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Indian Pediatr 2014;51: 324-325 |
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Papaya Leaves in Dengue Fever: Is there
Scientific Evidence?
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Neetu Sharma and *Devendra Mishra
Departments of Pediatrics,
GR Medical College, Gwalior, and *Maulana Azad Medical College,
Delhi, India.
Email:
[email protected]
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With the recent dengue outbreak, the use of papaya leaves as
natural cure for dengue has received much interest among the
public, and in the lay press [1]. Being easily available and
affordable, the use of papaya leaves occurs
indiscriminately. The physician however remains unclear of
his or her stand on the issue.
The therapeutic effects of aqueous
extract of papaya (Carica papaya) leaves are presumed
to be due to several active components such as papain,
chymopapain, cystatin, L-tocopherol, ascorbic acid,
flavonoids, cyanogenic glucosides and glucosinolates. These
are antioxidants that reduce lipid peroxidation, exhibit
anti-tumor activity and immune modulatory effects [2].
Animal studies suggest that papaya leaf extracts have
potential therapeutic effect on disease processes causing
destabilization of biological membranes as they inhibit
hemolysis in vitro [3] and may cause increased
platelet and red blood cell counts [4]. A recent
open-labelled trial from Malayasia demonstrated
significantly higher platelet count after 40-48 hours of
first dose of papaya leaves’ juice [5]. Others have also
reported encouraging findings. In spite of these small scale
studies, the fact remains that dengue is a mostly a
self-limiting disease with spontaneous increase in platelets
during recovery.
The role of papaya leaves cannot be
scientifically substantiated based on a few positive
preliminary reports. The need of the day is to commission
high quality trials in humans to provide scientific evidence
for or against papaya leaves. Herbal products are assumed to
be safe because they are natural, but this assumption cannot
be valued more than mere conventional wisdom. As reported,
anticoagulant effect of warfarin was found to be potentiated
after consuming an extract of Carica papaya [6].
The purpose of this communication is not
to raise questions on the use of herbal products for disease
management, or to belittle the patients’ efforts to use all
available measures, whether approved or not, to alleviate
their suffering; but, a call to the research community to
generate evidence so that any potential benefits are not
discredited. The science must provide evidence to dispel
myths and focus efforts on evidence-based management of
dengue.
References
1. Home Cure for Dengue Death Sting.
Available from: http://articles.timesofindia.
indiatimes.com/2012-09-12/kolkata/33788187_1_platelet-dengue-patients-papaya.
Accessed October 22, 2013
2. Otsuki N, Dang N H, Kumagai E, Kondo
A, Iwata S, Morimoto C. Aqueous extract of Carica papaya
leaves exhibits anti-tumor activity and immunomodulatory
effects. J Ethnopharmacology. 2010;127:760-7.
3. Ranasinghe P, Ranasinghe P, Kaushalya
M, Abeysekera WP, Sirimal Premakumara GA, Perera YS, et
al. In vitro erythrocyte membrane stabilization
properties of Carica papaya L. leaf extracts. Phcog
Res. 2012;4:196-202.
4. Dharmarathna SL, Wickramasinghe S,
Waduge RN, Rajapakse RP, Kularatne SA. Does Carica papaya
leaf-extract increase the platelet count? An experimental
study in a murine model. Asian Pac J Trop Biomed.
2013;3:720-4.
5. Subenthiran S, Choon TC, Cheong KC,
Thayan R, Teck MB, Muniandy PK, et al. Carica
papaya leaves juice significantly accelerates the rate of
increase in platelet count among patients with dengue fever
and dengue haemorrhagic Fever. Evid Based Complement
Alternat Med. 2013;2013:616-737.
6. Yaheya M, Ismail M. Herb-drug interactions and patient
counseling. Internat J Pharmacy Pharmaceut Sci.
2009;1:151-61.
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