The therapeutic properties of Mikania glomerata Spreng . (Asteraceae)

The Mikania glomerata Spreng is a specie found in Europe, Africa, North and South America and is commonly known as “guaco” and “guaco climber”. Many scientific studies confirm the bactericidal, anti -ophidic, antifungal, anti-inflammatory, antimalarial, and bronchodilator pharmacological activities. These studies aim to contribute to new research, report the phytotherapy aspects and describe the therapeutical properties of Mikania glomerata. This study is an integrative review with a descriptive approach. Were found during the study that the guaco therapeutical properties are diverse, such as: antiasthmatic, tonic, antipyretic, expectorant, appetite stimulant, anti-influenza, antirheumatic, soothing, healing, diuretic, emollient, fluidizing, bacterial growth inhibitor, antiallergic, antifungal, antioxidant, anthelmintic. Thereby, glomerata, in addition to showing the long-term effects of the use of your phytotherapic and safe doses, such as side effects. antiasmático, tónico, antipirético, expectorante, estimulador del apetito, antigripal, antirreumático, calmante, cicatrizante, diurético, emoliente, fluidificante, inhibidor del crecimiento bacteriano, antialérgico, antifúngico, antioxidante, antihelmíntico. Así como, los textos analizados apuntan más allá de las propiedades antes mencionadas, demostrando tener un rendimiento significativo en el tratamiento referido a úlceras duodenales y estomacales, enfermedades infecciosas como amigdalitis e inflamación de la orofaringe, gripe e infecciones de las vías respiratorias superiores (IVRS),

The M. glomerata was quite used by several indigenous people, to defeat the venom of the snakes and homemade pharmaceutical forms keep being used nowadays, such as poultice and plasters on the bite of snakes and other venomous animals, besides the infusion of the leaves is used in the treatment of respiratory tract diseases. The M. glomerata shows ethnopharmacological importance, because is part of the Brazilian Pharmacopoeia since 1929, in their first edition and, presently, the syrup and oral solution are provided by the Unified Health System (SUS). Was introduced in the fourth edition of the Brazilian Pharmacopeia, in 2005, the Mikania laevigata (Sch. Bip. ex Baker). Both vegetable species share chemical characteristics and morphological similarities, as the uses and therapeutical indications, being the phytotherapic medicine most consumed for the treatment of asthmatic bronchitis, cough, and hoarseness (Costa, Borghi, Mayer, & Sawaya, 2018;Coutinho, Gonçalves, & Marcucci, 2020;Della Pasqua et al., 2019;E Silva et al., 2012;João C. Gasparetto, Campos, Budel, & Pontarolo, 2010;Moreti et al., 2017).
The Brazilian legislation considers the coumarin (1,2-benzopyrone as a chemical marker for the species M. glomerata and M. laevigata, a metabolite responsible for the anti-inflammatory activity. For quality control, the Brazilian Pharmacopeia recommends the use of High-Performance Liquid Chromatography (HPLC) for quantification of coumarins in the extracts of leaves from both vegetable species. Beyond coumarin are reported other chemical substances as derivatives of coumaric acid, lupeol, dihydrocoumarin, caffeic, kaurenoic, and chlorogenic acids, among others, that can be used for chemical differentiation of the species (Bertol, Cobre, & Pontarolo, 2021;Della Pasqua et al., 2019;Ormond et al., 2022). and tincture, the recommended oral dosage is between 0.5 and 5 mg of coumarin as a daily dose (Brasil, 2012;Carvalho et al., 2012;Menezes et al., 2022;Saúde, 2009).
Given the search for new therapies for the disease treatment, this aimed to a report the pharmacological properties of the M. glomerata.

Methodology
This review is an integrative research, with a descriptive approach, based on several databases, PubMed/Mediline, Latin American, Caribbean Literature on Health Sciences (Lilacs), Scientific Electronic Library Online (Scielo), and Google Scholar. The descriptors used in the research were: Mikania glomerata, guaco, properties of guaco, properties of guaco.
The established limits or established inclusion criteria were the time frame from 2010 to 2022, in English and Portuguese, and only scientific articles were considered for the research. The selection of articles was conducted through the initial reading of the titles and abstracts that were suitable for the review. Table 1 presents the quantity of articles found for each descriptor used, total was 13 papers, after the exclusion 12 studies remain for development the integrative review. A flow diagram of review process. can be seen in Figure 1  Source: Own authorship (2022).

