Momordica charantia / Bitter melon

Wereldwijd zijn er honderden planten die tegen ouderdomsdiabetes gebruikt worden en die een invloed hebben op de bloedsuikerspiegel. Momordica charantia is een van de bekendste en ook een van de wetenschappelijk best onderzochte planten. Daarbij is het een vrucht die al eeuwen gebruikt wordt als groente en dus redelijk veilig is.

De vrucht van Momordica charantia heeft verschillende namen waaronder bittere meloen, wilde komkommer, balsempeer, karela, ampalaya, margose, cundeamor, sopropo, goya en kugua. Het is een snel groeiende klimplant uit de familie der Cucurbitaceae, zoals de komkommer en pompoen. De hangende vrucht, die 3 tot 40 cm lang wordt, lijkt op een komkommer en heeft een wrattige schil. Alleen de onrijpe vruchten (met groene schil en wit of bleekgroen vruchtvlees) worden gegeten; de rijpe (geel-oranje) vruchten zijn veel te bitter. De van oorsprong uit tropisch Azië afkomstige vrucht wordt ook op grote schaal in Oost-Afrika, Zuid-Amerika en in het Caribisch gebied gekweekt. In Nederland en België zijn de onrijpe vruchten te koop in toko's en speciaalzaken.
Bittere meloen kan worden gekookt, geblancheerd, geroerbakt, gefrituurd of gestoofd. De vrucht smaakt minder bitter als deze eerst een half uur tot een paar uur in zout water wordt geweekt om bittere stoffen (waaronder momordicine) te verwijderen. De jonge scheuten, bladeren en bloemen van Momordia charantia worden ook wel als groente gegeten.

Medicinale eigenschappen
In de Ayurvedische filosofie wordt bittere meloen gezien als een uitstekend voedingsmiddel om de dosha kapha (aarde) te balanceren. Voor medicinale toepassingen wordt meestal de vrucht gebruikt en soms de zaden, wortels of bladeren en uitlopers van de plant. Bittere meloen heeft talloze traditionele volksgeneeskundige toepassingen waaronder bloedreiniging, huidaandoeningen (psoriasis en eczeem), wonden, microbiële infecties, verminderde eetlust, maagzweren, verstopping en gasvorming, koorts, ontstekingen, diabetes mellitus, kanker en nog veel meer. Weer te veel indicaties om geloofwaardig te zijn.

Wetenschappelijk onderzoek richt zich hoofdzakelijk op de werking van bittere meloen (vooral de vrucht) bij diabetes, dyslipidemie, microbiële infecties, maagzweren en bepaalde vormen van kanker. Bittere meloen heeft een werking tegen virussen (o.m. HIV, herpes simplex, Epstein Barr virus), grampositieve en gramnegatieve bacteriën (o.m. E.coli, Salmonella, Shigella, Staphylococcus, Pseudomonas, Streptococcus, H. pylori), schimmels en parasieten (o.m. Entamoeba histolytica, Plasmodium falciparum).

Botanisch
De sopropo, balsempeer of paré (Momordica charantia) is een overblijvende, kruidachtige, snelgroeiende klimplant uit de komkommerfamilie (Cucurbitaceae). De tot 10 m lange groeischeuten zijn vijfkantig en in de lengterichting gegroefd. De plant heeft enkelvoudige ranken, die uit de zijkant van de stengelknopen ontspringen. De afwisselend geplaatste bladeren zijn 2,5-10 x 3-12 cm groot en hebben drie tot negen uitgesproken lobben. De 3 cm grote, gele, eenslachtige bloemen staan solitair in de bladoksels. Ze openen zich maar voor een dag.

De hangende, onrijp groene vrucht heeft een wrattige schil. De vruchten zijn zeer variabel van grootte (3-40 x 2-8 cm groot) en van vorm. Rijpe vruchten verkleuren naar geel tot oranje en klappen driekleppig open, waarbij rode zaadmantels tevoorschijn komen. Net als bij komkommers zijn het de onrijpe vruchten die worden gegeten. Het vruchtvlees van voor consumptie geschikte vruchten is wit of bleekgroen, sappig en smaakt bitter. De vrucht bevat vele tot 1,5 cm grote zaden. Vers plantensap is giftig. De vrucht moet daarom een aantal uur in zout water worden geweekt om de stoffen die de bittere smaak veroorzaken (momordicine), kwijt te raken. Hierna kunnen de vruchten worden gekookt of gestoofd. Kleinere vruchten worden ook wel zoetzuur ingelegd. Ook jonge scheuten, bladeren en bloemen worden wel als groente gegeten.

