Pomegranate as a Potential Alternative of Pain Management: A Review

José Antonio Guerrero-Solano, Osmar Antonio Jaramillo-Morales, Claudia Velázquez-González, Minarda De la O-Arciniega, Araceli Castañeda-Ovando, Gabriel Betanzos-Cabrera, Mirandeli Bautista, José Antonio Guerrero-Solano, Osmar Antonio Jaramillo-Morales, Claudia Velázquez-González, Minarda De la O-Arciniega, Araceli Castañeda-Ovando, Gabriel Betanzos-Cabrera, Mirandeli Bautista

Abstract

The use of complementary medicine has recently increased in an attempt to find effective alternative therapies that reduce the adverse effects of drugs. Punica granatum L. (pomegranate) has been used in traditional medicine for different kinds of pain. This review aims to explore the scientific evidence about the antinociceptive effect of pomegranate. A selection of original scientific articles that accomplished the inclusion criteria was carried out. It was found that different parts of pomegranate showed an antinociceptive effect; this effect can be due mainly by the presence of polyphenols, flavonoids, or fatty acids. It is suggested in the literature that the mechanisms of action may be related to the activation of the L-arginine / NO pathway, members of the TRP superfamily (TRPA1 or TRPV1) and the opioid system. The implications for the field are to know the mechanisms of action by which this effect is generated and thus be able to create alternative treatments for specific types of pain, which help alleviate it and reduce the adverse effects produced by drugs. The results propose that pomegranate and secondary metabolites could be considered in the treatment of inflammatory, nociceptive, and neuropathic pain.

Keywords: Pomegranate; Punica granatum L.; antinociceptive; pain.

Conflict of interest statement

The authors declare that there are no conflict of interest in the publication of this article.

Figures

Figure 1
Figure 1
Chemical structure of some tannins involved in antinociception mechanisms. (a) punicalagin, (b) punicalin, (c) ellagic acid hexoside, (d) ellagic acid pentoside, (e) corilagin.
Figure 2
Figure 2
Chemical structure of some flavonoids that modulate COX-2 transcription. (a) nobiletin, (b) flavone, (c) resveratrol, (d) quercetin penta-acetate, (e) apigenin, (f) chrysin, (g) quercetin, (h) galangin, (i) kaempferol.
Figure 3
Figure 3
Chemical structures involved in the antinociceptive effect of Punica granatum L. (a) ellagic acid, (b) gallic acid, (c) punicic acid.

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