Anti-Oxidant Activity of Some Medicinal Plants in Alzheimer’s Therapy: A Review

Zulvina Ramadhani Faozanudin and Silvana Oktaviana

Faculty of Medicine, Jenderal Soedirman University
Email: zr_faozanudin@live.com

Abstract
Introduction: Alzheimer is an emerging global challenge as it is estimated to bring about
46,8 millions of people worldwide in 2015. The pathophysiological process of the disease
involves stress oxidative mechanism which leads to neuroinflammatory process.
Objective: To conduct a review about the activity of some medicinal plants anti-oxidative
activity in Alzheimer.Method: This present study reviewed five animal studies assessing
the anti-oxidant property of some medicinal plants in Alzheimer. Result: The
mechanisms in which anti-oxidant can modulate the pathophysiological process in
Alzheimer are down-regulating oxidant agents and increasing endogen anti-oxidant
levels. Conclusion: It could be said that anti-oxidant from medicinal plants have
significant effect in pathophysiology of Alzheimer.
Keyword:Alzheimer Disease, Anti-Oxidant, Medicine Plant, Neurodegeneration

Introduction tangles (NFTs) inside neurons composed

Dementia is an emerging global public
health challenge for our generation as it is
estimated to bring about 46,8 millions of
people worldwide in 2015 and its
prevalence is expected to double every 20
years. Dementia, especially caused by
Alzheimer’s disease is a progressive
neurodegenerative disorder taking a huge
toll on the older population of over 60
years of age. (1). The disease is the most
common of dementing illness
characterized by the loss of cognitive
function, inability to learn new
information, forgetting names, losing
items, and less able to care for themselves,
which become more progressively more
severe (2).
Neuroimaging of the patient with
Alzheimer’s disease may show cortical
atrophy and loss of neurons, particularly in
the parietal and temporal lobes and
consequent change in ventricular
enlargement for the loss of brain tissue (3).
At the microscopic level, Alzheimer’s
disease is noted by the presence of senile
plaques outside neurons which contain β-
amyloid peptide and neurofibrillary
of hyper phosphorylated tau (4).
The pathophysiologic aspects which
lead to neurodegeneration and symptoms
in Alzheimer’s disease have not been
exactly concluded, but the emerging issue
of how the disease develop is now
directing to the involvement of
neuroinflammatory process. Inflammation
could contribute to the course of
Alzheimer’s disease as an initial innate
immune system generates a non-specific
response to a cell stress stimulus with
senile plaques and tangles or through the
low level ongoing inflammation over a
period of time impairs the microglia’s
ability to transit from an initial classic state
(pro-inflammatory) to an alternative (anti-
inflammatory) immune response which
eventually implicate in promoting
neurodegeneration. Both of the
mechanisms involve the releasing of pro-
inflammatory substances, most commonly
oxidants. Therefore, substances that can
halt the inflammation particularly the stress
oxidative process are sought as potential
drug candidates for treatment or
 preventive therapy of neurodegenerative
disorders such as Alzheimer’s disease.
Increase awareness of the widespread
toxicity and harmful after effects
associated with the use of synthetic drug
shifts the therapeutical habits to the natural
medicinal plants. There are many plants
and their products that have been reputedly
and repeatedly used in society. Recently,
extensive researches on different plants are
underway worldwide to find the
appropriate therapy agents for
neurodegenerative disease because of less
toxicity, easy availability, and easy
absorption in the body.
Table 1. Result of studies that measured anti-oxidant property
Author Medicinal Plants
Yu, et al. (5)
Curcuma longa L.
Dhanasekaran, et al. (6)
Centella asiatica
Tian et al. (7) Ginkgo biloba L.
Chen, et al. (8) Morinda officinalis
Oboh et al. (9) Zingiber officinale
Result and Discussion
Some plants with anti-oxidant property
have shown favorable effects on the
pathophysiological process of
neurodegenerative disease, particularly
Alzheimer. The appearance of oxidative
stress markers are one of the earliest
changes in brain preceding the
accumulation of visible amyloid deposits
and neurofibrillary tangles.
From 5 animal studies that we reviewed,
all studies demonstrated significant anti-
oxidative activities with similar
mechanism. Anti-oxidants have important
role in preventing cell death or apoptosis
by inhibiting membrane lipid peroxidation
and mitochondrial dysfunction. Anti-
oxidants protective effects are shown by
down-regulating oxidant agents or
increasing endogen anti-oxidants level.
According to Mukherjee, Cinelli, Kang,
and Silverman (2014), the effect of NO
depends on the concentration within the
In the present study, we review the
medicinal plant’s anti-oxidant activity in
Alzheimer’s therapy.
Method
Studies were searched through an online
PubMed search of all English-language
publications between 2006 - 2016. The
present study reviewed five animal studies
related to anti-oxidant activity of some
medicinal plants in Alzheimer Disease.
Results
Reduced activity of NOS (Nitric
Oxide Synthase)
Reduced generating of ROS and inhibited
lipid peroxidation
Improving SOD and GSH activities
Improving SOD, GSH, and CAT activities
Scavenging activities
cell. In normal concentrations, NO in the
brain is important as neuroprotective agent.
Excessive amount of NO can impair
cellular energy production via interaction
with the iron-sulfur centers in the
mitochondrial electron, production of
reactive nitrogen species (RNS) and
reactive oxygen species (ROS). Study
conducted by Yu, et al. (2013) proved that
Curcuma longa exerts a protective effect
upon brain damage by down-regulating
NOS activity in pre-frontal cortex,
hippocampus, and amygdala which
responsible in memories storage.
The similar mechanism occurred in the
Oboh, Ademiluyiu, and Akinyemi (2012)
study, anti-oxidative property of Zingiber
officinale was shown by reducing the
oxidant levels in the brain. Phytochemical
compounds contained in Zingiber
officinale such as terpenoids, alkaloids,
and flavonoids can be attributed to its
scavenging activity thus preventing
malondialdehyde (MDA) receptors as
reactive compound in the brain.
Another anti-oxidative mechanism
occurred in the studies of Centella
asiatica, Ginkgo biloba, and Morinda
officinalis. The studies suggested that the
lipid peroxidation is inhibited by
significantly enhancing the activities of
oxidative scavenging enzymes SOD and
GSH. SOD and GSH catalyze superoxides
to molecular oxygen and peroxide and are
important physiological anti-oxidants
against free radicals and subsequent lipid
peroxidation.
Conclusion
It’s clear from several animal studies that
the role of anti-oxidant in medicine plants
could significantly modulate the
pathophysiological process in Alzheimer
Disease through stress oxidative pathway.
Future studies need to determine what is
the oxidant agent most responsible in
Alzheimer disease to determine the best
agent in halting the degeneration process.
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