive Systematic Review of In Vitro and In Vivo Studies. Keluwih: Jurnal Kesehatan Dan Kedokteran, 6(1). https://doi.org/10.24123/kesdok.V6i1.6752
Section
Article Review
Copyright (c) 2024 Fiki Muhammad Ridho, Panggih Fahrudin, Andika Julyanto Syachputra, Iren Angelia Aruan, Kamailiya Ulfah, Alfi Syahri (Author)
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