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Mastic

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Background & General Info

Mastic gum is an aromatic lemon-white resin secreted from the stem of Pistacia lentiscus, an evergreen shrub that is very commonly distributed in the eastern Mediterranean region but is cultivated uniquely in Chios, a Greek island in the Aegean off the Anatolian coast. It is acquired as an exudate by “hurting” the trunk and branches of the plant and is called the “Chios tears” because of its shape. [1][2]



Botany

Pistacia lentiscus is an evergreen tree or shrub with alternately arranged, leathery, and pinnately compound leaves with winged petioles and five or six pairs of deep-green leaflets. Its stem is reddish in coloration at an early stage of growth but becomes grayish upon maturity. Although rarely present, the fruit is a drupe that transitions in appearance from red to black when ripe. [2]

History & Traditional Use

For more than 2,500 years, mastic gum has long been indicated in the traditional Greek medicinal system for a variety of gastrointestinal disorders such as stomach pain, dyspepsia, and peptic ulcer. In fact, its therapeutic properties had been mentioned in the works of the likes of Hippocrates, Dioscorides, Theophrastos, and Galenos, well-known ancient Greek physicians who recommended its use. [1] A number of Roman, Byzantine, Arab, and European authors had also extensively cited mastic’s healing properties. [3] Apart from its traditional remedial use, mastic gum is at present used as a seasoning in Mediterranean cuisines, in the production of chewing gum and food products, in perfumery, and in dentistry. [1]

General Herbal Uses

The essential oil and gum of the mastic tree are both used as natural antimicrobial agents with extensive uses in medicine, especially as a deterrent to gastric diseases and ulcers by acting against Helicobacter pylori according to evidence from modern in vivo and in vitro scientific research. [3][4] Mastic gum is also used as remedy for liver inflammation and disorders associated with the stomach and intestine and is said to be beneficial for the teeth. [5] There is ample evidence that points out the hepatoprotective, cardioprotective, and antiatherogenic properties of mastic gum. [6] Moreover, a number of studies have proven the antimicrobial, antifungal, antioxidant, hypolipidemic, anti-inflammatory, anti-Crohn, and anticancer properties of mastic, making it a therapeutic resin with a wide range of applications as a nature-originated treatment. [3]



Constituents/Active Components

According to a 2005 chemical analysis using gas chromatography–mass spectrometry (GC–MS), alpha-pinene, beta-myrcene, beta-pinene, limonene, and beta-caryophyllene are the chief components of mastic oil and gum. [4] A 2014 Japanese study also analyzed the chemical composition of mastic gum essential oil through GC–MS and identified its components, which are tabulated below, with α-pinene being the major constituent: [7]

Mastic Compounds

Medicinal/Scientific Research

Anti-inflammatory

A 2010 study demonstrated the anti-inflammatory and antioxidant effects of mastic gum. Mastic gum significantly inhibited the carrageenan-induced edema at all doses, denoting anti-inflammatory activity. At an intraperitoneal dose of 800 mg/kg, it completely inhibited the inflammation without producing any toxicity in mice. Mastic gum also showed weak DPPH and nitric oxide scavenging activities and good ferrous iron (Fe2+)-chelating ability. [8] Based on the research results of Triantafyllou et al. (2011), the anti-inflammatory property of Chios mastic gum is linked to its inhibition of oxidative stress elicited by tumor necrosis factor-alpha (TNF-α). Mastic gum dose-dependently prevented the cellular production of superoxide and H2O2 in aortic smooth muscle cells of rats treated with TNF-α and entirely eliminated the increase in cellular TNF-α-stimulated superoxide production. In addition, mastic gum had been revealed to inhibit the activity of purified protein kinase C, to diminish the activity of protein kinase C in cell homogenate, and to attenuate the production of superoxide in cells. [5]

Anticancer

Recently, several studies have further investigated the potential antiproliferative or anticancer properties of mastic gum against various types of human neoplasia and the triterpenoid constituents of mastic gum emerge to be largely accountable to its anticancer potential. [6] Balan et al. (2007) reported that compounds from 50% ethanol extract of Chios mastic gum inhibit the proliferation and trigger the death of HCT116 human colon cancer cells in vitro. Chios mastic gum had been noted to time- and dose-dependently cause induction of cell arrest at G1 phase of cell cycle; detachment of the cancer cells from the substrate; activation of procaspase-8, procaspase-9, and procaspase-3; and a number of apoptotic morphological changes in cell organelles. Additionally, it seems that Chios mastic gum kills cancer cells through a pathway not associated with death receptor- and mitochondrion-dependent pathways since its induction of apoptosis was not suppressed in HCT116 cell clones that expressed high levels of the anti-apoptotic protein, Bcl-2, or dominant-negative FADD. [9]

