Star fruit (Averrhoa carambola L.): Exploring the wonders of Indian folklore and the miracles of traditional healing

Abstract

Herbal medicines have been used for centuries to treat various ailments and have now gained global importance for their therapeutic and economic implications. One such plant is Averrhoa carambola commonly known as star fruit, a tropical plant belonging to the Oxalidaceae family. With a rich history of traditional medicinal uses in India and Southeast Asia, it has been employed to treat various ailments, including urinary infections, hypertension, diabetes, and gastrointestinal issues. The fruit is popular for its sweet and sour taste and finds culinary use in salads, beverages, and garnishing. The therapeutic potential of A. carambola is attributed to its abundance of natural antioxidants and phenolic compounds such as gallic acid in gallotannin form, catechins, and epicatechins. These bioactive constituents contribute to its medicinal properties and health benefits. However, scientific investigations have revealed potential health risks associated with A. carambola consumption. High oxalic acid content in the fruit poses a risk of toxicity, particularly for individuals with renal impairments who consume excessive fruit juices. Additionally, the presence of caramboxin, a neurotoxin, can interfere with the GABAergic system, leading to neurotoxic effects. This review offers a comprehensive and well-organized examination of the current progress regarding the benefits, phytochemistry, pharmacology, and toxicity of A. carambola. The insights presented in this review have the potential to drive advancements and novel treatments involving star fruit in modern times. As interest in herbal medicines continues to rise, further research on A. carambola holds promise for exploring new therapeutic applications in the realm of natural remedies.

Keywords

• Averrhoa carambola
• Urinary Infections
• Antioxidant
• Neurological disorders
• Caramboxin

References

1. Abeysekera, R.A., Wijetunge, S., Nanayakkara, N., Wazil, A.W.M., Ratnatunga, N.V.I., Jayalath, T., & Medagama, A. (2015). Star fruit toxicity: a cause of both acute kidney injury and chronic kidney disease: a report of two cases. BMC Res. Notes., 8, 1-4.. https://doi.org/10.1186/s13104-015-1640-8
2. Avinash, P., Swapneel, K., Darshana, P., & Anita, P. (2012). A comprehensive review of an important medicinal plant-Averrhoa carambola L. Pharmacognosy Commun, 2(2), 13-7.
3. Azeem, A. K., Mathew, M., & Nair, C. (2010). Hepatoprotective effect of Averrhoa carambola fruit extract on carbon tetrachloride induced hepatotoxicity in mice. Asian Pac J Trop Med., 3(8), 610-613. https://doi.org/10.1016/S1995-7645(10)60148-4
4. Bahramsoltani, R., Kalkhorani, M., Zaidi, S.M.A., Farzaei, M.H., & Rahimi, R. (2020). The genus Tamarix: Traditional uses, phytochemistry, and pharmacology. J. Ethnopharmacol., 246, 112245. https://doi.org/10.1016/j.jep.2019.112245
5. Kamboj, V.P. (2000). Herbal Medicine. Curr. Sci., 78(1), 35-39. https://www.jstor.org/stable/24103844
6. Bircher, A.G., & Bircher, W. H. (2000). Encyclopedia of fruit trees and edible flowering plants in Egypt and the subtropics. American University in Cairo Press.596.
