Volume 5, Issue 2, April 2015, Pages 66–70
Review article
- Open Access funded by Center for Food and Biomolecules, National Taiwan University
- Under a Creative Commons license
Abstract
The
purpose of this article is to use search engines such as PubMed and
Scifinder to locate scholarly articles and reports pertaining to Cinnamon
(肉桂 ròu guì), its novel effects, preparation, analysis, and use in the
prevention and treatment of serious illnesses, such as diabetes,
cardiovascular diseases, Alzheimer’s disease, and cancer. Cinnamon has
been used traditionally in food preparations and as an herbal medicine
to treat a variety of ailments and their symptoms. Cinnamon is known to
have antioxidant, antibacterial, anti-inflammatory, and other
therapeutic properties. New studies reaffirm the importance of cinnamon
as a spice but also suggest that it may be a natural remedy to treat
serious diseases such as type 2 diabetes, chronic digestion problems,
cardiovascular diseases, and even cancer and Alzheimer’s disease. This
article presents a comprehensive analysis of the botanical, chemical,
and pharmacological aspects of cinnamon.
Keywords
- Alzheimer's disease;
- angiogenesis inhibitor;
- cancer;
- cinnamon;
- chronic diseases;
- diabetes
1. Introduction
Cinnamon
(肉桂 ròu guì), which is derived from a Greek word that means sweet wood,
comes from the inner bark of tropical evergreen cinnamon trees. 1Cinnamomum (cinnamon) is a genus of the Lauraceae family, many of whose members are used as spices. 2 There are two main varieties of cinnamon: the Ceylon or true cinnamon (Cinnamon zeylanicum Blume), which is grown in Sri Lanka and Southern India ( Fig. 1A), and cassia (Cinnamom aromaticum Ness), which is grown in China, Indonesia, and Vietnam ( Fig. 1B). Cassia, when dried, rolls into a tubular form known as a quill or cinnamon stick. 1 and 3
Cinnamon has been used in food preparations and in traditional medicine by the Egyptians and the Chinese since ancient times.4 In addition, this spice has been found to have strong antioxidant, antibacterial, antipyretic,5 and anti-inflammatory properties, which play an important role in tissue repair.6
The bark of cinnamon has been used as a spice and to make tea and also
as an herbal remedy for the treatment of common colds, cardiovascular
diseases, and chronic gastrointestinal and gynecological disorders in
oriental herbal medicine.7
Cinnamon has likewise been used for treating sore throats, cough,
indigestion, abdominal cramps, intestinal spasms, nausea, flatulence,
and diarrhea.1 Moreover, it has been found that cinnamon slows down food spoilage and displays antifungal properties.8
One
study has found that cinnamon bark water extract enhances glucose
uptake by increasing insulin sensitivity. Several studies have also
found that cinnamon extract (CE) displays anticancer activity5
and inhibits angiogenesis by blocking vascular endothelial growth
factor (VEGF) 2 signaling. These results indicate that the observed
pharmacological activities may have originated from the polyphenolic
compounds in cinnamon water extract.7
2. Components
Cinnamon
(肉桂 ròu guì) is a plant with many uses as an herbal medicine and it
contains mucilage, tannin, sugar, resin, and essential oil, among which
essential oil is the most important constituent. The major portion of
the essential oil is made up of cinnamaldehyde or cinnamic aldehyde. 6 Cinnamaldehyde is responsible for the flavor and aroma of cinnamon. 9
A study found that cinnamaldehyde is the major volatile component of
cinnamon sticks, with 83.6% of essential oils extracted from cinnamon
stick powder. 2 The essential oils from Cinnamon cassia also contain 80–90% cinnamaldehyde with little or no eugenol, which is different from C. zeylanicum
bark, which contains 60–80% cinnamaldehyde and approximately 2%
eugenol, however, essential oils from its leaves were found to be rich
in eugenol (70–75%). 2
The study showed that the crude extracts of cinnamon stick also
contained high levels of nonvolatile compounds (mainly condensed
tannins), which consist of 23.2% proanthocyanidins and 3.6% catechins in
addition to cinnamaldehyde (64.1%). 2
3. Diabetes
Diabetes
mellitus is a chronic disorder of glucose metabolism caused by the
dysfunction of pancreatic beta cells and insulin resistance. Diabetes is
a serious health problem that affects both sexes in all age groups and
all over the world.10
Cinnamon
(肉桂 ròu guì) has been shown to have insulin mimetic properties because
its biologically active substances enhance glucose uptake by activating
insulin receptor kinase activity, autophosphorylation of the insulin
receptor, and glycogen synthase activity. 11
In
one study, a factor called methyl hydroxyl chalcone polymer, which was
isolated from cinnamon, was observed to increase insulin-dependent
glucose metabolism approximately 20-fold in vitro. Safdar et al 10
explained that methyl hydroxyl chalcone polymer made fat cells more
responsive to insulin by activating the enzyme that causes insulin to
bind to cells and inhibiting the enzyme that blocks the process leading
to maximal phosphorylation of the insulin receptor, which is associated
with increased insulin sensitivity.