Antibacterial And Antifungal

An early preliminary 1996 study established the in vitro antimicrobial activity of extracts from Pistacia lentiscus, the evergreen shrub from which the aromatic mastic resin is obtained from, especially on the Greek island of Chios. Decoctions produced from mastic demonstrated the best antibacterial activity against Sarcina lutea, Staphylococcus aureus, and Escherichia coli and interesting antimicrobial effect against the fungi Candida albicans, Candida parapsilosis, Torulopsis glabrata, and Cryptococcus neoformans. [10]

A 2010 randomized pilot study confirmed the bactericidal activity of mastic gum against Helicobacter pylori, a Gram-negative bacteria notorious for causing infection and chronic inflammation in the stomach lining. Four out of thirteen patients who received 350 mg of pure mastic gum and five out of thirteen patients administered with 1.05 g of pure mastic gum, both thrice a day for 14 days, had eradication of Helicobacter pylori, as confirmed by a (13)C urea breath test (UBT). In this study wherein UBT testing was performed 5 weeks after the conclusion of the Helicobacter pylori eradication regime, excellent tolerance with mastic gum was observed among all patients, with no serious adverse events having been documented. [11] Treatment using total mastic extract without polymer at an average dose of 0.75 mg/day for 3 months caused a nearly 30-fold reduction in the Helicobacter pylori colonization (1.5 log CFU/g of tissue) in mice infected with Helicobacter pylori SS1. Furthermore, in a test for in vitro activity against a panel of 11 Helicobacter pylori clinical strains, the acid fraction of mastic extract was demonstrated to be most active, with a minimum bactericidal concentration (MBC) of 0.139 mg/mL. The most active pure compound was found to be isomasticadienolic acid, with an MBC of 0.202 mg/mL. [1]

By employing disk diffusion method, Koutsoudaki et al. (2005) investigated the antibacterial activity of 12 components of mastic oil and identified verbenone, alpha-terpineol, and linalool as among the many trace components that seem to be responsible for the antibacterial activity of mastic oil. [4] Active constituents of mastic had been astoundingly verified by Miyamoto et al. (2014) to show antibacterial activity against clarithromycin-resistant and/or metronidazole-resistant Helicobacter pylori strains. In particular, (E)-methyl isoeugenol and α-terpineol were potent against drug-sensitive and drug-resistant strains and displayed much higher antibacterial activity against Helicobacter pylori than the same dose of the mastic essential oil itself. [7]

Peptic Ulcer

Local populations of Chios employ mastic to relieve gastralgia (or stomach pain) and prevent the occurrence of peptic ulcer. [1] An early double-blind clinical trial carried in 1984 determined the ability of mastic to heal ulcers in patients diagnosed with symptomatic and endoscopically proven duodenal ulcers. In this study, oral daily intake of 1 gram of mastic by 20 patients for 2 weeks led to symptomatic relief in 80% of patients and endoscopically proven healing in 70% of patients, with a highly significant difference between mastic treatment and placebo (p<0.01). Moreover, the mastic treatment was well tolerated by patients and did not cause side effects. [12] Later on, in 1986, a study provided observations that verified the clinical effectiveness of mastic as treatment of duodenal ulcer, which was elucidated to be likely attributable to mastic’s mild antisecretory and localized adaptive cytoprotectant activities. Gastric and duodenal ulcers were experimentally stimulated in rats in this study, and mastic was orally provided at a dose of 500 mg/kg. Its administration significantly reduced the intensity of gastric mucosal damage and decreased the free acidity in 6-hour pylorus-ligated rats. A discernible cytoprotective effect was also observed against 50% ethanol in rats. [13]

Dyspepsia

Findings from a 2010 prospective randomized double-blind placebo-controlled trial evinced the efficacy of mastic gum to considerably improve symptoms of functional dyspepsia in patients, including general stomach pain, stomach pain associated with anxiety, dull discomfort in the upper abdomen, and heartburn. The trial randomly assigned 148 patients suffering from functional dyspepsia to either Chios mastic gum treatment at a dose of 350 mg three times a day or placebo. The symptom scores of patients receiving mastic gum, as evaluated using the Hong Kong index of dyspepsia, were significantly lower than those of the placebo group, with 77% of mastic-treated individuals having been discerned to have marked symptomatic improvement. [14]

Contraindications, Interactions, And Safety

Mastic gum and essential oil is generally safe to use, with adverse reaction only limited to hypersensitivity and no drug interactions having been documented. Because of insufficient information and research data, pregnant and breastfeeding women should avoid its use without a medical professional’s supervision.

