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Family Malvaceae
Lagikuway
Abelmoschus manihot (L.) Medik.
SUNSET HIBISCUS
Huang shu kui

Scientific names Common names
Abelmoschus manihot (L.) Medik.                Barakue (Batanes)
Hibiscus manihot L. Gikway (Bis.)
Hibiscus manihot var. typicus Hochr. Glikway (Subanon)
Hibiscus papyriferus Salisb. Lagikuway (Tagalog)
Accepted Infraspecifics Lagikway (Tagalog)
Abelmoschus manihot subsp. manihot Nating saluyot (Tagalog)
Abelmoschus manihot var. pungens (Roxb.) Hochr. Hibiscus manihot (Engl.)
A. manihot subsp. tetraphyllus (Roxb. ex Hornem) Borss. Waalk. Hibiscus spinach (Engl.)
  Sunset hibiscus (Engl.)
  Sunset musk-mallow (Engl.)
  Yellow hisbiscus (Engl.)
Abelmoschus manihot (L.) Medik. is an accepted name. KEW: Plants of the World Online

Other vernacular names
ASSAMESE: Usipak.
CHINESE: Huang shu kui, Hoang chou k'oei, Huang kui.
FIJI: Bele, Mbele.
FRENCH: Ketmie a feuilles comestibles, Ketmie epinard d'Australie.
GERMANY: Maniok-bisameibisch.
HINDI: Jangli bhindi.
INDONESIAN: Gedi, Degi.
JAPANESE: Tororo aoi.
KOREAN: Dahk pool, Hwang chok kyu.
MARATHI: Jangali bhendi.
NEPALESE: Van lasun.
PAPUA NEW GUINEA: Aibika.
PORTUGUESE: Quiabo-bravo, Quiabo-de-jardim.
RUSSIAN: Abel'moskhus maniokovyj, Gibiskus manioikovyj, Zheltyi gibiskus.
SWEDEN: Solokra.
THAI: Po-fai.

Gen info
- Abelmoschus is a genus of about 15 species of flowering plants in the mallow family (Malvaceae), formerly a species of Hibiscus, but not classified in the genus Abelmoschus.
- Etymology: The genus name Abelmoschus derives from Arabic,
meaning 'father of musk' or 'source of musk' referring to the scented seeds. (5) In Chinese, Huang-Kui means yellow (Huang) and sunflower (Kui). (6)
- Abelmoschus manihot is a traditional Chinese medicine first recorded in Jiayou Materia Medica dating back to the Song dynasty to eliminate heat and for diuretic effect.

Botany
Abelmoschus manihot is a perennial shrub, 1-3(-7) m tall. Root system usually adventitious and fairly shallow with most of the roots in the top 30-40 cm of the soil. Stem erect, woody,branching, glabrous or pubescent (without prickly hairs unlike related wild forms). Leaves simple, alternate, extremely variable in shape, size, color and pigmentation (or marking); petiole 3-25 cm long, stipules filiform orlanceolate,5-12 mm long; leaf-blade linear, lanceolate, cordate or deeply lobed or parted with 3-7 segments, color varying from light to dark green through red to purple. Flowers large, bell-shaped, 7-15cm in diameter, axillary, solitary or in racemes by the reduction or abortion of the upper leaves; pedicel 1-5(-7) cm long; epicalyx segments 4-6(-8), free, ovate to oblong, 1-3 cm × 0.5-1 cm; calyx spathaceous, 2-3 cm long, splitting on one side during the expansion of the corolla, adnate to and falling with the corolla; corolla consisting of 5 large, obovate to orbicular petals, 3-8 cm in diameter, pale yellow with a dark brown or reddish central spot; ovary superior, 5-celled; style surrounded by the staminal column from which it emerges and divides into 5 lobes, each ending in a flattened, disk-shaped, dark brown stigma; staminal column up to 3 cm long, white, bearing numerous filaments and anthers. Fruit an oblong-ovoid capsule, 3.5-6 cm × 2-2.5 cm, hairy, usually 5-angled and splitting into 5 segments. Seeds numerous, spherical to reniform, 2-4 mm in diameter, black. (2)

Distribution
- Native to the Philippines.
- Also native to Assam, Bangladesh, Bismark Archipelago, China, Christmas Is., Himalaya, India, Jawa, Laos, Lesser Sunda Is., Maluku, Myanmar, Nepal, New Guinea, Pakistan, Queensland, Sulawesi, Sumatera, Thailand, Vietnam. (1)
- Grows primarily in wet tropical biome.

