IN VIVO AND IN VITRO TOXICOLOGICAL EFFECTS OF AESCULUS HIPPOCASTANUM AND ITS DERIVATIVES (HORSE CHESTNUT): A SYSTEMATIC REVIEW

Resumo

Introduction: Horse chestnut (Aesculus hippocastanum) is traditionally used to alleviate chronic venous insufficiency symptoms due to its anti-edematous, anti-inflammatory, and venotonic properties. The main active ingredient, aescin, benefits patients with hemorrhoids or peripheral edema. However, studies on the toxicological safety of horse chestnut and its products are scarce. Objective: The aim of this systematic review was to summarize the current evidence on the toxicological evaluation of Aesculus hippocastanum and its derivatives in order to determine the safety of in vitro and in vivo use. Materials and Methods: This systematic review was conducted following the PRISMA 2020 recommendations. The study protocol was registered in the Open Science Framework Database, available at the following link: https://osf.io/srdpe. The electronic search was performed in five databases and grey literature. Studies that included animal models and in vitro techniques (Population) exposed to Aesculus hippocastanum and its derivatives (Exposure), and that reported an assessment of toxicological effects (Outcome), were included. Methodological quality was assessed using the ToxRTool. Results: From 465 identified studies, 12 were included according to the eligibility criteria. Of which, eight were in vitro studies. Six of these studies were considered "reliable without restriction" due to good methodological quality, while two in vitro studies were considered unreliable. Of the total of 12 studies included, five were in vivo studies. Only one was considered "reliable without restriction" with good methodological quality, while four were classified as "Not reliable." Most in vivo studies evaluated acute toxicity, with doses ranging from 1 to 6000 mg/kg. The most used in vitro method was MTT. Conclusion: We conclude that there is an urgent need for more robust studies, with better methodological descriptions and experimental rigor, to guarantee data reliability, especially in vivo data.