Anti-thrombocytopenic Activities of 15 Selected Indonesian Medicinal Plants: Psidium guajava Leaves, Phyllanthus niruri Aerial Parts, and Andrographis paniculata Leaves as Potential Sources in Enhancing Platelet Levels in Rats
Abstract
BACKGROUND: Thrombocytopenia is a medical condition characterized by a low platelet count in the blood, which can cause excessive bleeding and serious complications. Current conventional treatments for thrombocytopenia often present significant side effects and limitations, necessitating the exploration of alternative therapeutic options. Therefore, this study was conducted to evaluate the potential of Indonesian ethnomedicinal plants as alternative therapies.
METHODS: The research was conducted by ethanol maceration of 15 medicinal plants selected based on their use in traditional Indonesian medicine to treat thrombocytopenia. Male white rats, aged three month and weighing between 150 and 250 g, were divided into four groups, which each group consists of five rats: the negative control group, group receiving 250 mg/kg BW extract, group receiving 500 mg/kg BW extract, and the normal control group. The effects of the test preparations on platelet count, erythrocyte count, and hematocrit were observed after 7 days of treatment.
RESULTS: Among of 15 medicinal plants extract tested at a dose of 500 mg/kg BW, Psidium guajava L. leaves extract showed to increase blood platelets counts in thrombocytopenic mice by 60.82% (p<0.01) followed by Phyllanthus niruri L. aerial parts extract at (48.22%; p<0.01), and Andrographis paniculata (Burm.f.) Wall. ex Nees leaves extract (47.14%; p<0.01).
CONCLUSION: The extracts of P. guajava leaves, aerial parts of P. niruri, and A. paniculata leaves exhibited significant potential in enhancing platelet levels. These findings suggest that some Indonesian medicinal plants can be used as alternative therapy for thrombocytopenia.
KEYWORDS: dengue hemorrhagic fever, Phyllanthus niruri, Psidium guajava, Andrographis paniculata, thrombocytopenia
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Kementerian Kesehatan Republik Indonesia. Strategi Nasional Penanggulangan Dengue 2021-2025. Jakarta: Kementerian Kesehatan RI; 2021, article.
Yuningsih R. Kebijakan Penggerakan Partisipasi Masyarakat dalam Penanggulangan DBD. Jakarta: Pusat Analisis Keparlemenan Badan Keahlian DPR RI; 2024, article.
Jinna S, Khandhar PB. Thrombocytopenia. Treasure Island: StatPearls Publishing; 2023, NLMID.
Tjepkema M, Amini S, Schipperus M. Risk of thrombosis with thrombopoietin receptor agonists for ITP patients: A systematic review and meta-analysis. Crit Rev Oncol Hematol. 2022; 171:103581, CrossRef.
Yamasaki S. Bisphosphonate Use for glucocorticoid-induced osteoporosis in older patients with immune thrombocytopenia: A clinical perspective. Ann Hematol. 2023; 102(7): 1645-56, CrossRef.
See KC. Dengue Vaccination: A Practical Guide for Clinicians. Vaccines. 2025; 13(2): 145, CrossRef.
Sumartini R. Pengaruh tanaman herbal terhadap peningkatan kadar trombosit pada anak demam berdarah dengue (DBD). Profesional Health Journal. 2023; 5(1): 311-9, CrossRef.
Bordoloi P, Devi D, Dasgupta. A comparative study of the platelet augmentation potential of leaf extracts of Psidium guajava with Carica papaya in thrombocytopenic rats. Sch J App Med Sci. 2016; 4(8A): 2774-2782, article.
Lee NY, Khoo WK, Adnan MA, Mahalingam TP, Fernandez AR, Jeevaratnam K. The pharmacological potential of Phyllanthus niruri. J Pharm Pharmacol. 2016; 68(8):953-69, CrossRef.
Juan-Pablo BP, David PE, Mónica SR, Ashutosh S, Daniel NA, Dealmy DG, et al. Medicinal plants with anti-dengue and immunomodulatory activity. Curr Pharm Biotechnol. 2023; 24(4): 486-94, CrossRef.