7. Cabrini, D.A., Moresco, H.H., Imazu, P., Silva, C.D.D., Pietrovski, E.F., Mendes, D.A.G.B., ... & Otuki, M.F. (2011). Analysis of the potential topical anti-inflammatory activity of Averrhoa carambola L. in mice .Evid. Based Complementary Altern. Med., 1-7. https://doi.org/10.1093/ecam/neq026
8. Carolino, R.O., Beleboni, R.O., Pizzo, A.B., Del Vecchio, F., Garcia-Cairasco, N., Moyses-Neto, M., ... & Coutinho-Netto, J. (2005). Convulsant activity and neurochemical alterations induced by a fraction obtained from fruit Averrhoa carambola (Oxalidaceae: Geraniales). Neurochem. Int., 46(7), 523-531. https://doi.org/10.1016/j.neuint.2005.02.002

9. Cazarolli, L. H., Folador, P., Moresco, H. H., Brighente, I. M. C., Pizzolatti, M. G., & Silva, F. R. M. B. (2009). Mechanism of action of the stimulatory effect of apigenin-6-C-(2 ″-O-α-l-rhamnopyranosyl)-β-l-fucopyranoside on 14C-glucose uptake. Chem. Biol. Interact., 179(2-3), 407-412. https://doi.org/10.1016/j.cbi.2008.11.012
10. Cazarolli, L.H., Kappel, V.D., Pereira, D F., Moresco, H.H., Brighente, I.M.C., Pizzolatti, M.G., & Silva, F.R.M.B. (2012). Anti-hyperglycemic action of apigenin-6-C-β-fucopyranoside from Averrhoa carambola. Fitoterapia., 83(7), 1176-1183. https://doi.org/10.1016/j.fitote.2012.07.003
11. Chau, C. F., Chen, C. H., & Lee, M. H. (2004). Characterization and physicochemical properties of some potential fibres derived from Averrhoa carambola. Food/Nahrung, 48(1), 43-46. https://doi.org/10.1002/food.200300354
12. Chen, C.L., Fang, H.C., Chou, K.J., Wang, J.S., & Chung, H.M. (2001). Acute oxalate nephropathy after ingestion of star fruit. Am. J. Kidney Dis., 37(2), 418-422. https://scite.ai/reports/10.1053/ajkd.2001.21333
13. Chen, L.L., Fang, J.T., & Lin, J.L. (2005). Chronic renal disease patients with severe star fruit poisoning: hemoperfusion may be an effective alternative therapy. Clin. Toxicol., 43(3), 197-199. https://doi.org/10.1081/CLT-57872
14. Chen, C., Nong, Z., Xie, Q., He, J., Cai, W., Tang, X., ... & Gao, Y. (2017). 2-Dodecyl-6-methoxycyclohexa-2, 5-diene-1, 4-dione inhibits the growth and metastasis of breast carcinoma in mice. Sci. Rep., 7(1), 6704. https://doi.org/10.1038/s41598-017-07162-3
15. Chopra, R.N., & Nayar, S.L. (1956). Glossary of Indian medicinal plants. Council of Scientific and Industrial Research., 1,197
16. Compendium of Medicinal Plants Used in Malaysia (2002), Herbal Medicine Research Centre, Institute for Medical Research. 1, 92. https://books.google.co.th/books?id=smlaKAAACAAJ
17. Dasgupta, P., Chakraborty, P., & Bala, N.N. (2013). Averrhoa carambola: an updated review. Int. j. pharma res. rev., 2(7), 54-63.
18. de Paulo Farias, D., Neri-Numa, I.A., de Araujo, F.F., & Pastore, G.M. (2020). A critical review of some fruit trees from the Myrtaceae family as promising sources for food applications with functional claims. Food Chem., 306, 125630. https://doi.org/10.1016/j.foodchem.2019.125630
19. Dr. Nandkarni, K.M. (1976). Indian Materia Medica. Mumbai. Bombay Popular Prakashan, 1, 165-166.
20. Ferreira, E.B., Fernandes, L.C., Galende, S.B., Cortez, D.A., & Bazotte, R.B. (2008). Hypoglycemic effect of the hydroalcoholic extract of leaves of Averrhoa carambola L.(Oxalidaceae). Rev Bras Farmacogn., 18, 339-343.https://doi.org/10.1590/S0102-695X2008000300005 Ferrara, L. (2018). Averrhoa carambola Linn: is it really a toxic fruit?. Int. J. Med. Rev., 5(1), 2-5. http://doi.org/10.29252/IJMR-050102 Ghani, A. (1998). Medicinal plants of Bangladesh: chemical constituents and uses. Asiatic society of Bangladesh.. 42-48.
21. Gao, Y., Huang, R., Gong, Y., Park, H.S., Wen, Q., Almosnid, N.M., ... & Altman, E. (2015). The antidiabetic compound 2-dodecyl-6-methoxycyclohexa-2, 5-diene-1, 4-dione, isolated from Averrhoa carambola L., demonstrates significant antitumor potential against human breast cancer cells. Oncotarget., 6(27), 24304. https://doi.org/10.18632/oncotarget.4475
22. Garcia‐Cairasco, N., Moyses‐Neto, M., Del Vecchio, F., Oliveira, J.A., dos Santos, F.L., Castro, O.W., Arisi, G.M., Dantas. M., Carolino, R.O., Coutinho‐Netto, J., Dagostin, A.L. (2013). Elucidating the neurotoxicity of the star fruit. Angew. Chem., Int. Ed. Engl., 52, 13067-13070. https://doi.org/10.1002/anie.201305382.