Constituents
- Phytochemical study of ethanol extract of flower yielded seven flavonoids: rutin, hyperoside, isoquercetrin, gossypetin-8-O-ß-D-glucoronide (Hibifolin), myricetin, quercetin 3-O-ß-D-glucoronide, and quercetin. (see study below) (6)
- Study for phytoconstituents have yielded hibifolin, stigmasterol, sitosterol, myricetin, cannabistrin, myricetin 3-O-ß-D-glucopyranoside, 2,4-dihydroxy benzoic acid, maleic acid, quercetin, guanosine, adenosine, guanosine, adenosine.  (7)
- GC/MS study of ethanol extract of flowers for volatile oil have shown major constituents of maleic acid (113, 2.46%), tetracosane (114, 11.02%), hexadecane (115, 1.96%), heneicosane (116, 1.38%), octadecane (117, 1.34%), allyl undecylenate (118, 1.41%), docosane (119, 15.06%), hexadecanoic acid (120, 53.37%), tetradecanoic acid (122, 3.15%), undecanone, 6,10-dimethyl (123, 2.06%), heptadecane, 2,6,10,15-tetramethyl (124, 2.84%), and 9,12-octadecadienoic acid (125, 6.41%) (Lai et al., 2006Zhang et al., 2008). (12)
- TFA comprises eight flavone glycosides: quercetin 3-O-robinobioside, gossypetin-3-O-glucoside, quercetin-3'-O-glucoside, isoquercetin, hyperosdie, myricetin, gossypetin and quercetin. (see study below) (23)
- Study evaluated the presence of flavonoids in flowers at four stages: Stage A (bud), B (post-bud), C (full-bloom), and D (final-bloom). A total of 182 flavonoid metabolites were identified, 53 flavone, 40 flavonol, 13 isoflavone, 14 flavanone, 28 flavone C-glycosides, 5 flavonolignan, 3 proanthocyanidins, 16 anthocyanins, and 10 catechin derivatives. (see study below) (28)
- Proximate composition of leaves and shoots revealed the major component is water (85.18-86.42% of total weight), followed by total carbohydrates (7.10-8.09) and protein (2.49-2.90%). Fat ranged from 0.92-1.10%, fiber 1.17-1.30%. Proximate composition study (Gurnah 1993) yielded per 100 g edible portion of aibika leaves and stem tips: 90 g water, 4.1 g protein, 0.4 g fat, 4 g carbohydrates, and 1 g fiber. (35)
- Study of flowers for chemical constituents yielded 13 compounds: myricetin (1), cannabiscitrin (2), myricetin-3-O-beta-D-glucopyranoside (3), glycerolmonopalmitate (4), 2, 4-dihydroxy benzoic acid (5), guanosine (6), adenosine (7), maleic acid (8), heptatriacontanoic acid (9), 1-triacontanol (10) , tetracosane (11), beta-sitosterol (12), and beta-sitosterol-3-O-beta-D-glucoside (13). (40)

Properties
Studies have suggested hepatoprotective, nephroprotective, wound healing, osteoblastogenesis-promoting, analgesic, microbiota-enhancing, radical scavenging, angiotensin converting enzyme inhibitory, anti-inflammatory, gastroprotective, antipyretic, neuroprotective, anthelmintic, antidiabetic, mucilage-excipient properties.

Parts used
Roots, seeds, flowers.

Uses

Edibility
- Leaves and shoots are edible, eaten as vegetable.
- In the Philippines, added to dishes like tinola, sinigang, and pinangat, and added to salads.
- Flower buds are edible, raw or cooked.
Folkloric
- In traditional Chinese medicine, capsules made from flower extract used for treatment of kidney diseases and proteinuria. Dried flowers used for treatment of dampness and heat, edema, carbuncles, inflammation, skin sores and ulcers, and diseases of the urinary system. (6)
- In India, roots, seeds, and aerial parts have been used in the treatment of chronic bronchitis, toothache, and as emmenagogue. As vulnerary, paste of bark is used to treat cuts and wounds. In Nepal, root juice is warmed and applied to treat sprains.
(7)
- In China, flowers used for the treatment of jaundice and various types of hepatitis. (9)
- In Papua New Guinea and Pacific Islands, flowers used in alleviating kidney pain, lowering cholesterol, treat menorrhagic, induce abortions, ease childbirth, stimulate lactation, treat diarrhea, and prevent osteoporosis. (12)
- In Africa, seeds and leaves used to treat rheumatism, fever, headache, hemorrhoids. In Nigeria, used for treatment of ringworn, tumors, conjunctivitis, sores and abscesses. (12)
- In Sulawesi, leaves used for treatment of hypertension.

Others
- Papermaking: In Japan, known as tororo aoi, the plant is used to make neri, a starchy substance used in making washi, a traditional Japanese paper.
In Korea, known as hwang chok kyu, used to make dak pul, which is used in making hanji (Korean paper). (4)