De sopropo komt van oorsprong uit tropisch Azië. De soort wordt onder andere in warme gebieden in Zuid- en Zuidoost-Azië, in China, in tropisch Zuid-Amerika (onder andere in Suriname) en in het Caribisch gebied gekweekt. In Nederland worden de vruchten te koop aangeboden in toko's, de beter gesorteerde supermarkten in de grote steden en op markten in de grote steden.



BITTER MELON AND DIABETES

MOMORDICA CHARANTIAThe use of Bitter melon (Momordica charantia) for diabetes has been reported in the Ayurvedic and Chinese systems of medicine [15], but only explained since recently by scientists, who discovered some active constituents present in Bitter melon that was able to act on a similar way as insulin, with the only difference that insulin stops the use of fat as an energy source by inhibiting the release of glucagon [11] and Bitter melon inhibits key carbohydrate hydrolysing enzymes as α-amylase and α-glucosidase [10,11]. 

The study showed how Bitter melon exerted a hypoglycemic action and could be studied as an alternative nutritional therapy in the management of diabetes [10], in fact Bitter melon (Momordica charantia) is used as anti-diabetic plant because of its hypoglycemic effect [12].
Studies have shown that Bitter melon (Momordica charantia) repairs damaged β-cells, increases insulin levels, and also enhance the sensitivity of insulin [14].
From the active constituents found in Bitter melon (Momordica charantia) thought to exert these hypoglycemic properties, namely charantin, momordenol and momordicilin, the study showed that momordicilin was found as the most active compound in the respective target site [12].
Karela (Momordica charantia) contains Gurmarin, a polypeptide considered to be similar to bovine insulin and has been shown in clinical studies to achieve a strong sugar regulating effect by suppressing the neural responses to sweet taste stimuli [24,25].
Other commonly used supplements making use of the hypoglycemic effects include emblica officinalis (gooseberry), fenugreek, green tea, and cinnamon [13], this last one used in many diets including teas of honey and cinnamon.

BITTER MELON FOR WOUND HEALING IN DIABETIC PATIENTS

Wound healing is a very complex process that requires different phases to take place in order, from haemostasis, to inflammation, proliferation and finally remodeling. In diabetic patients wound healing is grossly impaired and results many times in chronic wounds failing to heal.
Some herbs as Bitter melon (Momordica charantia), Aloe vera, Calotropis procera, Portulaca oleracea, Acalypha langiana, Plagiochasma appendiculatum have been subject of study [16].
In studies done in diabetic rats, the application of Bitter melon (Momordica charantia) extract improved and accelerates the process of wound healing in diabetic animals [17,18].

ANTI-CANCER PROPERTIES OF BITTER MELON

Eleven active constituents isolated from Bitter melon (Momordica charantia), including two new cucurbitanetype triterpene glycosides, one new sterol, were tested for their Cytotoxicity activities against lung cancer cell line A549, glioblastoma cell line U87, and hepatoma carcinoma cell line Hep3B.
Two of them exhibited significant cytotoxic activities against cancer cells two new cucurbitane-type triterpene glycosides, one new sterol [19].

BITTER MELON AND BREAST CANCER 

Breast cancer is one of the most common cancers among women in the United States.
One of the approaches to control breast cancer is prevention through diet, which inhibits one or more neoplastic events and reduces cancer risk [21].
As part of this approach some herbs, fruits and vegetables have been subject of study among scientists and researchers.
In some cases, as for example with the use of Bitter melon (Momordica charantia) extracts, the resulsts of these studies have demonstrated certain effectiveness against breast cancer cells, MCF-7 and MDA-MB-231 cell lines, and the treatment of breast cancer cells resulted in a significant decrease in cell proliferation and apoptotic cell death, suggesting that the use of Bitter melon (Momordica charantia) can be used as a dietary supplement for prevention of breast cancer [21]. Image left: Bixa by Kazuhiro Keino under Creative Common license (CC BY 2.0).
In another study, ribonucleases from Bitter gourd seeds reported also certain anti-cancer properties in some studies [20]. One of these studies, done on the effects of Ribonucleases from Bitter gourd seeds on breast cancer cells, showed that this plant may be a potential agent that could be exploited as a new worldwide agent against breast cancer [20].