23. Gupta, R., & Gupta, J. (2020). Chromatographic fingerprint analysis of piperine in polyherbal and marketed formulation by HPTLC and GC-MS methods. Curr. Trends Biotechnol. Pharm., 14(2), 164-173. https://doi.org/10.5530/ctbp.2020.2.17
24. Gupta, J., & Gupta, R. (2020). Nutraceutical status and scientific strategies for enhancing production of omega-3 fatty acids from microalgae and their role in healthcare. Curr. Pharm. Biotechnol., 21(15), 1616-1631. https://doi.org/10.2174/1389201021666200703201014.
25. Gupta, R., Gupta, J., & Kumar, D. (2021). Alternative Approaches for Rheumatoid Arthritis Management: Future Perspective, Herbal, Dietary, Lifestyle, Psychological, Nutritional Intervention and Healthcare. J. Pharm. Res. Int., 33(54A), 342-363. https://doi.org/10.9734/JPRI/2021/v33i54A33756
26. Gupta, J., Gupta, R., & Varshney, B. (2021). Green approaches of flavonoids in cancer: chemistry, applications, management, healthcare and future perspectives. J. Pharm. Res. Int., 33(59A), 130-143. https://doi.org/10.9734/JPRI/2021/v33i59A34255
27. Gupta, J., Ahuja, A., & Gupta, R. (2022). Green Approaches for Cancers Management: An Effective Tool for Health Care. Anticancer Agents Med Chem (Formerly Current Medicinal Chemistry-Anti-Cancer Agents)., 22(1), 101-114. https://doi.org/10.2174/1871520621666210119091826.
28. Goncalves, S. T., Baroni, S., Bersani-Amado, F.A., Melo, G.A., Cortez, D. A., Bersani-Amado, C.A., & Cuman, R.K. (2006). Preliminary studies on gastric anti-ulcerogenic effects of Averrhoa carambola in Rats. Acta Farm Bonaer., 25(2), 245. https://doi.org/ 10.1002/fsn3.2135
29. Gunawardena, D.C., Jayasinghe, L., & Fujimoto, Y. (2015). Phytotoxic constituents of the fruits of Averrhoa carambola. Chem. Nat. Compd., 51, 532-533. https://doi.org/10.1007/s10600-015-1332-6
30. Jain, J.B., Kumane, S.C., Bhattacharya, S. (2006). Medicinal flora of Madhya Pradesh and Chhattisgarh – A review. Indian J. Tradit. Knowl., 5(2), 237-242.
31. Jia, X., Yang, D., Xie, H., Jiang, Y., & Wei, X. (2017). Non-flavonoid phenolics from Averrhoa carambola fresh fruit. J. Funct. Foods., 32, 419-425. https://doi.org/10.1016/j.jff.2017.03.025
32. Jia, X., Yang, D., Yang, Y., & Xie, H. (2019). Carotenoid-derived flavor precursors from Averrhoa carambola fresh fruit. Molecules., 24(2),256 https://doi.org/10.3390/molecules24020256
33. Kirtikar, K.R., & Basu, B.D. (1987). Indian Medicinal Plants. International Book Distributors, Dehradun. Volume I-IV, 355-440.
34. Kirtikar, K.R., & Basu, B.D. (2005). Indian Medicinal Plants, Dehradun: International Book Distributors. Booksellers and Publishers, 1(4), 23-25.
35. Li, J., Wei, X., Xie, Q., Hoa Pham, T.T., Wei, J., He, P., ... & Huang, R. (2016). Protective Effects of 2-Dodecyl-6-Methoxycyclohexa-2, 5-Diene-1, 4-Dione Isolated from Averrhoa carambola L.(Oxalidaceae) roots on high-fat diet-induced obesity and insulin resistance in mice. Cell. Physiol. Biochem., 40(5), 993-1004.https://doi.org/10.1159/000453156
36. Liao, P., Zhou, Z., Chen, Y., Chen, H., Pan, W., Yang, X., & Huang, Z. (2019). Chemical constituents of the water extracts of Averrhoa carambola L. root and their biological activities. Natural Product Research and Development, 31(1), 81-86. http://doi.org/10.16333/j.1001-6880.2019.1.013
37. Lu, S., Zhang, H., Wei, X., Huang, X., Chen, L., Jiang, L., ... & Huang, R. (2019). 2-dodecyl-6-methoxycyclohexa-2, 5-diene-1, 4-dione isolated from Averrhoa carambola L. root ameliorates diabetic nephropathy by inhibiting the TLR4/MyD88/NF-κB pathway. Diabetes Metab Syndr Obes : Targets Ther., 12, 1355-1363. https://doi.org/10.2147/DMSO.S209436
38. Luan, F., Peng, L., Lei, Z., Jia, X., Zou, J., Yang, Y., ... & Zeng, N. (2021). Traditional uses, phytochemical constituents and pharmacological properties of Averrhoa carambola L.: A review. Front. Pharmacol., 12, 699899. https://doi.org/10.3389/fphar.2021.699899
39. Manda, H., Vyas, K., Pandya, A., & Singhal, G. (2012). A complete review on: Averrhoa carambola. World J Pharm Pharm Sci, 1(1), 17-33.
