Hepatoprotective Potential of Syzygium cumini: A Systematic Review of Animal Models

Abstract

Aims: This study aimed to systematically evaluate the hepatoprotective properties of Syzygium cumini in experimental models of liver injury, focusing on biochemical, oxidative, inflammatory, and histopathological outcomes. Study Design: Systematic review conducted in accordance with PRISMA 2020 recommendations; protocol registered in PROSPERO (CRD42024556476). Place and Duration of Study: Comprehensive searches were performed in PubMed, Scopus, Web of Science, and ScienceDirect covering studies published up to January 2025. Methodology: Eligible studies included in vivo experiments in rodents with induced hepatotoxicity (carbon tetrachloride, ethanol, acetaminophen, high-fat/high-carbohydrate diet, alloxan-induced diabetes, monosodium glutamate-induced obesity, and Triton WR1339 hyperlipidemia). Extracts of S. cumini (aqueous, ethanolic, hydroalcoholic, and methanolic, from seeds or leaves) were administered at doses ranging from 200 mg/kg to 0.9 g/kg/day for periods varying from single exposure to eight weeks. Outcomes comprised serum biomarkers (ALT, AST, bilirubin), inflammatory mediators (TNF-α, IL-6), oxidative stress markers (MDA, SOD), and histological alterations. Risk of bias was assessed using CAMARADES and SYRCLE tools. Results: Ten studies fulfilled the inclusion criteria. Most reported reductions in transaminase activity, attenuation of oxidative stress and pro-inflammatory mediators, and improvement in liver architecture, including reduced vacuolization, steatosis, inflammation, and fibrosis. However, heterogeneity in extract type and dosing was evident, and in some protocols higher doses not only failed to confer benefit but were associated with aggravation of hepatic injury. Methodological limitations, particularly regarding randomization and blinding, were frequent. Conclusion: Current evidence suggests that S. cumini exerts hepatoprotective effects in preclinical models, primarily through antioxidant and anti-inflammatory mechanisms. Nevertheless, significant heterogeneity across studies and overall limited methodological rigor prevent definitive conclusions. Standardized experimental protocols and well-designed clinical investigations are required before translation to therapeutic use in humans.