BITTER MELON SEED OIL

Eleostearic acid (alpha-ESA) is a conjugated linolenic acid that makes up approximately 60% of Momordica charantia (bitter melon) seed oil.
As studies on the subject showed that a water extract from bitter melon was able to inhibit breast cancer MDA-MB-231 and MDA-ERalpha7 human breast cancer cells, the alpha-ESA acid was also subject of study. The results showed that Eleostearic acid (alpha-ESA) can block breast cancer cell proliferation and induce apoptosis [22].

BITTER MELON SIDE EFFECTS AND CONTRAINDICATIONS: As with other herbs, plants, fruits and vegetables, bitter melon can interact with many physical conditions, as for example lowering blood sugar levels in diabetics (Hypoglycemia), toxicity from the seeds.
It should not be taken by pregnant or nursing women as it can cause bleeding. The information presented in this website is for informational purposes.

REFERENCES

[1] Antileukemic Potential of Momordica charantia Seed Extracts on Human Myeloid Leukemic HL60 Cells Ramani Soundararajan, 1, 2 , Punit Prabha, 1 Umesh Rai, 2 and Aparna Dixit 1 ,*
[2] Ng TB, Liu WK, Sze SF, Yeung HW. Action of α-momorcharin, a ribosome inactivating protein, on cultured tumor cell lines. General Pharmacology. 1994;25(1):75–77.
[3] 10. Grover JK, Yadav SP. Pharmacological actions and potential uses of Momordica charantia: a review. Journal of Ethnopharmacology. 2004;93(1):123–132.
[4] Lee-Huang S, Huang PL, Chen HC, et al. Anti-HIV and anti-tumor activities of recombinant MAP30 from bitter melon. Gene. 1995;161(2):151–156.
[5] Akihisa T, Higo N, Tokuda H, et al. Cucurbitane-type triterpenoids from the fruits of Momordica charantia and their cancer chemopreventive effects. Journal of Natural Products. 2007;70(8):1233–1239. [PubMed]
[6] Vesely DL, Graves WR, Lo TM. Isolation of a guanylate cyclase inhibitor from the balsam pear (Momordica charantia abreviata) Biochemical and Biophysical Research Communications. 1977;77(4):1294–1299. [PubMed]
[7] Claflin AJ, Vesely DL, Hudson JL. Inhibition of growth and guanylate cyclase activity of an undifferentiated prostate adenocarcinoma by an extract of the balsam pear (Momordica charantia abbreviata) Proceedings of the National Academy of Sciences of the United States of America. 1978;75(2):989–993. [PMC free article] [PubMed]
[8] Barbieri L, Lorenzoni E, Stirpe F. Inhibition of protein synthesis in vitro by a lectin from Momordica charantia and by other haemagglutinins. Biochemical Journal. 1979;182(2):633–635.
[9] Bitter melon (Momordica charantia) extract suppresses adrenocortical cancer cell proliferation through modulation of the apoptotic pathway, steroidogenesis, and insulin-like growth factor type 1 receptor/RAC-α serine/threonineprotein kinase signaling. Brennan VC, Wang CM, Yang WH. Department of Biomedical Sciences, Mercer University School of Medicine, Savannah, Georgia 31404-3089, USA.
[10] Traditional medicinal herbs and food plants have the potential to inhibit key carbohydrate hydrolyzing enzymes in vitro and reduce postprandial blood glucose peaks in vivo. Mahomoodally MF, Subratty AH, Gurib-Fakim A, Choudhary MI, Nahar Khan S. Department of Health Sciences, Faculty of Science, University of Mauritius, Reduit 230, Mauritius.
[11] Wikipedia article on insulin and bitter melon.
[12] Binding Energy calculation of GSK-3 protein of Human against some anti-diabetic compounds of Momordica charantia linn (Bitter melon). Hazarika R, Parida P, Neog B, Yadav RN.
[13] A review of the hypoglycemic effects of five commonly used herbal food supplements. Deng R. Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, 41 Lower College Road, Kingston, RI 02881, USA.
[14] Antidiabetic potentials of Momordica charantia: multiple mechanisms behind the effects. Chaturvedi P. Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone, Botswana.
[15] Bitter gourd (Momordica charantia) is a cornucopia of health: a review of its credited antidiabetic, anti-HIV, and antitumor properties. Fang EF, Ng TB. School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin.
[16] Wound healing in diabetes mellitus: traditional treatment modalities. Laitiff AA, Teoh SL, Das S. Department of Anatomy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
[17] The effect of topical extract of Momordica charantia (bitter gourd) on wound healing in nondiabetic rats and in rats with diabetes induced by streptozotocin. Department of Anatomy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.Teoh SL, Latiff AA, Das S.
[18] Wound-healing property of Momordica charantia L. fruit powder. Prasad V, Jain V, Girish D, Dorle AK. Source Department of Pharmaceutics, Central Drug Research Institute, Chattar Manzil Palace, Lucknow, India.
[19] Structures of new triterpenoids and cytotoxicity activities of the isolated major compounds from the fruit of Momordica charantia L. School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang, China. Wang X, Sun W, Cao J, Qu H, Bi X, Zhao Y.
[20] RNase MC2: a new Momordica charantia ribonuclease that induces apoptosis in breast cancer cells associated with activation of MAPKs and induction of caspase pathways. Fang EF, Zhang CZ, Fong WP, Ng TB. School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
[21] Bitter melon (Momordica charantia) extract inhibits breast cancer cell proliferation by modulating cell cycle regulatory genes and promotes apoptosis. Ray RB, Raychoudhuri A, Steele R, Nerurkar P. Department of Pathology, Saint Louis University, St. Louis, Missouri 63104, USA.
[22] Eleostearic Acid inhibits breast cancer proliferation by means of an oxidation-dependent mechanism. Grossmann ME, Mizuno NK, Dammen ML, Schuster T, Ray A, Cleary MP. University of Minnesota, 801 16th Avenue NE, Austin, MN 55912, USA.
[23] Inhibition of MDA-MB-231 human breast tumor xenografts and HER2 expression by anti-tumor agents GAP31 and MAP30. Lee-Huang S, Huang PL, Sun Y, Chen HC, Kung HF, Huang PL, Murphy WJ. Source Department of Biochemistry, New York University School of Medicine, NY 10016, USA.
[24] Subhose V, et al. Bull Indian Inst Hist Med Hyderbad. 2005;35:83.
[25] A compilation of Bioactive Compounds from Ayurveda Ramar Perumal Samy,1 Peter Natesan Pushparaj,2 and Ponnampalam Gopalakrishnakone1,*
[26] Pixabay image  Pixabay image under Public Domain License CC0 1.0 Universal (CC0 1.0).