Studies
Benefit in Renal Diseases / Flowers / Review:
In traditional Chinese medicine, capsules from flower extracts used for treatment of kidney diseases, to improve renal function and reduce proteinuria in patients with diabetic kidney disease or IgA nephropathy. Huangkui capsules made from flower powder is composed of 80% ethanol extract, 3% magnesium stearate and 17% calcium hydrogen phosphate. Review discusses phytoconstituents and possible molecular mechanisms of action, which may include reduced inflammation and oxidative stress, improved immune response, protection of renal tubular epithelial cells, ameliorating podocyte apoptosis, glomerulosclerosis and mesangial proliferation, and inhibition of renal fibrosis. Current studies include investigation on effects of Huangkui capsules on its potential as a novel microbiota-targeting therapy in treatment of kidney diseases. (see constituents above) (6)
Huangkui for Chronic Kidney Disease: Huangkui is a single-plant drug extracted from the dry corolla of Flos A. Manihot approved by China's State FDA for treatment of chronic glomerulonephritis. Primary constituents are flavonoids, which in vivo can be transformed into glucoronide-sulphate conjugates that are major metabolites of Flos. A. manihot and could contributed to renoprotective effect. Renoprotective effects are related to infiltration of ED1 and ED3 macrophages, downregulation of oxidative stress, inhibition of p38  mitogen-activated protein kinase and serine/threonine kinase pathways and suppression of transforming growth factor-ß1 and tumor necrosis factor-α expression. A recent multicenter randomized controlled trial demonstrated Flos A. manihot was more effective than angiotensin receptor blocker losartan in reducing proteinuria in patients with primary glomerular disease. (8)
Hepatoprotective / Carbon Tetrachloride Toxicity / Flowers: Study evaluated the hepatoprotective effect of total flavonoids (TFA) extracted from flowers of A. manihot against carbon tetrachloride (CCl4)-induced hepatocyte damage in vitro and in vivo. Total flavonoids were the major constituent of flowers. Results showed concentration-dependent increase in percentage viability on treatment of CCl4-exposed hepatocytes. In animal studies, TFA showed significant protection with depletion of ALT, AST, ALP, and
γ-GT raised by CCl4. Activities of antioxidant enzymes i.e. SOD, GPx, CAT, and GST were enhanced dose-dependently with TFA, along with inhibition of inflammatory mediators (TNF-α, IL-1ß and NO) both at serum and mRNA levels. Histologically, there was reduction in extent of liver lesions. (9)
Nephroprotective / Type2 Diabetic Nephropathy / Efficacy and Safety / Review: Study reviewed seven randomized controlled clinical trials on the effect of Flos A. manihot on type2 diabetic patients with subnephrotic-range proteinuria (500-3,500 mg/24h). Serious adverse effects were not observed. Results suggest A. manihot may be considered an important adjunctive therapy with first-line and indispensable therapeutic strategies for type 2 diabetic nephropathy. (10)
Attenuation of DSS-Induced Colitis / Effect on Gut Microbiota: Study showed A. manihot extract significantly alleviated DSS-induced colitis in mice. AM modified gut microbiota composition, increased microbial diversity, and elevated the abundance of short chain fatty acids (SCFAs)-producing gut  microbiota in colitic mice. Increased SCFAs, especially butyrate and acetate, primarily through peroxisome proliferator-activated receptor gamma (PPARγ) pathway, led to enhanced Treg generation and suppressed Th17. Results suggest the AM can potentially reset gut microbiome and metabolism, resume immune and tissue homeostasis to prevent colitis. Study provides a new perspective on IBD pathogenesis and suggests a novel microbiota-targeting therapy for inflammatory gut diseases. (11)
Benefit in Multiple Myeloma: Study evaluated the potential efficacy of A. manihot and underlying mechanisms on multiple myeloma, which exhibits malignant plasma cell clonal expansion in the bone marrow. A 5TMM3VT syngeneic MM-prone model was established and treated HKC (Huangkui capsules). Results showed MM-prone animals appeared to be protected following HKC treatment, as evidenced by prolonged survival rate. Bioactive ingredients of HKC exhibited protective effects on MM mouse survival through promotion of osteoblastogenesis and suppression of osteoclastogenesis, thus improving the bone marrow microenvironment to inhibit MM cell proliferation. (13)
Prevention of Renal Damage and Podocyte Apoptosis / Diabetic Nephropathy / Total Flavone Glycosides: Study evaluated the preventive effect of total flavone glycosides of Flos A. manihot (TFA) on urinary microalbumin and glomerular podocyte apoptosis in experimental DN rats. Preliminary administration of TFA (200 mg/kg/day) for 24 weeks significantly decreased urinary microalbumin to creatine ration and 24-h urinary total protein in STZ-induced DN rats. Hyperoside, the major active ingredient, could significantly mitigate cultured podocyte apoptosis induced by advanced glycation end-products (AGEs). Results suggest TFA pretreatment can decrease urinary excretion in early-stage DN, possibly via prevention of renal damage and podocyte apoptosis. (14)
Antiviral / Influenza A Virus Lung Inflammation / Total Flavones: Study evaluated the antiviral and anti-inflammatory effects of TFA (total flavones) on IAV (Influenza A virus) infection. Mice were intranasally infected with IAV to induced lung infection. The TFA provided profound protection against pulmonary IAV infection, which alleviated inflammatory responses, decreased MAPK signaling pathway, and expedited viral eradication. (15)
Amelioration of Stress-Induced Microbial Alterations in Ulcerative Colitis / Total Flavones: Study evaluated the anti-ulcerative effects of TFA in the context of depression in mice with ulcerative colitis (UC) by regulating the gut microbiota to drive the intestinal barrier. Chronic stress (CS) and dextran sodium sulfate (DSS) were used to induced depression and UC. CS disrupts gut micobiota, triggers intestinal barrier injury, and aggravates DSS colitis. Results showed TFA effectively improved UC aggravated by CS. TFA treatment improved the depression-like phenotype, the disturbed gut microbiota, and the intestinal barrier functions in CS mice. Study suggests TFA is a promising drug for the treatment of UC in patients with depression. (16)
Efficacy and Safety in Primary Glomerular Disease / Clinical Trial: A prospective, open-label, multicenter, randomized, controlled clinical trial evaluated the efficacy and safety of A. manihot as a single medicament of traditional Chinese medicine. Interventions include huangkui capsule, 2.5 g, 3 times daily, losartan 50 mg/d, or combined treatment of huangkui and losartan, for 24 weeks. Primary outcome was change in 24-hour proteinuria from baseline after treatment. After 24 weeks, mean changes in proteinuria were protein excretion of -508, -376, and -545 mg/d respectively ( p=0.003 for A manihot vs losartan, p<0.001 for combined treatment). Mean eGFR did not change significantly. There was not difference in adverse drug reactions. No severe adverse effects occurred in any group. Study suggests manihot is a promising therapy for patients with primary kidney disease (chronic kidney disease stages 1-2) with moderate proteinuria. (17)