40. Maqsood, S., Adiamo, O., Ahmad, M., & Mudgil, P. (2020). Bioactive compounds from date fruit and seed as potential nutraceutical and functional food ingredients. Food Chem., 308, 125522. https://doi.org/10.1016/j.foodchem.2019.125522
41. Martin, L.C., Caramori, J.S.T., Barreti, P., & Soares, A. (1993). Intractable hiccups induced by carambola (Averrhoa carambola) ingestion in patients with end-stage renal failure. J Bras Nefrol, 15, 92-94.
42. Mia, M.M., Rahman, M.S., Begum, K., Begum, B., & Rashid, M.A. (2007). Phytochemical and biological studies of Averrhoa carambola. Dhaka Univ. J. Pharm. Sci., 6(2), 125-128.. https://doi.org/10.3329/dujps.v6i2.688 Morton, J.F. (1987) Fruits of Warm Climates. Flair Books, Miami FL. 125–128. http://www.hort.purdue.edu/newcrop/morton/banana.html Muir, C.K., & Lam, C.K. (1980). Depressant action of Averrhoa carambola. Med J Malaysia, 34(3), 279-80.
43. Mukherjee, P.K. (2002). Quality control of herbal drugs: an approach to evaluation of botanicals. Business horizons., 2, 39-98.
44. Napahde, S., Durve, A., Bharati, D., & Chandra, N. (2010). Wine production from Carambola (Averrhoa carambola) juice using Saccharomyces cerevisiae. Asian J Exp Biol Sci, 1, 20-23.
45. Neto, M.M., da Costa, J.A.C., Garcia‐Cairasco, N., Netto, J.C., Nakagawa, B., & Dantas, M. (2003). Intoxication by star fruit (Averrhoa carambola) in 32 uraemic patients: treatment and outcome. Nephrol. Dial. Transplant., 18(1), 120-125. https://doi.org/10.1093/ndt/18.1.120
46. Nordby, H.E., & Hall, N.T. (1979). Lipid markers in chemotaxonomy of tropical fruits: Preliminary Studies with carambola and loquat. In Proceedings of the Florida State Horticultural Society, 92, 298-299.
47. Orwa, C., Mutua, A., Kindt, R., Jamnadass, R., & Simons, A. (2009). Agroforestree Database: a tree reference and selection guide. Version 4. Agroforestree Database: a tree reference and selection guide. Version 4. https://apps.worldagroforestry.org/treedb/
48. Pang, D., You, L., Li, T., Zhou, L., Sun-Waterhouse, D., & Liu, R.H. (2016). Phenolic profiles and chemical-or cell-based antioxidant activities of four star fruit (Averrhoa carambola) cultivars. Rsc Advances, 6(93), 90646-90653. https://doi.org/10.1039/c6ra15692d
49. Pang, D., You, L., Zhou, L., Li, T., Zheng, B., & Liu, R.H. (2017). Averrhoa carambola free phenolic extract ameliorates nonalcoholic hepatic steatosis by modulating mircoRNA-34a, mircoRNA-33 and AMPK pathways in leptin receptor-deficient db/db mice. Food Funct., 8(12), 4496-4507.https://doi.org/10.1039/c7fo00833c
50. Patel, M.V., Patel, K.B., Gupta, S., Michalsen, A., Stapelfeldt, E., & Kessler, C.S. (2015). A complex multiherbal regimen based on Ayurveda medicine for the management of hepatic cirrhosis complicated by ascites: nonrandomized, uncontrolled, single group, open-label observational clinical study. Evid. Based Complementary Altern. Med., 2015. https://doi.org/10.1155/2015/613182
51. Patil, A.G., Patil, D.A., Phatak, A.V., & Chandra, N. (2010). Physical and chemical characteristics of carambola (Averrhoa carambola L.) fruit at three stages of maturity. Int. j. appl. biol. pharm., 1(2), 624-629.