Prasetyaningsih Y, Sari N, Prasetya HR, Wulandari R, Naer VG. Potensi etnomedicine daun ubi jalar ungu (Ipomoea batatas L. Poir) dan daun ubi jalar putih (Ipomoea batatas L.) sebagai obat demam berdarah di Sleman DIY. Journal of Health. 2019; 6(1): 6-11, CrossRef.
Salehi B, Zakaria ZA, Gyawali R, Ibrahim SA, Rajkovic J, Shinwari ZK, et al. Piper species: A comprehensive review on their phytochemistry, biological activities and applications. Molecules. 2019; 24(7): 1364, CrossRef.
Djati MS, Christina YI, Rifa'i M. The combination of Elephantopus scaber and Sauropus androgynus promotes erythroid lineages and modulates follicle-stimulating hormone and luteinizing hormone levels in pregnant mice infected with Escherichia coli. Vet World. 2021; 14(5): 1398-404, CrossRef.
Mohan V, Doss A, Tresina P. Ethnomedicinal Plants with Therapeutic Properties. CRC Press: Boca Raton. 2019, CrossRef.
Munir S, Liu ZW, Tariq T, Rabail R, Kowalczewski PL, Lewandowicz J, et al. Delving into the therapeutic potential of Carica papaya Leaf against thrombocytopenia. Molecules. 2022; 27(9):2760, CrossRef.
Beaudry AG, Law ML. Variable body and tissue weight reporting in preclinical cachexia literature may alter study outcomes and interpretation. Dis Model Mech. 2023; 16(7): dmm050148, CrossRef.
Fithria RF, Wulandari R, Hidayati DN, Annisa P, Putri NE. Antithrombocytopenia activity of peanut shell (Arachis hypogea L.) extract and infusa on heparin induced balb/C mice. Jurnal Tumbuhan Obat Indonesia. 2019; 12(1): 1-9, CrossRef.
Jundi M, Tadasa E, Adissu W. Correlation of red blood cell parameters and platelet count among adult anemic patients attending Madda Walabu University Goba Referral Hospital, Goba, Southeast Ethiopia: A comparative cross-sectional study. Medicine. 2025; 104(2): e41156, CrossRef.
Warkentin TE, Kelton JG. Temporal aspects of heparin-induced thrombocytopenia. N Engl J Med. 2001; 344(17): 1286-92, CrossRef.
Hossain MJ, Das M, Shahjahan M, Islam MW, Towhid ST. Clinical and hematological manifestation of dengue patients in 2022 outbreak: A tertiary care hospital-based cross-sectional study. Health Sci Rep. 2025; 8(1): e70356, CrossRef.
Kumar M, Tomar M, Amarowicz R, Saurabh V, Nair MS, Maheshwari C, et al. Guava (Psidium guajava L.) leaves: Nutritional composition, phytochemical profile, and health-promoting bioactivities. Foods. 2021; 10(4): 752, CrossRef.
Jiang L, Lu J, Qin Y, Jiang W, Wang Y. Antitumor effect of guava leaves on lung cancer: A network pharmacology study. Arab. J. Chem. 2020; 13(11): 7773-97, CrossRef.
Simamora A, Paramita L, Azreen N, Santoso AW, Timotius KH. In vitro antidiabetic and antioxidant activities of aqueous extract from the leaf and fruit of Psidium guajava L. Indones Biomed J. 2018; 10(2): 156-64, CrossRef.
Pereira GA, Chaves DSA, Silva TME, Motta REA, Silva ABRD, Patricio TCDC, et al. Antimicrobial activity of Psidium guajava aqueous extract against sensitive and resistant bacterial strains. Microorganisms. 2023; 11(7): 1784, CrossRef.
Laily N, Kusumaningtyas RW, Sukarti I, Rini MRDK. The potency of Guava Psidium guajava (L.) leaves as a functional immunostimulatory ingredient. Procedia Chem. 2015; 14: 301-7, CrossRef.
Handayani V, Nurfadillah. Kajian farmakognostik herba meniran hijau (Phyllanthus niruri L.) dan herba meniran merah (Phyllanthus urinaria L.). Jurnal Fitofarmaka Indonesia. 2018; 1(1): 18-25, CrossRef.