Cinnamon
is rich in polyphenolic components, and it was shown that an intake of
500 mg/d for 12 weeks decreased oxidative stress and improved impaired
fasting glucose.12
Another
finding also indicated that the consumption of 500 mg/d of a specific
aqueous extract of cinnamon (Cinnulin PF) for a 12-week period
significantly improved some metabolic syndromes such as fasting blood
sugar, systolic blood pressure, and body composition, and because there
is a relationship between metabolic syndrome and cardiovascular disease,
these results can have an important effect for the improvement of
public health.13
4. Anticholesterol
The compounds present in Cinnamon
(肉桂 ròu guì) have shown to be beneficial for glucose uptake, insulin
regulation, and blood lipid profile. A study was performed on patients
with type 2 diabetes consuming cinnamon. The results showed that there
were significant decreases in fasting serum glucose (18–29%),
triglycerides (23–30%), total cholesterol (12–26%), and low-density
lipoprotein cholesterol (7–27%) for patients who consumed 1 g, 3 g, or 5
g of cinnamon for 40 days. 4 and 14
5. Antioxidant
Polyphenols, which are among the natural dietary antioxidants found in Cinnamon (肉桂 ròu guì), have been shown to reduce oxidative stress in a dose-dependent manner via the inhibition of 5-lipoxygenase. 15
Specific antioxidant phytochemicals that have been identified in
cinnamon include epicatechin, camphene, eugenol, gamma-terpinene,
phenol, salicylic acid, and tannins. 16
Today,
natural antioxidants are the focus of considerable attention and
efforts are ongoing for the replacement of synthetic ones. In addition,
these natural antioxidants can be formulated as functional foods and can
help prevent oxidative damage from occurring in the body.4
6. Cancer
Plants
have been used as a source of effective anticancer agents, and 60% of
currently used anticancer drugs are derived from natural sources such as
plants, marine organisms, and microorganisms.17
Several studies have been conducted on herbs that possess anticancer
properties and these have been used as potent anticancer drugs.17 Recently, the antitumor activity of Cinnamon
(肉桂 ròu guì) has been shown to inhibit the proliferation of several
human cancer cell lines including breast, leukemia, ovarian, and lung
tumor cells. 17
It
is well known that metastasis, one of the major causes of mortality in
cancer, involves cell adhesion, invasion, and migration. In one study,
the effect of CE on the migration of SiHa (human cervical tumor) cells
was examined. The result showed that cinnamon significantly reduced the
migration of cancer cells, demonstrating its potential use as an
anticancer drug in cervical cancer.17
CE, which contains a mixture of polyphenols together with
cinnamaldehyde as the major bioactive component, plays a therapeutic
role in cervical cancer cells by depolarization of the mitochondrial
membrane potential, resulting in cellular apoptosis.17
In
another study, CE was shown to inhibit the growth of hematologic tumor
cells. Moreover, the treatment of melanoma cell lines with CE also
induced a decrease in Cox-2 and HIF-1α expression in the tumor tissues
that mediate the potent antitumor activity of cinnamon. Cox-2 and HIF-1α
are well known as master regulators in cancer progression to aggravate
angiogenesis and metastasis.18
The
use of herbal medicine is supported by scientific studies for potent
anticancer drugs. However, the use of an herbal medicine as an
anticancer agent requires extensive research and strict criteria for
standardization, safety, quality control, toxicity, and clinical trials.18
7. Angiogenesis inhibitor
Angiogenesis
is the development of new blood vessels in a mechanism used by tumors
to promote growth and metastasis. VEGF is one of the most critical and
specific angiogenesis factors. Various approaches for the inhibition of
VEGF are currently being reviewed and studied in clinical trials.5
Currently
available anti-VEGF agents have been shown to have serious side effects
such as hypertension, bleeding, and gastrointestinal perforation. There
has been a renewed interest in identifying natural anti-VEGF agents,
given their advantage of being safe for human use. Additionally,
consumption of a plant-based diet has been effective in the prevention
of cancer development.5
One study has shown that Cinnamon (肉桂 ròu guì) is a natural diet-derived source of anti-VEGF agents. 5
It was found that cinnamon and its components (such as type A
procyanidin trimer and tetrameric procyanidins) effectively inhibited
the activity of VEGFR2 kinase as well as VEGF signaling in endothelial
cells. The various aspects of angiogenesis, including endothelial cell
proliferation, migration, as well as tumor-induced blood vessel
formation in mice, were inhibited by CE. Further research is required to
determine the major components responsible for the antiangiogenic
property of CE. As a natural inhibitor of VEGFR2, CE has the potential
to be a routine diet-based strategy for cancer prevention and treatment.