Analgesic / Leaves: Study evaluated the analgesic activity of petroleum ether and methanol extract of Abelmoschus manihot air-dried leaves using hot plate and tail immersion models using doses of 100, 200, and 400 mg/kg. Results showed the extracts possessed significant (p<0.05, p<0.01) dose dependent analgesic activity. There was significant inhibition in pain threshold in hot plate test. In flick test,  highest activity was observed only with 400 mg/kg. (18)
Gum as Matrix of Chinese Medicinal Gel / Invention: Invention reports on Chinese medicine pharmacy technique and invention relating to application of gum extracted from Abelmoschus manihot as a matrix of gynecological gels and a preparation method of A. manihot gum. Invention makes full use of waste plants, increases material selection range of Chinese medicinal gel matrixes, reduces cost of waste treatment and pollution, and provides a gel matrix which aids in treatment of vaginitis, cervicitis, and other gynecological diseases. (19)
Wound Healing: Study evaluated the potential of petroleum ether and methanolic extracts of Abelmoscus manihot in wound healing in Wistar albino rats in an incision wound model. Results showed significantly increased wound breaking strength. (20)
Regulation of Cell Proliferation / Flowers: Study evaluated the effect of flower extract of A. manihot on cell proliferation. Results showed the flower extract increased the proliferation of human diploid fibroblast (HDF) and HEK293 cells. Through cell cycle analysis, the extract increased the number of HDF cells in S phase and G2/M phase. It also increased the expression of cyclin D1 and enhanced the migration of HDF cells. With ≥30 passages, FA to HDF decreased the number of senescence-associated ß-galactosidase-positive cells, indicating FA can ameliorate cellular senescence. (21)
Anthelmintic / Stems, Leaves, Roots: Study evaluated the anthelmintic potential of methanol extracts of stems, leaves, and roots of Abutilon indicum and Abelmoschus manihot against earthworm Pheretima posthuma. Both plant extracts exhibited considerable anthelmintic activity with order of sensitivity of stems > roots > leaves, with methanol extracts showing more prominent activity. (22)
Amelioration of Crohn's Disease / Stems, Leaves, Roots: Total flavone of A. manihot (TFA) has been used as anti-inflammatory and myocardial ischemia protective drug. Study evaluated the effects of TFA on Crohn's disease (CD) and its underlying mechanism. TFA promoted the survival of TNBS (2,4,6-trinitrobenzene sulfonic acid)-induced colitis in mice, decreased weight loss, and increased colon length in a dose-dependent manner. TFA also ameliorated the inflammatory response in mice with TNBS-induced colitis as determined by histopathological analysis. Results suggest TFA could suppress inflammatory response in mice with TNBS-induced colitis via inhibition of NF-kB and MAPK signaling pathways. Study provides a novel theoretical basis for treatment of CD. (see constituents above) (23)
Radical Scavenging Activity / Leaves: Study evaluated the antiradical scavenging activity of leaf extracts by binding of free radical DPPH. Results showed leaf extract of Abelmoschus manihot has high potency as antiradical scavenging with IC50 <50 µg/mL. (24)
Effect on Second Degree Burn Wounds / Leaf Gel: Study evaluated the effect of A. manihot leaf gel as topical therapy for second degree burn wounds on male rats. Gel forms in concentration of 6.25, 12.5 and 25% were used. Results showed gel containing 12.5 and 25% AMML extract facilitated the healing of burned skin. Gel containing 12.5% AMML extract was more effective than creams containing 1% SSD for treating burn wounds. Collagen density and organization was also higher in wounds treated with 12.5% gel than wounds treated with other agents. The AMML may have beneficial effects on wound healing parameters such as revascularization, fibroplasia, wound contraction, and collagen synthesis, along with antibacterial, anti-inflammatory and antioxidant properties. (25)
Antibacterial / Antioxidant / Leaves: Study evaluated the antibacterial and antioxidant activities of chloroform leaf extract of A. manihot. Phytochemical screening yielded flavonoids, phenolics, tannins, and vitamins.  In vitro antioxidant assay via DPPH exhibited IC50 of 234.7 ± 37.53 mg/mL, and activity was attributed to presence of α-tocopherol. Antimicrobial activity by disc diffusion method showed zones of inhibition of 12 to 14 mm against S. aureus and E. coli at concentrations of 100-500 µg, which was attributed to presence of flavonoids. No activity was observed against fungal strains Aspergillus niger and Candida albicans. (26)
Conjugated Metabolites / Flavonoids: A randomized controlled clinical trial has shown the nephron-protective efficacy of Abelmoschus manihot. The flavanoids, main active constituents, can be transformed into glucuronide/sulfate conjugates in vivo. Study explored the phamacokinetic profile of these conjugates and its mechanism of action. The glucuronide/sulfate conjugates represent the major circulating forms of A. manihot flavonoid in vivo. AUC of isorhamnetic-glucuronide conjugates and quercetin-sulfate conjugates was 719.65 and 275.49 µmol h/L, indicating less conjugated metabolites were formed in CKD rats compared to normal rats. Glucuronide-sulphate conjugates provide an important clue for further elucidation of the activity of conjugated metabolites and their relationship with the nephroprotective efficacy of A. manihot. (27)
Flavonoid Composition During Stages of Flower Development: Flavonoids extracted from flowers have been used to treat burns, chronic kidney disease and oral ulcers. Little is known of its composition and dynamic changes during different stages of flowers. Study evaluated the presence of flavonoids in flowers at four stages: Stage A (bud), B (post-bud), C (full-bloom), and D (final-bloom). A total of 182 flavonoid metabolites were identified, 53 flavone, 40 flavonol, 13 isoflavone, 14 flavanone, 28 flavone 
C-glycosides, 5 flavonolignan, 3 proanthocyanidins, 16 anthocyanins, and 10 catechin derivatives. Total flavonoid content of flowers was highest at Stage C. There were 67, 88, and 61 different metabolites between Stage A and Stage B/C/D, respectively. There was significant increase of metabolites at Stage B and C, including four major bioactive flavonols i.e., hyperoside, rutin, quercetin, and myricetin. Several flavonols with high relative content and different biological activities were first reported in this plant: myricetin 3-O-galactoside, avicularin, and isorhamnetic 3-O-neohesperidoside. Results provide benefit to understanding the relationship between flavonoid metabolites and flower development. (28)
Anti-Inflammatory / Woody Stems: Study evaluated the anti-inflammatory activity of petroleum ether and methanol extract of A. manihot wood stems using carrageenan and histamine paw edema models with doses of 100, 200, and 400 mg/kg. Results showed significant (p<0.01) dose dependent anti-inflammatory activity. (29)
Angiotensin Converting Enzyme Inhibitor / Leaves: Study evaluated the bioactive compounds in leaves with potential ACE inhibitory activity using molecular docking method. Results yielded 37 compounds, three of which with potential as ACE inhibitors and better free binding energy than captopril. Spirost-8-en-11-one, 3-hydroxy, and (3ß,5a,14ß,20ß,22ß,25R) had the best inhibitory activity, with potential to be developed as antihypertensive drugs with ACE inhibitory activity. (30)