Widhawati R, Solehah M. Pengaruh jambu biji terhadap kenaikan trombosit pasien demam berdarah dengue (DBD) di Ruang Ayana Rumah Sakit Permata Ibu Kunciran Tangerang. Jurnal Kesehatan. 2018; 7(1): 1-9, article.
Wiyasihati SI, Wigati KW, Wardani T. Comparing the effect of red yeast rice, date palm, and guava leaf extract on thrombocyte and megakaryocyte count in thrombocytopenic white rats. Folia Medica Indonesiana. 2013; 49(2): 82-7, article.
Atik N, Tarawifa S, Avriyanti E, Rahmadi AR, Hilmanto D. Psidium guajava L. extract increases platelet count through enhancement of stem cell factor expression in thrombocytopenic mice model. Int J Pharm Pharm Sci.2018; 10(1): 23-6, CrossRef.
Manisha P, Alekhya KP, Tejaswini A, Swathi K, Venkat Sai K. Screening of Phyllanthus niruri leaves phytoconstituents for antiviral and antibacterial activity by molecular docking studies. Adv Exp Med Biol. 2023; 1423: 115-22, CrossRef.
Zheng ZZ, Chen LH, Liu SS, Deng Y, Zheng GH, Gu Y, et al. Bioguided fraction and isolation of the antitumor components from Phyllanthus niruri L. Biomed Res Int. 2016; 2016: 9729275, CrossRef.
Zimmerman R, Tsai AG, Salazar Vázquez BY, Cabrales P, Hofmann A, Meier J, et al. Posttransfusion increase of hematocrit per se does not improve circulatory oxygen delivery due to increased blood viscosity. Anesth Analg. 2017; 124(5): 1547-54, CrossRef.
Kartika RW, Alwi I, Suyatna FD, Yunir E, Waspadji S, Immanuel S, et al. Advance-platelet rich fibrin and hyaluronic acid combination improves interleukin-6 and granulation index in diabetic foot ulcer patients. Indones Biomed J. 2021; 13(2): 170-7, CrossRef.
Sumiati RL, Baehaki F, Nurdin N, Pakpahan SE. Meniran leaf extract (Phyllanthus niruri L.): How does it affect the number of platelets in the blood?. Stannum Jurnal Sains dan Terapan Kimia. 2024; 6(1): 48-56, CrossRef.
Patin EW, Zaini MA, Sulastri Y. Pengaruh variasi suhu pengeringan terhadap sifat fisiko kimia teh daun sambiloto (Andrographis paniculata). Pro Food. 2018; 4(1): 251-8, CrossRef.
Ardika RG, Budiono BP, Widiastiti NS, Maharani N, Susilaningsih N, Sandra F. Andrographis paniculata leaves extract inhibit TNF-α and caspase-3 expression of septic rats' intestinal tissues. Indones Biomed J. 2024; 16(1): 66-71, CrossRef.
Eziefule OM, Arozal W, Wanandi SI, Louisa M, Wuyung PE, Dewi S, et al. Andrographis paniculata ethanolic extract improved doxorubicin-induced cardiac inflammation, alterations in liver function parameters and anemia. Mol Cell Biomed Sci. 2024; 8(2): 117-26, CrossRef.
Chang CC, Duann YF, Yen TL, Chen YY, Jayakumar T, Onge ET, et al. Andrographolide, a novel NF-kB inhibitor, inhibits vascular smooth muscle cell proliferation and cerebral endothelial cell Inflammation. Acta Cardiol Sin. 2014; 30: 308-15, article.
Venkataraman N, Pamukuntla S, Banoth J, Boini P, Sampathi S, Swami V, et al. Platelet augmentation activity of Andrographis paniculata extract and andrographolide against cyclophosphamide induced thrombocytopenia in rats. Pharm Pharmacol Int J. 2015; 2(4): 126-31, CrossRef.
Korn EL, Moscow JA, Freidlin B. Dose optimization during drug development: Whether and when to optimize. J Natl Cancer Inst. 2023; 115(5): 492-7, CrossRef.
DOI: https://doi.org/10.18585/inabj.v17i3.3575
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