5
8. Alzheimer’s disease
Alzheimer’s
disease (AD) is a progressive, neurodegenerative, and irreversible
brain disorder with symptoms such as memory loss, confusion, impaired
judgments, and loss of language skills.19
Many studies have proven that the accumulation of soluble oligomeric
assemblies of β-amyloid polypeptides [amyloid-beta (Aβ)] play a key role
in AD development.19 Compounds made from natural sources have been reported in many studies to inhibit the formation of Aβ plaques.19 A study found that Cinnamon
(肉桂 ròu guì) extract (CEppt) inhibits the formation of toxic Aβ
oligomers and prevents the toxicity of Aβ on neuronal PC12 cells. In
another study, the oral administration of CEppt to an aggressive AD
transgenic mice model led to the reduction of plaques and improvement in
cognitive behavior. The results showed that the use of natural
compounds such as cinnamon can inhibit toxic oligomeric Aβ species
formation in AD. 19
Extracellular
plaques (such as Aβ) and also intracellular neurofibrillary tangles of
tau can cause the emergence of AD. Tangles are formed in later stages in
relation to amyloid formation and are effective in the process of
neurodegenerative progression.9
Most
of the drugs used for the prevention or treatment of AD are aimed to
inhibit cholinesterase function or amyloid plaque formation. The agents
capable of preventing the tau aggregation may be a key factor in the
development of new drugs.9
Tau
is a protein that displays little to no structure in regular
conditions, and the molecule contains significant polyrich regions. The
effects of an aqueous extract of cinnamon containing proanthocyanidins
was examined on tau aggregation, and it was found that the extract of
the whole cinnamon effectively inhibited the aggregation of human tau in vitro, and this could be attributed to both proanthocyanidin timer and cinnamaldehyde in CE. 9
9. Antigastric ulcer
Helicobacter pylori
is a major cause of chronic gastritis, peptic ulceration, and gastric
cancer. Probiotic bacteria have been used for the inhibition of H. pylori
and intestinal pathogens, prevention of inflammatory bowel diseases,
reduction of the risks associated with mutagenicity and carcinogenicity,
and improvement of the immune system. 20 Yogurt containing bifidobacterium and Lactobacillus acidophilus can suppress the growth of H. pylori in infected clinical patients. 20 Behrad et al 20 showed that cinnamon yogurt exerted the strongest inhibitory effect on H. pylori growth in vitro in comparison with licorice yogurt and control yogurt for both strains tested. 20
The
study showed that cinnamon preparations traditionally used for the
treatment of gastrointestinal disorders are effective on suppressing H. pylori with little or no adverse reactions. These preparations could provide a potent anti-H. pylori effect that overcomes the problem of resistance to antibiotic treatments. 21
Simethicone
is the medication most commonly used in treating dyspepsia. A study
showed that the use of a cinnamon stomachic mixture is effective in
alleviating the symptoms of dyspepsia by 70% and is similar to
simethicone. The longer use of cinnamon stomachic mixture can increase
the favorable response up to 80%, and it is considered safe, effective,
and affordable compared to simethicone.22
10. Antibacterial, antifungal
Cinnamon (肉桂 ròu guì) oil has the most potential bactericidal properties. 16
The antibacterial activity of cinnamon oil has been demonstrated, and
it has been shown that cinnamon oil alone or in combination with
triclosan, gentamicin, or chlorhexidine can effectively inhibit biofilm
formation, detach existing biofilms, and kill bacteria in biofilms of
clinical Staphylococcus epidermidis strains. Another advantage
of the essential oil over antibiotics may be that bacteria do not
develop resistance to essential oils. 23 However, further study is needed to clarify the complex mode of action of cinnamon and its components against biofilms of S. epidermidis and other clinically relevant microbes. 23
Cinnamaldehyde is one of the main components of cinnamon oil.23
Cinnamaldehyde has been shown to destroy the cytoplasmic membrane of
both Gram-positive and Gram-negative bacteria and induce depletion of
the intracellular ATP concentration. Cinnamaldehyde inhibits the growth
of fungi, including yeasts, filamentous molds, and dermatophytes, as
well as the eggs and adults of human head lice, Pediculus humanus capitis. Aqueous and alcohol extracts of cinnamon also have demonstrated antibacterial effects against H. pylori. 15
Cinnamon osmophloeum
Kaneh (Lauraceae), named as “indigenous cinnamon tree,” is one of the
hardwood species that possesses significant antifungal activity. C. osmophloeum
is an endemic tree that grows in Taiwan’s natural hardwood forest, and
the chemical constituents of the essential oils found in its leaves are
similar to those of C. cassia bark oil. The leaf essential oils of C. osmophloeum were found to have strong inhibitory effects on the growth of fungi. 24
Cinnamaldehyde, the major compound in leaf essential oils, had the
strongest antifungal activities compared with the other components.