References:

[1] S. Paraschos, P. Magiatis, S. Mitakou, K. Petraki, et al., "In vitro and in vivo activities of Chios mastic gum extracts and constituents against Helicobacter pylori," Antimicrobial Agents and Chemotherapy, vol. 51, no. 2, p. 551–559, 2007. https://www.ncbi.nlm.nih.gov/pubmed/17116667

[2] "Pistacia lentiscus," Codif Recherche & Nature. http://www.codif-tn.com/wp-content/uploads/2016/02/LAKESIS-FICHE-BOTANIQUE-GB.pdf

[3] S. Paraschos, S. Mitakou and A. Skaltsounis, "Chios gum mastic: A review of its biological activities," Current Medicinal Chemistry, vol. 19, no. 14, p. 2292–2302, 2012. https://www.ncbi.nlm.nih.gov/pubmed/22414110

[4] C. Koutsoudaki, M. Krsek and A. Rodger, "Chemical composition and antibacterial activity of the essential oil and the gum of Pistacia lentiscus var. chia," Journal of Agricultural and Food Chemistry, vol. 53, no. 20, p. 7681–7685, 2005. https://www.ncbi.nlm.nih.gov/pubmed/16190616

[5] A. Triantafyllou, A. Bikineyeva, A. Dikalova, et al., "Anti-inflammatory activity of Chios mastic gum is associated with inhibition of TNF-alpha induced oxidative stress," Nutrition Journal, vol. 10, p. 64, 2011. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127998/

[6] C. Giaginis and S. Theocharis, "Current evidence on the anticancer potential of Chios mastic gum," Nutrition and Cancer, vol. 63, no. 8, p. 1174–1184, 2011. https://www.ncbi.nlm.nih.gov/pubmed/22044444

[7] T. Miyamoto, T. Okimoto and M. Kuwano, "Chemical composition of the essential oil of mastic gum and their antibacterial activity against drug-resistant Helicobacter pylori," Natural Products and Bioprospecting, vol. 4, no. 4, p. 227–231, 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4111869/

[8] M. Mahmoudi, M. Ebrahimzadeh, S. Nabavi, S. Hafezi, S. Nabavi and S. Eslami, "Antiinflammatory and antioxidant activities of gum mastic," European Review for Medical and Pharmacological Sciences, vol. 14, no. 9, p. 765–769, 2010. https://www.ncbi.nlm.nih.gov/pubmed/21061835

[9] K. Balan, J. Prince, Z. Han, K. Dimas, et al., "Antiproliferative activity and induction of apoptosis in human colon cancer cells treated in vitro with constituents of a product derived from Pistacia lentiscus L. var. chia," Phytomedicine, vol. 14, no. 4, p. 263–272, 2007. https://www.ncbi.nlm.nih.gov/pubmed/16713222

[10] L. Iauk, S. Ragusa, A. Rapisarda, S. Franco and V. Nicolosi, "In vitro antimicrobial activity of Pistacia lentiscus L. extracts: preliminary report," Journal of Chemotherapy, vol. 8, no. 3, p. 207–209, 1996. https://www.ncbi.nlm.nih.gov/pubmed/8808717

[11] K. Dabos, E. Sfika, L. Vlatta and G. Giannikopoulos, "The effect of mastic gum on Helicobacter pylori: a randomized pilot study," Phytomedicine, vol. 17, no. 3–4, p. 296–299, 2010. https://www.ncbi.nlm.nih.gov/pubmed/19879118

[12] M. Al-Habbal, Z. Al-Habbal and F. Huwez, "A double-blind controlled clinical trial of mastic and placebo in the treatment of duodenal ulcer," Clinical and Experimental Pharmacology and Physiology, vol. 11, no. 5, p. 541–544, 1984. https://www.ncbi.nlm.nih.gov/pubmed/6395994

[13] M. Al-Said, A. Ageel, N. Parmar and M. Tariq, "Evaluation of mastic, a crude drug obtained from Pistacia lentiscus for gastric and duodenal anti-ulcer activity," Journal of Ethnopharmacology, vol. 15, no. 3, p. 271–278, 1986. https://www.ncbi.nlm.nih.gov/pubmed/3724207

[14] K. Dabos, E. Sfika, L. Vlatta, et al., "Is Chios mastic gum effective in the treatment of functional dyspepsia? A prospective randomised double-blind placebo controlled trial," Journal of Ethnopharmacology, vol. 127, no. 2, p. 205–209, 2010. https://www.ncbi.nlm.nih.gov/pubmed/19961914

Article researched and created by Dan Albir for herbs-info.com. © herbs-info.com 2018

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