52. Prati, P., Nogueira, J.N., & Dias, C.T.D.S. (2002). Avaliação de carambola (Averrhoa carambola L.) dos tipos doce e ácido para o processamento de fruta em calda. Bol. Cent. Pesqui. Process. Aliment., 20(2), 221-246 .https://doi.org/10.5380/cep. v20i2.1249
53. Roopa, N., Chauhan, O. P., Raju, P. S., Das Gupta, D.K., Singh, R.K.R., & Bawa, A.S. (2014). Process optimization for osmo-dehydrated carambola (Averrhoa carambola L) slices and its storage studies. . Food Sci. Technol., 51, 2472-2480. https://doi.org/10.1007/s13197-012-0756-2
54. Sheth, A. (2005). The Herbs of Ayurveda. Sheth publisher.1, 1-140. Shui, G., & Leong, L.P. (2004). Analysis of polyphenolic antioxidants in star fruit using liquid chromatography and mass spectrometry. J. Chromatogr. A, 1022(1-2), 67-75.
55. Siddika, A., Zahan, T., Khatun, L., Habib, M.R., Aziz, M.A., Tareq, A.R.M., ... & Karim, M.R. (2020). In vivo the antioxidative extract of Averrhoa carambola Linn. leaves induced apoptosis in Ehrilch ascites carcinoma by modulating p53 expression. Food Sci. Biotechnol., 29, 1251-1260.https://doi.org/10.1007/s10068-020-00775-x
56. Silva, K.D.R.R., & Sirasa, M.S.F. (2018). Antioxidant properties of selected fruit cultivars grown in Sri Lanka. Food Chem., 238, 203-208. https://doi.org/10.1016/j.foodchem.2016.08.102 Soncini, R., Santiago, M. B., Orlandi, L., Moraes, G. O., Peloso, A. L. M., dos Santos, M. H., ... & Giusti-Paiva, A. (2011). Hypotensive effect of aqueous extract of Averrhoa carambola L.(Oxalidaceae) in rats: An in vivo and in vitro approach. J. Ethnopharmacol., 133(2), 353-357.https://doi.org/10.1016/j.jep.2010.10.001
57. Soncini, R., Santiago, M.B., Orlandi, L., Moraes, G.O., Peloso, A.L.M., dos Santos, M.H., ... & Giusti-Paiva, A. (2011). Hypotensive effect of aqueous extract of Averrhoa carambola L.(Oxalidaceae) in rats: An in vivo and in vitro approach. J. Ethnopharmacol., 133(2), 353-357.https://doi.org/10.1016/j.jep.2010.10.001
58. Sritharan, T., Savitri Kumar, N., Jayasinghe, L., Araya, H., & Fujimoto, Y. (2019). Isocoumarins and dihydroisocoumarins from the endophytic fungus Biscogniauxia capnodes isolated from the fruits of Averrhoa carambola. Nat. Prod. Commun., 14(5), 1934578-19851969.. https://doi.org/10.1177/1934578X19851969
59. Sripanidkulchai, B., Tattawasart, U., Laupattarakasem, P., & Wongpanich, V. (2002). Anti-inflammatory and Bactericidal Properties of Selected Indigenous Medicinal Plants Used for Dysuria (ฤทธิ์ ต้าน การ อักเสบ และ ฆ่า แบคทีเรีย ของ พืช สมุนไพร ท้อง... Thai J. Pharm. Sci., 26(1), 33-38. https://digital.car.chula.ac.th/tjps/vol26/iss1/4
60. Sung, C.K., Kimura, T., But, P.P., & Guo, J.X. (1998). International Collation of Traditional and Folk Medicine: Northeast Asia, 3, 1-178. https://doi.org/10.1142/9789812815866_0001 Tadros, S. H., & Sleem, A. A. (2004). Pharmacognostical and biological study of the stem and leaf of Avehrroa carambola L. Bull Fac Pharm, 42, 225-246.
61. Thomas, S., Patil, D.A., Patil, A.G., & Chandra, N. (2008). Pharmacognostic evaluation and physicochemical analysis of Averrhoa carambola L. fruit. J Herb Med Toxicol, 2(2), 51-54.