People can simply harvest the leaves to obtain a large amount of natural
bioactive essential oils or cinnamaldehyde without debarking the trees;
this could potentially lead to the development of wood decay
preservation agents or fumigants in the future. 24
11. Nematicidal
There
is a growing public concern for the environmental effects of pesticides
on human health and the increase of undesirable effects on nontarget
organisms by repeated applications of chemical pesticides.25
Natural alternative sources such as plant essential oils have been
suggested because they degrade to nontoxic products and have few harmful
effects on nontarget organisms and the environment.25
Pine wood nematode, Bursaphelenchus xylophilus, is associated with dead or dying conifers such as pines throughout North America and Japan. 25 In one study, the nematicidal activities of two cassia oils and four Cinnamon (肉桂 ròu guì) oils were evaluated, and the results showed that they are active against adult B. xylophilus and might be a good choice as a natural control agent. 25 The study showed that cinnamaldehyde is the most toxic compound against adult B. xylophilus, followed by (E)-2 methoxy cinnamaldehyde and (E)-cinnamic acid. 25
12. Acaricidal and repellent effect
House dust mites (Dematophagoides farina, Dematophagoides pteronyssinus)
are a major source of allergy in human households causing symptoms such
as atopic dermatitis, asthma, perennial rhinitis, and even infant death
syndrome. The use of chemical methods or treatment with repellents such
as DEET and benzyl benzoate are related to the control of mite species.
26
However, the repeated use of these chemicals has resulted in the
development of resistance against such chemicals and raised concerns
regarding their effect on human health. 26
It
is more effective to repel than to kill house mites because the
allergen does not come from living dust mites but from their dead bodies
or fecal particles.26
To control house dust mites, it is better to find natural repellent
materials such as plants with a range of bioactive chemicals.26 The concentrated essential oil of Cinnamon
(肉桂 ròu guì) has been tested for its acaricidal and repellent effect
against house dust mites and has been shown to be a very effective
material for this particular purpose, and could also reduce chemical
resistance and harmful effects on human health. 26
13. Safety
Cinnamon
(肉桂 ròu guì) has been used in food preparation and as medicinal
remedies from ancient times. It is the most frequently consumed spice
and is both safe and relatively inexpensive. 14 In one study, the intake of up to 6 g/d of C. cassia
for > 40 days did not show any adverse effects. The most common
adverse effects related to the excessive use of cinnamon were irritation
and allergic reaction in skin or mucus membranes. 15
According to the United States Food and Drug Administration, Cinnamon spp., including common cinnamon and cassia cinnamon, are generally safe and well tolerated in amounts commonly found in food. 15
Cinnamon oil has also being listed and recognized as safe and is exempt
from toxicity data requirements by the US Environmental Protection
Agency. 25
14. Conclusion
Cinnamon
(肉桂 ròu guì) has been used as a spice for flavoring foods and as a
natural traditional remedy in many cultures throughout the world. From
the findings of various studies, it can be concluded that cinnamon
possess many specific functional properties such as antioxidant,
anti-inflammatory, antimicrobial, and acaricidal activities, in addition
to its medicinal values in relieving and treating a number of serious
illnesses such as diabetes, hyperlipidemia, gastrointestinal disorders,
AD, and cancer. Further studies are required to determine the
effectiveness of the active principles of cinnamon and their therapeutic
effects in the prevention and treatment of such diseases.
Conflict of interest
I
Rafie Hamidpour Sign on behalf of all authored and as Corresponding
authored that we have no conflict of interest with anyone and any agency
at all.
