Libidibia ferrea (jucá) anti-inflammatory action: A systematic review of in vivo and in vitro studies

Libidibia ferrea (Mart. ex Tul.) L. P. Queiroz (jucá) is a plant extensively used in the Brazilian folk medicine for the treatment of the inflammatory process. Primary studies have focused on the verification of these biological activities, highlighting the role of this plant in inflammatory conditions. This systematic review aimed to critically establish which part of the plant and what type of plant extract present the highest evidence of anti-inflammatory activity as in vivo and in vitro experimental models. This study has followed the recommendations by PRISMA and was registered in the PROSPERO database under number CRD42020159934. The literature review was carried out in several medical and scientific databases (Google Scholar, LILACS, ProQuest, PubMed, ScienceDirect, Scopus and Web of Science) in studies published up to February 2020 and updated on March 2021. No language restriction was made to this search. Eligibility criteria were adopted instead. The risk of bias was evaluated through SYRCLE's RoB tool for the in vivo studies. 609 studies were initiated to identify the whole and the subsequent steps of screening. 13 studies remained in the results (10 in vivo and 3 in vitro). In most studies the risk of bias was low or unclear. The high risk of bias was related to the risk of attrition and reporting bias. The fruit and the aqueous extract were identified as the most used in the studies carried out on the qualitative analysis and the results of the in vivo and in vitro studies were conducive to the anti-inflammatory action, a meta-analysis could not be performed due to heterogeneity between studies and the potential risk of bias to estimate the side effects. Therefore, the implementation of in vivo studies following the international guidelines could collaborate with analyses of the anti-inflammatory effect of jucá.