Osteoporosis is a major global health problem. Osteoporosis is characterized by the loss of bone mass and
strength which leads to an increased risk of fracture. Glucocorticoid treatment is the leading cause of secondary osteoporosis.
Glucocorticoid action in bone depends upon the expression of 11beta-hydroxysteroid dehydrogenase type 1 enzyme
(11β-HSD1). The oestrogen deficient state causes osteoporosis due to enhancement of osteoclastogenesis by oxidative
stress which leads to increased bone resorption. Piper sarmentosum (Daun Kaduk) is commonly used in the local cuisine
of South East Asia. It is also traditionally used to treat many diseases such as inflammation, dermatitis and joint pain.
Studies have revealed antioxidant properties through its flavonoids compound naringenin which acts as a superoxide
scavenger that may help in the endogenous antioxidant defence system to protect bone against osteoporosis. Recent studies
found that Ps extract has the ability to inhibit the expression and activity of 11β-HSD1 in adipose tissue and bone
which restored bone structure and strength. It also accelerates fracture healing in the oestrogen deficient state through its
antioxidant properties. The cost of conventional treatment is high and together with the adverse effects it leads to noncompliance.
Treatment modalities with herbal medicine, less side effects and is cheaper need to be explored.This review
focused on the therapeutic effect of Ps extract on fracture healing in ovariectomized rats and its protective effects against
glucocorticoid induced osteoporotic rats.
Keywords: Antioxidant, fracture healing, glucocorticoid induce osteoporosis, 11β-hydroxysteroid dehydrogenase type 1, oestrogen
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