References
- 1
- In vitro anticandidal activity of Cinnamomum verum
- J Med Sci, 8 (2008), pp. 425–428
- |
- 2
- Antibacterial properties and major bioactive component of cinnamon stick (Cinnamomum burmannii): activity against food has borne pathogenic bacteria
- J Agric Food Chem, 55 (2007), pp. 5484–5490
- | |
- 3
- Effects of Cinnamomum zeylanicum (Ceylon cinnamon) on blood glucose and lipids in a diabetic and healthy rat model
- Pharmacognosy Res, 4 (2012), pp. 73–79
- | |
- 4
- Evaluation of the biological effects for adding cinnamon volatile oil and TBHQ as antioxidant on rats’ lipid profiles
- Asian J Plant Sci, 11 (2012), pp. 100–108
- |
- 5
- Novel angiogenesis inhibitory activity in cinnamon extract blocks VEGFR2 kinase and downstream signaling
- Carcinogenesis, 31 (2010), pp. 481–488
- | |
- 6
- The effect of cinnamaldehyde on mucositis and salivary antioxidant capacity in gamma-irradiated rats (a preliminary study)
- J Pharm Sci, 20 (2012), p. 89
- 7
- Anti-inflammatory activity of cinnamon water extract in vivo and in vitro LPS-induced models
- BMC Complement Altern Med, 12 (2012), p. 237
- | |
- 8
- The effect of the cinnamon on dog's heart performance by focus on Korotkoff sounds
- J Anim Vet Adv, 11 (2012), pp. 3604–3608
- |
- 9
- Cinnamon extract inhibits tau aggregation associated with Alzheimer's disease in vitro
- J Alzheimers Dis, 17 (2009), pp. 585–597
- |
- 10
- Effect of various doses of cinnamon on blood glucose in diabetic individuals
- Pak J Nutr, 3 (2004), pp. 268–272
- 11
- Effect of cinnamon on glucose control and lipid parameters
- Diabetes Care, 31 (2008), pp. 41–43
- | |
- 12
- Antioxidant effects of a cinnamon extract in people with impaired fasting glucose that are overweight or obese
- J Am Coll Nutr, 28 (2009), pp. 16–21
- | |
- 13
- Effect of a water- soluble cinnamon extract on body composition and features of the metabolic syndrome in pre-diabetic men and women
- J Int Soc Sports Nutr, 3 (2006), pp. 45–53
- | |
- 14
- Isolation and characterization of polyphenol type-A polymers from cinnamon with insulin- like biological activity
- J Agric Food Chem, 52 (2004), pp. 65–70
- | |
- 15
- From type 2 diabetes to antioxidant activity: a systematic review of the safety and efficacy of common and cassia cinnamon bark
- Can J Physiol Pharmacol, 85 (2007), pp. 837–847
- | |
- 16
- In vitro antibacterial activity of some plant essential oils
- BMC Complement Altern Med, 6 (2006), p. 39
- | |
- 17
- Aqueous cinnamon extract (ACE-c) from the bark of Cinnamomum Cassia causes apoptosis in human cervical cancer cell line (SiHa) through loss of mitochondrial membrane potential
- BMC Cancer, 10 (2010), p. 210
- 18
- Cinnamon extract suppresses tumor progression by modulating angiogenesis and the effecter function of CD8+ T cells
- Cancer Lett, 278 (2009), pp. 174–182
- | | |
- 19
- orally administrated cinnamon extract reduces β-Amyloid oligomerization and corrects cognitive impairment in Alzheimer's disease animal models
- PLoS One, 28 (2011), p. e16564
- 20
- Manipulation of probiotics fermentation of yogurt by cinnamon and licorice: effects on yogurt formation and inhibition of Helicobacter pylori growth in vitro
- World Acad Sci Eng Technol, 60 (2009), pp. 590–594
- |
- 21
- Efficacy of ginger and cinnamon pharmaceutical preparations in patients with Helicobacter pylori-associated functional dyspepsia
- Prime J Microbiol Res, 2 (2012), pp. 67–72
- |
- 22
- Efficacy and safety of cinnamon stomachic mixture for patients with functional dyspepsia
- Siriraj Med J, 58 (2006), pp. 1103–1106
- |
- 23
- Effect of cinnamon oil on IcaA expression and biofilm formation by Staphylococcus epidermidis
- Appl Environ Microbiol, 75 (2009), pp. 6850–6855
- | |
- 24
- Antifungal activities of essential oils and their constituents from indigenous cinnamon (Cinnamomum osmophloeum) leaves against wood decay fungi
- Bioresour Technol, 96 (2005), pp. 813–818
- | | |
- 25
- Nematicidal activity of cassia and cinnamon oil compounds and related compounds toward Bursaphelenchus xylophilus (Nematoda: Parasitaphelenchidae)
- J Nematol, 39 (2007), pp. 31–36
- |
- 26
- The acaricidal and repellent effect of cinnamon essential oil against house dust mite
- World Acad Sci Eng Technol, 60 (2011), pp. 710–714
- |
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