Antidiabetic / Leaves: Study evaluated the effect of ethyl acetate fraction of ethanol extract of leaves of A. manihot in STZ-induced rats using extract concentrations of 1.2%, 1.8%, and 2.4%. Results showed the EA fraction of leaves has antidiabetic effect as evidenced by reduction of blood glucose. Hypoglycemic effect was attributed to flavonoids. (31)
Efficacy and Safety in IgA Nephropathy: IgA nephropathy is considered the most common type of glomerulonephritis in the world, and is known to slowly progress to end-stage renal disease. A meta-analysis evaluated the effectiveness of Abelmoschus manihot for IgA nephropathy as adjuvant therapy with ARBs/ACEIs. Results showed that combination of conventional therapy and Abelmoschus manihot was significantly more effective for the total efficacy rate. The meta-analysis had some limitations: small size, short treatment periods, nature of disease course, and regional bias since all involved studies were conducted in different centers in China. (32)
Gastroprotective / Total Flavones / Flowers: Study evaluated the gastroprotective activity and possible mechanism of total flavones from A. manihot flowers in gastric ulcer induced by oral ethanol in mice measured by gastric ulcer index and histopathological examinations. Omeprazole was used as standard antiulcer drug. Results showed gastroprotective effect which was attributed to the increased in activity of SOD and GSH and decrease in levels of MDA and levels of Bax, TNF-α, and NF-kB(p65) expressions and increase in the Bcl-2 expression level. Study demonstrated TFA could significantly attenuate ethanol-induced gastric injury via antioxidative, anti-inflammatory, and anti-apoptotic effects.     (33)
Mucilage / Pharmaceutical Excipient Application / Leaves: Leaves have mucilaginous features, which are used in making soupy dishes. Study reported on the extraction of mucilages from leaves of A. manihot, A. spinosus, and T. triangulare. Qualitative screening yielded carbohydrates, polysaccharides, and mucilages. Mucilage from A. manihot exhibited significantly higher swelling index (357.78%) and total sugar content (273.65 mg glucose/g extract), and significantly lower loss on drying (10.72%) and total uronic acid content (105.20 mg glucoronic acid/g extract). Results showed A. manihot mucilage has potential for utilization as pharmaceutical excipient. (34)
Combination with Irbesartan for Reduction of Albuminuria in T2 Diabetes / Clinical Trial: A multicenter randomized double-blind parallel controlled clinical trial showed the A. manihot, in the form of huangkui capsule, combined with irbesartan (an angiotensin receptor blocker) is an effective therapy for T2D patients with DKD for reduction of albuminuria and proteinuria. (36)
Anti-Hepatitis B Virus / Hyperoside: Study evaluated the anti-hepatitis B virus (HBV) effect of hyperoside extracted from A. manihot using human hepatoma HepG2.2.15 cell culture system and duck hepatitis B virus (DHBV) infection model as in vivo and in vitro models. Results showed hyperoside is a strong inhibitor of HBsAg and HBeAg secretion in 2.2.15 cells and DHBV-DNA levels in the HBV-infected duck model. (37)
Total flavones (TFA) / Enhancement of Angiogenesis / Wound Healing: Angiogenesis is a process of new blood vessel formation from existing vessels, a vital process in wound healing and formation of granulation tissue. Study evaluated the effect of TFA on angiogenic ability using human umbilical vein endothelial cells *HUVECs) in vitro and chick chorioallantoic membrane (CAM) in vivo. Results showed TFA promoted HUVECs proliferation in a dose- and time-dependent manner. It increased HUVECs migratory ability and number of tubular structure, promoted vessel formation in HUVECs culture and CAM model. TFA treatment decreased cell apoptosis and enhanced expression of VEGF and KDR. TFA can enhance angiogenic ability and may be used in the treatment of wound healing and ischemic/reperfusion injuries. (38)
Treatment of Contrast-Induced Nephropathy: Contrast-induced nephropathy (CIN) is increasingly seen in patients receiving contrast medium. Study evaluated A. manihot as adjuvant therapy for CIN. Vitro experiments were used to verify the effect of TFA, the main active ingredient of A. manihot, in the intervention of iopromide-induced cells injury. A total of 17 chemical components and 133 potential targets in A. manihot were obtained.  Enrichment analysis indicated A. manihot was involved in the regulation of P13/AKT signaling pathway, FoxO signaling pathway, VEGF, HIF-1, TNF signaling pathway, malanoma, hepatitis B and other signaling pathways. Study illustrated that TFA reduces iopromide-induced renal tubular cell injury and apoptosis, which may be related to regulating the phosphorylation of AKT. Preliminary findings revealed multi-component, multi-target, and multi-pathway synergistic effects of A. manihot on CIN, and provide theoretical reference and basis for the study of pharmacological mechanism of A. manihot in the treatment of CIN. (39)
Fiber Property and Structure: Study evaluated the structure and property of A. manihot fibers. It belonged to cellulose I crystalline structure with crystallinity near to cotton and ramie. Breaking strength was lower than ramie fibers. Moisture regain was better than cotton, with higher thermal stability. (41)
Neuroprotective / Reversal of Sleep Deprivation Learning and Memory Deficit / Flowers: Study evaluated the neuroprotective effects of A. manihot flower extract against memory deficit induced by sleep deprivation (SD) in mice. Results showed flower extract treatment improved the cognitive functions of mice in object location recognition test and passive avoidance task. EAM also improved the activities of antioxidant enzyme, decreased content of MDA, restored protein expression of brain-derived neurotrophic factor (BDNF), tyrosine kinase B (TrkB) and glutamate receptor 1 (GluR1) in brain tissue. Results suggest EAM could improve SD-evoked learning and memory impairments, which may be related to its antioxidant capacity and enhanced BDNF/TrkB/GluR1 levels in the hippocampal memory.   (42)
Fever Reducing Effect After Dtp-Hb-Hib Vaccine / Leaves: Fever is common in toddlers following immunization with DTP-HB-Hib vaccine. Study evaluated the effect of A. manihot leaf boiled water in reducing the fever after vaccination. Toddlers who developed fever were given leaf boiled water as much as 200 cc. Leaf boiled water has vitamins A and C, potassium, folic acid, collagen substances, riboflavin, flavonoids, methanol, polyphenols, saponins, alkaloids, which can give an anti-inflammatory effect and antioxidant effect after consumption. Results showed significant differences in body temperature (p=0.001), with favorable effects before and after administration. Results suggest it can be recommended as natural therapy to relieve fever. (43)
Anti-Inflammatory / LPS-Induced Cystitis: Study evaluated the anti-inflammatory activity of A. manihot on a mouse model of lipopolysaccharide (LPS)-induced cystitis. Results showed A. manihot decreased WBC count in urine sediments of cystitis mice, alleviated bladder congestion, edema, histopathological damage, reduced expression of tumor necrosis factor-α, interleukin-6, and interleukin-1ß simultaneously. Results suggest a protective effect against LPS-induced cystitis, which is attributed to its anti-inflammatory profile by suppressing TLR4/MYD88/NF-κB pathways. Study suggests potential candidate for cystitis treatment. (44)