Bitter Melon
Scientific Name1-9
Momordica charantia
Common Names1-9
Bitter melon, balsam pear, bitter cucumber, bitter pear, karalla, balsam apple, cerasee, carilla
cundeamor, papailla, melao de sao ceatano, bitter gourd, sorosi, karela, kurela, kor-kuey, pavaaki,
salsamino, sorossies, pare, peria, karla, margose, goo-fah, mara chean
Herb Description7-9
Bitter melons may be cultivated in tropical areas including Africa, India, South America, and
Asia. It is characterize as a perennial vine bearing yellowish green oblong bumpy fruit
resembling a cucumber. Once ripened, it releases brown and white color seeds which are
embedded in its red pulp.

Principal Constituents
1,4,7,9,10
Medicinal components of bitter melon include its seeds, fruits and to a lesser extent leaves and
roots. Alpha and beta-momorcharin are proteins that may be isolated in seeds, fruit as well as
the leaves. Insulin-like polypeptides called p-insulin and alkaloid momordicine could be isolated
from both the fruits and seeds. The seeds, additionally, contains vicine and 32% oil combined
with stearic, linoleic, and oleaic acids. Other chemical components include steroid glycosides
momordin and charantin which has been identified in the fruits and leaves. The leaves alone
contain iron, sodium, thiamine, riboflavin, niacin, and ascorbic acid.

Mechanism of Action1,4,7,9,10
Many mechanisms of action have been proposed for the hypoglycemic effects of bitter melon.
However, many clinical studies showed contradictory results therefore the mechanism of action
for hypoglycemic effects remains unclear. Some data indicated that bitter melon stimulates the
functioning pancreatic islet cells causing a release in insulin while others would contradict and
report that an increase in utilization of glucose by the liver rather than the secretion of insulin by
pancreatic cells are responsible for the hypoglycemic effects. Less common mechanisms that are
proposed for hypoglycemic effects include inhibition of glucose absorption and increase glucose
tissue uptake.