Results
The Table 2 shows the information removed from the studies, organized according of the used part used, pharmacological properties, uses and conclusion of the studies.
Syrup and tea. The phytotherapy medicines based on guaco have been used on large scale in the public mesh.
The participation of health professionals is important, as alternative therapies have a lot to offer and can contribute to health sciences, in addition to allowing the individual relative autonomy in relation to health care.
Powder, indication for use up to 300 mg/kg.
The powder was obtained from the leaves of M. glomerata, it is suggested that the powder be used in a solid pharmaceutical form formulation.
Syrup (adult 15 ml 3x a day and child over 2 years 15 ml 2x a day).
The guaco for containing coumarin is inadvisable for use by children younger than 1 year and in pregnant women. Besides, the long-term use may cause hemorrhagic accidents by the antagonism to vitamin K. Beyond the interaction with anticoagulants and some antibiotics such as tetracyclines, chloramphenicol, gentamicin, vancomycin, and penicillin, however, the mechanism of action is still unknown.
Tonic, depurative, antipyretic and bronchodilator action, as well as appetite stimulant.
Tincture and extract. The biggest concentration of coumarins was found near the apical bud on the leaves, with make better the relationship with the development process of guaco.
The techniques used for determining coumarins in M. glomerata, were high performance liquid chromatography (HPLC) and gas chromatography (GC).
Bronchodilator, influenza and cold. Extract. The leaves and stem are used by the Brazilian population because of their medicinal effects used in natura for the treatment of influenza and common cold.
Extract. M. glomerata promotes relaxation of the smooth muscles of the airways, mainly bronchi, by improving the fluidity of exudates through the tracheobronchial cough reflex.
Extract and oil. Drug of increasing use in Brazil with the aim of treaty clinical conditions of the airway, mainly dyspnea, with an important interest of the Unified Health System.

Extract.
The study is about guaco extract in oral treatment as mouthwash, also used on caries treatment.
Bronchodilator, anti-inflammatory e anti-allergen. Syrup. It shows the main metabolites of the plant responsible for the therapeutic effects.
Source: Own authorship (2022). Table 3 were described the majority compounds reported in the studies for in vitro and in vivo treatment.

Discussion
The use of therapeutical plants for the prevention and/or combat of organism diseases comes from a historical practice provided by the easy access of the population, due to the vast biodiversity. In addition to being affordable because of its cost, it proves to be a therapeutic alternative to the choice of synthetic drugs (Pinto et al., 2021).
Medicinal plants symbolize an element of great relevance for monitoring people's health conditions. Moreover, the validation of the therapeutic action of some popularly used plants in phytotherapy symbolizes an important part of the class of a people, as it starts from a knowledge applied and propagated by populations over several generations (Pinto et al., 2021).
M. Glomerata is easily found and used in popular medicine in homemade preparations, such as teas airway diseases treatment because of their many pharmacological actions. Despite that, exist industrialized syrups mostly totally qualified with quality control, guarantee, efficacy, and saved. Among the secondary metabolites found in the specie stand out coumarin and kaurenoic acid for their pharmacological actions, such as anti-inflammatory and bronchodilator. Due to this important effect, guaco syrup and other presentations are dispensed in the Basic Component of Pharmaceutical Assistance (Gasparetto et al., 2015).
Ethnopharmacological studies report that the species M. laevigata and M. glomerata are popularly named guaco despite being morphologically and chemically similar both possess differences in the concentration and composition of some chemical compounds. Pasqua et al (2019) reported that the M. glomerata presents a bigger amount of coumarin than the specie M. laevigata, on the other hand, Santos et al (2006) and Bolina et al (2009)  Based on the results, it can be seen that there are several parts of guaco used for treatment, such as: leaves and stems with their expectorant, anti-inflammatory, anxiolytic, bronchodilator, appetite stimulant properties; flowers and roots with their property of tonic, depurative, antipyretic action; bark with its anti-influenza, anti-inflammatory, anti-neuralgic, anti-rheumatic, antiseptic, bekic, depurative, diuretic and emollient property; plant with its antimicrobial, anti-inflammatory, analgesic, spasmodic, vasodilator, anti-ulcer, central nervous system depressant and anti-venom property . In the studied extracts of M. glomerata, one of the main classes of secondary metabolites is coumarin, which is richly used to treat symptoms such as cough, expectoration, and dyspnea. Gasparetto et al. (2010) attribute the presence of diterpenes from the plant species to anti-cancer, antibacterial, antiparasitic, and hemolytic effects. Moreira et al. (2017) reported that M. Glomerata extract can be used to prevent dental caries, as it can inhibit the growth of oral pathogens and reduce dental plaque. In this way, they demonstrate that the addition of extracts to oral products is an important strategy in caries control.
Therefore, the use of medicinal plants is part of the knowledge and customs of many populations. The guaco, is the reason of this present study for being a medicinal plant of easy access and cost for the plants fulfilling its role as studies on its research more than 90% therapeutic success of users for treating diseases such as influenza syndrome and oropharyngeal inflammation (Fraga & Borges, 2020).

Conclusion
All the selected studies that composed this article demonstrated effective clinical improvement in the reduction of signs and symptoms. Thus, it is essential to highlight the importance of the medicinal use of this compound and emphasize its benefits for the clinical improvement of several health conditions, which affect many patients in the current scenario. However, given the data that were previously presented, as well as the limited number of studies, it is essential to carry out more research to define more safely the therapeutic properties of M. glomerata, and the long-term effects of its phytotherapy medicine, safe dose approach and main side effects.