Availability
Wild-crafted.
Capsules, flower extracts in the cybermarket.


January 2023

                                                 PHOTOS / ILLUSTRATIONS
IMAGE SOURCE: Photo: Abelmoschus manihot / Dinesh Valke / Creative Commons Attribution-Share Alike 2.0 Generic / click on image to go to source page / Wikimedia Commons
OTHER IMAGE SOURCE: Photo: Abelmoschus manihot flower / Ram-Man (Derek Ramsey) 2006 / Creative Commons Attribution 2.5 Generic / click on image to go to source page / Wikimedia Commons
OTHER IMAGE SOURCE: Photo: Abelmoschus manihot subsp tetraphyllus-Swwet hibiscus / R M Garg / CC by 3.0 / click on image to go to source page / Wikipedia

Additional Sources and Suggested Readings
(1)
Abelmoschus manihot (L.) Medik. / KEW: Plants of the World Online
(2)
Abelmoschus manihot / PROSEA: Plants Resources of South-East Asia
(3)
Sorting Abelmoschus names / /Maintained by: Michel H. Porcher / MULTILINGUAL MULTISCRIPT PLANT NAME DATABASE / Copyright © 1995 - 2020 / A Work in Progress. School of Agriculture and Food Systems. Faculty of Land & Food Resources. The University of Melbourne. Australia.
(4)
Abelmoschus manihot / Wikipedia
(5)
Abelmoschus / Wikipedia
(6)
Chemical constituents, clinical efficacy and molecular mechanisms of the ethanol extract of Abelmoschus manihot flowers in the treatment of kidney diseases / Nan Li, Haitao Tang, Liang Wu, Harvest F Gu et al / Phytotherapy Research, 2021; 35(1): pp 198-206 / DOI: 10.1002/ptr.6818
(7)
Abelmoschus manihot Linn: ethnobotany, phytochemistry, and pharmacology
/ Amol Todarwarl, Pritam Jain, Sanjay Bari / Asian Journal of Traditional Medicines, 2011; 6(1)
(8)
Treatment of chronic kidney disease using a traditional Chinese medicine, Flos Abelmochus manihot (Linnaeus) Medicus (Malvaceae) / Yizhi Chen, Guangyan Cai, Xuefeng Sun, Xiangmei Chen / Clinical and Experimental Pharmacology and Physiology, 2016' 43(2): pp 145-148 / DOI: 10.1111/1440-1681.12528
(9)
Hepatoprotective evaluation of total flavonoids extracted from flowers of Abelmoschus manihot (L.) Medic: In vitro and in vivo studies / Guo Ai, Qingchuan Liu, Wei Hua, Zhengming Huang, Dewen Wang / Journal of Ethnopharmacology, 2013; 146(3): pp 794-802 / DOI: 10.1016/j.jep.2013.02.005
(10)
Efficacy and safety of Flos Abelmoschus manihot (Malvaceae) on type 2 diabetic nephropathy: A systematic review / Yi-Zhi Chen, Zi-Xiang Gong, Jian-Hui Zhour et al / Chin J Integr Med., 2015; 21(6): pp 464-472 / DOI: 10.1007/s11655-014-1891-6

