A Systematic Review: Potential Gastroprotective and Antimicrobial Effects of the Genus Sterculia, along with Their Mechanism of Action / Tinjauan Sistematis Potensi Efek Gastroprotektif dan Antimikroba dari Genus Sterculia, beserta Mekanisme Kerja

Gastrointestinal disorders, particularly peptic ulcer and gastritis associated with Helicobacter pylori infection, remain a pressing global health burden that is compounded by rising antimicrobial resistance to standard eradication therapies. The genus Sterculia (Malvaceae) has long been used in traditional medicine to treat these conditions, yet no systematic synthesis of its efficacy and underlying phytochemical mechanisms has previously been available. This systematic review followed the PRISMA 2020 guidelines and a PICO framework, searching PubMed, ScienceDirect, Scopus, and Google Scholar, with study quality appraised using the Young and Solomon instrument. Ten eligible articles were narratively synthesized. Findings showed that a methanolic seed extract of Sterculia nobilis inhibited reserpine-induced gastric ulceration by up to 65.1% at 400 mg/kg, approaching the efficacy of ranitidine, through reduced gastric acid secretion, modulation of serum neuropeptides, and enhanced superoxide dismutase activity. Sterculia urens gum functioned dually as a gastroretentive drug-delivery matrix and an intrinsic antioxidant agent. Antimicrobial activity was consistently observed across species: fraxetin from Sterculia quadrifida significantly inhibited gastrointestinal bacterial pathogens, while Sterculia foetida exhibited notable antifungal potential against Candida spp. Three convergent mechanisms free-radical scavenging, neuropeptide modulation, and polysaccharide-mediated mucosal protection appear to underlie the gastroprotective effects of this genus. However, the absence of clinical trials and direct evaluation against Helicobacter pylori represent major evidence gaps. These findings provide a scientific basis for developing Sterculia-based gastrointestinal therapeutic agents, although further preclinical and clinical research is warranted to confirm their efficacy and safety.

Gangguan gastrointestinal, khususnya tukak peptik dan gastritis yang dipicu infeksi Helicobacter pylori, tetap menjadi masalah kesehatan global yang kian diperberat oleh meningkatnya resistensi antimikroba terhadap terapi eradikasi standar. Genus Sterculia (Malvaceae) telah lama digunakan dalam pengobatan tradisional untuk mengatasi gangguan tersebut, namun bukti ilmiah mengenai efikasi dan mekanisme fitokimianya belum dikaji secara sistematis. Tinjauan sistematis ini disusun mengacu pada pedoman PRISMA 2020 dengan pendekatan PICO, menelusuri literatur dari PubMed, ScienceDirect, Scopus, dan Google Scholar, serta menilai kualitas artikel menggunakan instrumen Young and Solomon. Sepuluh artikel yang memenuhi kriteria inklusi dianalisis secara naratif. Hasil menunjukkan bahwa ekstrak metanol biji Sterculia nobilis menghambat tukak lambung terinduksi reserpin hingga 65,1% pada dosis 400 mg/kgBB, mendekati efikasi ranitidin, melalui penurunan sekresi asam lambung, modulasi neuropeptida serum, dan peningkatan aktivitas superoksida dismutase. Gom Sterculia urens terbukti berfungsi ganda sebagai matriks penghantaran obat gastroretentif dan agen antioksidan intrinsik. Aktivitas antimikroba terkonfirmasi pada beberapa spesies, dengan senyawa fraxetin pada Sterculia quadrifida menghambat bakteri patogen saluran cerna secara signifikan, sementara Sterculia foetida menunjukkan potensi antijamur terhadap Candida spp. Tiga mekanisme utama penangkapan radikal bebas, modulasi neuropeptida, dan proteksi mukosa berbasis polisakarida, mendasari efek gastroprotektif genus ini. Namun, ketiadaan uji klinis dan evaluasi langsung terhadap Helicobacter pylori menjadi keterbatasan utama. Temuan ini memberikan landasan ilmiah bagi pengembangan agen terapi gastrointestinal berbasis Sterculia, meskipun diperlukan penelitian praklinis dan klinis lebih lanjut untuk validasi efikasi dan keamanannya.