62. Tiwari, K.P., Masood, M., & Minocha, P.K. (1979). Chemical constituents of Gmelina phillipinensis, Adenocalymna nitida, Allamanda cathartica, Averrhoa carambola and Maba buxifolia. J. Indian Chem. Soc., 56, 944. https://doi.org/10.5281/zenodo.6393444
63. Tsai, M.H., Chang, W.N., Lui, C.C., Chung, K.J., Hsu, K.T., Huang, C.R., ... & Chuang, Y.C. (2005). Status epilepticus induced by star fruit intoxication in patients with chronic renal disease. Seizure, 14(7), 521-525. https://doi.org/10.1016/j.seizure.2005.08.004
64. Valim, F.D.P., Aguiar-Oliveira, E., Kamimura, E.S., Alves, V.D., & Maldonado, R.R. (2016). Production of star fruit alcoholic fermented beverage. Indian J. Microbiol., 56, 476-481.. https://doi.org/10.1007/s12088-016-0601- 9. Vasant, R.A., & Narasimhacharya, A.V.R.L. (2014). Antidotal activity of Averrhoa carambola (Star fruit) on fluoride induced toxicity in rats. Interdiscip. Toxicol., 7(2), 103-110. https://doi.org/10.2478/intox-2014-0014.
65. Wang, X.Q., Zou, X.R., & Zhang, Y.C. (2016). From “kidneys govern bones” to chronic kidney disease, diabetes mellitus, and metabolic bone disorder: a crosstalk between traditional Chinese medicine and modern science. Evid. Based Complementary Altern. Med., 2016. https://doi.org/10.1155/2016/4370263
66. Warrier, P.K. (1993). Indian medicinal plants: a compendium of 500 species. Orient Blackswan., 5, 104- 289.
67. Wei, X., Xu, X., Chen, Z., Liang, T., Wen, Q., Qin, N., ... & Huang, R. (2018). Protective effects of 2-Dodecyl-6-Methoxycyclohexa-2, 5-Diene-1, 4-Dione isolated from Averrhoa Carambola L.(Oxalidaceae) roots on neuron apoptosis and memory deficits in Alzheimer's disease. Cell. Physiol. Biochem., 49(3), 1105-1114. https://doi.org/10.1159/000493289
68. Wen, Q., Lin, X., Yeqi, L., Xu, X., Liang, T., Zheng, N., & Huang, R. (2012). Phenolic and lignan glycosides from the butanol extract of Averrhoa carambola L. root. Molecules., 17(10), 12330-12340.. https://doi.org/10.3390/molecules171012330
69. Xie, Q., Zhang, S., Chen, C., Li, J., Wei, X., Xu, X., ... & Wen, Q. (2016). Protective Effect of 2-Dodecyl-6-Methoxycyclohexa-2, 5-Diene-1, 4-Dione, Isolated from Averrhoa carambola L., Against Palmitic Acid-Induced Inflammation and Apoptosis in Min6 Cells by Inhibiting the TLR4-MyD88-NF-κ B Signaling Pathway. Cell. Physiol. Biochem., 39(5), 1705-1715. https://doi.org/10.1159/000447871
70. Yadav, J.P., Kumar, S., Siwach, P. (2006). Folk medicines used in gynecological and other related problems by rural population of Haryana, Indian J. Tradit. Knowl., 5(3), 323- 326. Yang, D., Xie, H., Yang, B., & Wei, X. (2014). Two tetrahydroisoquinoline alkaloids from the fruit of Averrhoa carambola. Phytochem. Lett., 7, 217-220. https://doi.org/10.1016/j.phytol.2013.12.007
71. Yang, D., Xie, H., Jia, X., & Wei, X. (2015). Flavonoid C-glycosides from star fruit and their antioxidant activity. J. Funct. Foods., 16, 204-210. https://doi.org/10.1016/j.jff.2015.04.048 Yang, Y., Xie, H., Jiang, Y., & Wei, X. (2020). Flavan-3-ols and 2-diglycosyloxybenzoates from the leaves of Averrhoa carambola. Fitoterapia, 140, 104442. https://doi.org/10.1016/j.fitote.2019.104442
72. Yao, Q., Gao, Y., Lai, C., Wu, C., Zhao, C.L., Wu, J.L., & Tang, D.X. (2020). The phytochemistry, pharmacology and applications of Melicope pteleifolia: A review. J. Ethnopharmacol., 251, 112546.https://doi.org/10.1016/j.jep.2020.112546