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Flos Abelmoschus manihot extract attenuates DSS-induced colitis by regulating gut microbiota and Th17/Treg balance / Wei Zhang, Cheng Cheng, Liyun Shi et al / Biomedicine & Pharmacotherapy, 2019; Vol 117: 109162 / DOI: 10.1016/j.biopha.2019.109162
(12)
Traditonal Uses, Chemical Constituents, Biological Properties, Clinical Settings, and Toxicities of Abelmoschus manihot L.: A Comprehensive Review
/ Fei Luan, Qianhong Wu, Yan Yang, Haizhen Lv, Daoheng Liu, Zhaoping Gan, Nan Zeng / Front. Pharmacol., 2020; Vol 11 /
DOI: 10.3389/fphar.2020.01068
(13)
Bioactive Compounds from Abelmoschus manihot L. Alleviate the Progression of Multiple Myeloma in Mouse Model and Improve Bone Marrow Microenvironment
/ J Hou, J Qian, A Gong, S Zhong, C Gu et al / Onco Targets and Therapy, 2020; pp 959-973 / DOI: 10.2174/OTT.5235944
(14)
Pretreatment with the Total Flavone Glycosides of Flos Abelmoschus manihot and Hyperoside Prevents Glomerular Podocyte Apoptosis in Streptozotocin-Induced Diabetic Nephropathy / Leii Zhou, Xiao-Fei An, Jiang-Yi Yu et al / Journal of Medicinal Food, 2011; 15(5) / DOI: 10.1089/jmf.2011.1921
(15)
Exploring the total flavones of Abelmoschus manihot against IAV-induced lung inflammation by network pharmacology / Yanan Gao, Zihao Liang, Nianyin Lv, Liyun Shi et al / BMC Complementary Medicine and Therapies, 2022, 22: Article 36 / DOI: 10.1186/s12906-022-03509-0
(16)
Total Flavone of Abelmoschus manihot Ameliorates Stress-Induced Microbial Alterations Drive Intestinal Barrier Injury in DSS Colitis / Rong Wang, Tuo Chen, Qiong Wang, Ze-Yu Feng et al / Drug Design, Development and Therapy, 2021; Vol 15: pp 2999-3016 / DOI: 10.2147/DDDT.S313150
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Efficacy and safety of Abelmoschus manihot for primary glomerular disease: a prospective, multicenter randomized controlled clinical trial / Zhang L, P Li, CY Xing, JY Zhao, YN He / Am J Kidney Dis., 2014; 64(1): pp 57-65 / PubMed ID 24631042
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Analgesic Activity of Abelmoschus manihot Extracts / S Jain Pritam, A Todarwal Amol, B Bari Sanjay, J Surana Sanjay / International Journal of Pharmacology, 7: pp 716-720 / DOI: 10.3923/ijp.2011.716.720
(19)
Application of gum extracted from Abelmoschus manihot as matrix of Chinese medicinal gel
/ CN102526754A:China / Google Patents
(20)
Evaluation of wound healing effect of petroleum ether and methanolic extract of Abelmoschus manihot (L.) Medik., Malvaceae, and Wrightea tinctoria R.Br., Apocynaceae in rats /  Pritam S Jain, Sanjay B Bari / Rev. Bras. Farmacogn., 2010; 20(5) / DOI: 10.1590/S0102-695X2010005000009
(21)
The Flower Extract of Abelmoschus manihot (Linn) Increases Cyclin D1 Expression and Activates Cell Proliferation / Yea-In Park, Yeo Eun Cha, Minsu Jang, Junsoo Park et al / JMB: Journal of Microbiology and Biotechnology, 2020; 30(7): pp 1044-1050 / DOI: 10.4014/jmb.2002.02024 / eISSN: 1738-8872 / pISSN: 1017-7825
(22)
In Vitro Anthelmintic Activity of Abutilon Indicum (L.) Sweet and Abelmoschus manihot (L.) Medik / D S Chumbhale, S R Chaudhari, C D Upasani / Asisan Journal of Pharmaceutical Research and Development, 2013; 1(6): pp 37-41 / ISSN: 2320-4850
(23)
Total flavone of Abelmoschus manihot ameliorates Crohn's disease by regulating the NF-kB and MAPK signaling pathways / Dan Zhang, Ping Zhu, Bo-Lin Yang, Yu-Gen Chen et al / International Journal of Molecular Medicine, 2019; 44(1): pp 323-334 / DOI: 10.3892/ijmm.2019.4180 / pISSN: 1107-3756 / eISSN: 1791-244X
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Radical Scavenging Activity of Leaf Extract of Edible Hibiscus (Abelmoschus manihot (L.) Medik) Using 1,1-Diphenyl-2-Picryl Hydrazil (DPPH) / Risda Waris, Esti Dewi Pratiwi A.M., Ahmad Najib / International Journal of Pharma Tech Research, 2016; 9(6): pp 343-347 / eISSN: 2455-9563 / pISSN: 0974-4304
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The effect of gel Abelmoschus manihol (l.) Medik leaf extract on second degree burn wound healing process / Wiwik Misaco Yuniarti, Erva Fatmareta, Laila Nur Hidayati, Nadhila Arieska, Bambang Sektiari Lukiswanto / Sys Rev Pharm, 2020; 11(10): pp 884-889
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Phytochemical analysis and in vitro antioxidant and antibacterial activity of the chloroform leaf extract of Abelmoschus manihot (L.) Medik (Malvaceae) / Selvaraj Divya, Subramanian Arivoli, Samuel Tennyson / RJPT: Research Journal of Pharmacy and Technology, 2021; 14(9) /
DOI: 10.52711/0974-360X.2021.00821
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Conjugated metabolites represent the major circulating forms of Abelmoschus manihot in vivo and show an altered pharmacokinetic profile in renal pathology / Jianming Guo, Leyue Du, Erxin Shang, Ting Li et al / Pharmaceutical Biology, 2016; 54(4): pp 595-603 / DOI: 10.3109/13880208.2015.1068337
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New insights on Abelmoschus manihot flower development: dynamic changes of flavonoids based on a metabolomic approach / Jie Li, Guang-Ying Ye, Hai-Lin Liu, Zai-Hua Wang / Journal of Plants Biochemistry and Biotechnology, 2022; 31(2): pp 351-360
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Anti-inflammatory activity of Abelmoschus manihot extracts / P S Jain, S B Bari / IJP: International Journal of Pharmacology, 2010; 6(4): pp 505-509 / DOI: 10.3923/ijp.2010.505.509 / Record No 20113060212 /
ISSN: 1811-7775
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Angiotensin converting enzyme inhibitors from Abelmoschus manihot (L.) Medik leaves: A molecular docking study / Siboantua Broolin Simanjuntak, Marko Jeremia Kalalo, Tri Hebber, Trina Ekawati Tallei, Fatimawali / AIP Conference Proceedings 2638, 2022; 070002 / DOI: 10.1063/5.0104277
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Antidiabetic effect test of ethyl acetate fraction ethanol extract of Abelmoschus manihot L Medik leaves in streptozotocin-induced rats (Rattus novegicus) / Elisabeth N Barung, Selfie P Ulaen, Yos Banne, Jovie M Dumanauw, Gledis S Maluenseng / Proceeding Manado Health Polytechnic 1st International Conference, 2017, 1(1) / ISSN: 2599-2031
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The Effectiveness and Safety of Abelmoschus manihot in Treating IgA Nephropathy: A Systematic Review and Meta-Analysis / Qi Jia, Jing Guo, Yuzi Cai, Weijing Liu et al / Evidence-Based Complementary and Alternative Medicine, Volume 2022; Artilce ID 0730753 / DOI: 10.1155/2022/9730753

