The Promising Therapeutic Effects of Pomegranate (Punica granatum) on Gastric Ulcers: A Comprehensive Review on Antioxidant, Anti-inflammatory Properties and Molecular Mechanisms

Peptic ulcer disease is a common gastrointestinal disorder. The current treatment for gastric ulcers (GUs) is pharmacological interventions including antacids, mucosal defensive agents, H2-receptor blockers, proton pump inhibitors (PPIs) as well as antibiotics targeting H. pylori infections. Additionally, there has been an increasing focus on the application of natural treatments, such as pomegranate extracts, which have significant potential in the prevention and management of GUs. The therapeutic effects of pomegranate (Punica granatum) on GUs include its ability to inhibit ulcer formation, reduce gastric acidity, and promote the healing of gastric mucosal lesions. This is attributed to the antioxidant, anti-inflammatory, and antimicrobial properties of the active constituents in pomegranate such as polyphenols, flavonoids, tannins, and anthocyanins. The results of this study showed that pomegranate extracts could significantly suppress gastric ulceration, reduce tissue lipid peroxidation, and enhance the levels of antioxidative enzymes. Pomegranate exerts its anti-inflammatory effects through the suppression of pro-inflammatory cytokine synthesis, including TNF-α, IL-1β, and IL-6. Additionally, pomegranate extracts increase the production of gastric mucosal protective factors such as PGE2 and NO, and have antimicrobial activity against H. pylori. Overall, while pomegranate showed promise as a natural remedy for the prevention and management of GUs, further research is needed to optimize its therapeutic efficacy.