Current Indications1,6,10
Bitter melon has many worldwide indications however most clinical data are from trials
examining the hypoglycemic properties of bitter melon. In addition to the hypoglycemic effects
of bitter melon, other worldwide traditional uses include antimicrobial, psoriasis, gastrointestinal
upset, ulcers, colitis, constipation, intestinal worms, kidney stones, fever, menstrual disorder,
leprosy, cough, headache, hypertension, anemia, and appetite stimulant.
Efficacy Data11
Alcoholic extract taken from the pulp of bitter melon was administered to rat models to evaluate
its hypoglycemic activity in comparison to a sulphonylurea, tolbutamide. The alcoholic extract
was prepared by blending 1 kg of unripe bitter melon fruit in 1500ml of 95% alcohol. Results in
rat models showed that bitter melon 500mg/kg cause a 10-15% reduction in blood glucose after 1
Original Author Alene Tran
Reviewed 5/14/03 Susan Paulsen PharmD
hour while tolbutamide 100mg/kg has a more modest reduction of 40% in blood glucose after 1
hour.

Contraindications3,10
Hypersensitivity to bitter melon, pregnancy, lactation, hepatic disease, fertility drugs, and
hypoglycemia.

Dosage Forms Availability2,3,5,6,10
Bitter melons are available in tablet, aqueous extract, fruit, juice, seed, and tea.
Recommended Doses2,3,5,6,10
Adult: PO aqueous extract: 15g QD or 100ml QD
PO juice: 2 oz QD
PO standard leaf: 0.5-1 cup QD-BID
Tincture: 1-3 ml of 4:1 BID
Powdered leaf in tablets/capsules: 1g QD, 3 tbsp QD
Children (<18 years old): There have been 2 reports of coma associated with the use of
bitter melon in children due to hypoglycemia. The use of bitter melon is
not recommended in children less than 18 years of age.

Duration4
Bitter melon is considered relatively safe for duration of ≤ 4 weeks. Use for more than 4 weeks
is not recommended.

Drug Interactions1,10
Bitter melon may interact with antidiabetic drugs. Concomitant use of bitter melon with other
antidiabetic drugs may enhance blood glucose reduction resulting in hypoglycemia

Drug-Disease Interactions1,10
Hepatic disease
Diabetes
Drug-Lab Interactions1
Urinary glucose

Additional Safety Issues4,6,8
Bitter melon is relatively safe with side effects including headache, diarrhea, nausea, vomiting
and abdominal pain with excessive amounts. Concomitant use of bitter melon with other
antidiabetic drugs may enhance blood glucose reduction resulting in hypoglycemia. Use bitter
melon with other antidiabetics only under the supervision of a physician. Bitter melon has toxic
red arils that surround the seeds, avoid gestation and keep away from children.
Original Author Alene Tran
Reviewed 5/14/03 Susan Paulsen PharmD
Original Author Alene Tran
Reviewed 5/14/03 Susan Paulsen PharmD

Reference:
1. Natural Medicines Comprehensive Database [online database]. Available at:
http://www.natural database.com/monograph.asp?mono_id=795&hilite=1 Accessed
January 29, 2003.
2. Shapiro K, Gong W. Natural Products Used for Diabetes. Journal of the American
Pharmaceutical Association.2002;42:221
3. Micromedex®Healthcare Series: MICROMEDEX, Inc., Englewood, Colorado (Edition
expires [12/2002])
4. Short RM, editors. The Review of Natural Products. St. Louis: Facts and Comparisons®;
March 1999. p.1-3
5. Bratman S. The Natural Pharmacist. Prima Publishing; 1999.
6. http://www.intelihealth.com
7. Murray M, Pizzorno J. Encyclopedia of Natural Medicine. 2nd ed. California: Prima
Publishing;1998.
8. White LB, Foster S. The Herbal Drugstore: the best natural alternatives to over-thecounter
& prescription medicines. Rodale: Herb Companion Press;2000
9. http://www.himalayahealthcare.com/herbfinder/h_momord.htm
10. Skidmore-Roth L. Mosby’s Handbook of Herbs&Natural Supplements. St. Louis: Mosby
Inc;2001. p. 92-3
11. Sarkar S, Pranava M, Marita RA. Demonstration of the Hypoglycemic Action of
Momordica Charantia in a Validated Animal Model of Diabetes. Pharmacological
Research. 1996;33(1):1-4 

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