A COMPREHENSIVE SYSTEMATIC REVIEW ON THE GASTROPROTECTIVE POTENTIAL AND MECHANISM OF ACTION OF LIMONIA ACIDISSIMA IN PEPTIC ULCER DISEASE

Background: Peptic Ulcer Disease (PUD) remains a significant global health burden, driven primarily by Helicobacter pylori infections and the widespread use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). While synthetic treatments like Proton Pump Inhibitors (PPIs) are effective, their long-term use is limited by adverse effects and rising antibiotic resistance. Limonia acidissima L. (Wood Apple), a plant deeply rooted in Ayurvedic medicine, has emerged as a promising phytotherapeutic candidate for gastroprotection. Objective: This systematic review aims to evaluate the phytochemical profile, pharmacological mechanisms, and safety of L. acidissima in the management of PUD. Methods: The review analyzes evidence from diverse experimental models, including ethanol, indomethacin, and pylorus ligation-induced ulcers in Wistar rats. It explores the synergistic role of secondary metabolites such as coumarins (luvangetin, marmesin), flavonoids, and tannins. Results: The findings reveal a "three-pronged" mechanism of action 1. Anti-secretory: Significant reduction in gastric acid volume and inhibition of the H+/K+ ATPase pump. 1. Cytoprotective: Enhancement of the gastric mucus-bicarbonate barrier and physical shielding of the mucosa. 2. Antioxidant: Neutralization of Reactive Oxygen Species (ROS) and restoration of endogenous enzymes (SOD, Catalase, and GSH). Experimental data demonstrate that doses of 400–500 mg/kg achieve an ulcer protection rate (up to 81.0%) comparable to the standard drug Ranitidine. Safety profiles indicate the extract is non-toxic at doses up to 4000 mg/kg. Conclusion: L. acidissima offers a multi-targeted approach to gastroprotection, addressing the imbalance between aggressive and defensive factors. Beyond its therapeutic efficacy, its natural gums and mucilage present significant potential for Novel Drug Delivery Systems (NDDS). While preclinical evidence is robust, further human clinical trials are essential to standardize dosages and integrate this ethnomedicinal resource into modern gastroenterology.