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Gastroprotective Activity of the Total Flavones from Abelmoschus manihot (L.) Medic Flowers
/ Jun Zhang, Zai-Lin Fu, Zhao-Xing Chu, Bi-Wei Song / Evid-Based Complement. Med, 2020; 2(25) /
DOI: 10.1155/2020/6584945
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Characterization of Mucilages from Abelmoschus manihot Linn., Amaranthus spinosus Linn., and Talinum triangulare (Jacq.) Willd. Leaves for Pharmaceutical Excipient Application / Aileen May Gabule Ang, Inocencion Canete Raman Jr / Asian Journal of Biological and Life Sciences, 2019; 8(1)
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Yield, Proximate Composition, and Phytochemical Screening of "Lagikway," Abelmoschus manihol (L.) Medik / Rodel G Maghirang, Claudette D Oraye, John Marty C Mateo / Philippine Journal of Science, 2021; 150(6A) / ISSN: 0031-7683
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Efficacy of Combined Abelmoschus manihot and Irbesartan for Reduction of Albuminuria in Patients with Type 2 Diabetes and Diabetic Kidney Disease: A Multicenter Randomized Double-Blind Parallel Controlled Clinical Trial / Jing Zhao, Isabelle Tostivint, Lingdong Xu, Laetitia Gambotti et al / Diabetes Care, 2022; 45(7): e113-e115 / DOI: 10.2337/dc22-0607
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In vivo and in vitro antiviral activity of hyperoside extracted from Abelmoschus manihot (L) Medik
/ Lin-lin Wu, Xin-bo Yang, Zheng-ming Huang, He-zhi Liu, Guang-xia Wu / Acta Pharmacol Sin, 2007; 28(3): pp 404-409 / DOI: 10.1111/j.1745-7254.2007.00510.x
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Total flavones of abelmoschus manihot enhances angiogenic ability both in vitro and in vivo / Lingyi Tang, Wu Pan, Guisong Zhu, Zhihui Liu, Dongling Lv, Meng Jiang / Oncotarget, 2017; 8: 69768-69778 /
DOI: 10.18632/oncotarget.19264
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Mechanism of Abelmoschus manihot L. in the treatment of Contrast-Induced Nephropathy on the Basis of Network Pharmacology Analysis / Zhongchi Xu, Lichao Qian, Ruge Niu, Xin Lin et al / Frontiers in Nephrology, 2022; Vol 2: Article No 834513 / DOI: 10.3389/fneph.2022.834513
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Studies on chemical constituents in flower of Abelmoschus manihot
/ Xian-Yin Lai, Yu-Ying Zhao, Hong Liang / Zhongguo Zhong Yao Za Zhi, 2006; 31(19): pp 1597-1600 / PMID: 17165583
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Study on Structure and Property of Abelmoschus manihot Fibers / Lijun Qu, Mingwei Tian, Shifeng Zhu et al / Journal of Natural Fibers, 2016; 13(2): pp 215-226 / DOI: 10.1080/15440478.2014.1004010
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Hydroalcoholic extract from Abelmoschus manihot (Linn.) Medicus flower reverses sleep deprivation-evoked learning and memory deficit / Hai-rui Zhou, Jing-ru Wu, Lei Bei, Shu-xia Ma et al / Food & Function, 2020; Issue 10
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Abelmoschus manihot L. as Fever Reducing (Adverse Event Following Immunization) After Dtp-Hb-Hib Vaccine / Kholilah Lubis, Nopa Darmiati, Desti Nataria, Indah Putri Ramadhanti, Riri Aprianti / Proceedings of the 2nd Syedza Saintika International Conference on Nursing, Midwifery, Medical Laboratory Technology, Public Health, and Health Information Management (SeSICNiMPH 2021)
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Anti-inflammatory effets of Abelmoschus manihot (L.) Medik. on LPS-induced cystitis in mice: potential candidate for cystitis treatment based on classic use / Su Zhou, Kai-Kai Fan, Li-Fei Gu, Bo-Yang Yu, Cheng-Zhi Chai / Chinese Journal of Natural Medicines, 2022; 20(5): pp 321-331 /
DOI: 10.1016/S1875-5364(22)60140-7

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