BIODIVERSITAS ISSN: 1412-033X

Volume 24, Number 10, October 2023 E-ISSN: 2085-4722

Pages: 5464-5477 DOI: 10.13057/biodiv/d241028

Ethnopharmacology of medicinal plants used by the Tenggerese

community in Bromo Tengger Semeru National Park, Indonesia

WEKA SIDHA BHAGAWAN1,2, WIWIED EKASARI3, MANGESTUTI AGIL3,

1
Department of Pharmacy, Faculty of Health and Science, Universitas PGRI Madiun. Jl. Setia Budi No. 85, Madiun 63118, East Java, Indonesia
2
Doctoral Program of Pharmaceutical Sciences, Faculty of Pharmacy, Universitas Airlangga. Nanizar Zaman Joenoes Building Jl. Mulyorejo, Surabaya
60155, East Java, Indonesia
3
Department of Pharmaceutical Sciences, Faculty of Pharmacy, Universitas Airlangga. Nanizar Zaman Joenoes Building Jl. Mulyorejo, Surabaya 60155,
East Java, Indonesia. Tel./fax.: +62-315-933150, email: mmangestuti@yahoo.com

Manuscript received: 6 September 2023. Revision accepted: 20 October 2023.

Abstract. Bhagawan WS, Ekasari W, Agil M. 2023. Ethnopharmacology of medicinal plants used by the Tenggerese community in
Bromo Tengger Semeru National Park, Indonesia. Biodiversitas 24: 5464-5477. Bromo Tengger Semeru National Park is a repository
of biodiversity with profound cultural significance. The Tenggerese community residing within the park possesses rich
ethnopharmacological knowledge, using medicinal plants for various ailments. This study aims to comprehensively explore the
medicinal plant diversity, traditional uses, and potential pharmacological activities among the Tenggerese people. Ethnopharmacological
data was gathered through interviews with informants in seven Tenggerese villages. Ethnopharmacological indices like Species Use
Value (SUV) and Fidelity Level (FL) were calculated to identify the most important medicinal plants. Phytochemical analysis of
selected medicinal plants was conducted using UPLC-QTOF-MS/MS, and its pharmacological potential was assessed through
antibacterial tests. A total of 124 medicinal plant species from 54 families were documented. The Tenggerese community utilizes plants
to treat diverse diseases, with reproductive healthcare being prominently featured. Elaeocarpus longifolius emerged as a key species
with high SUV and FL values. Phytochemical analysis identified 25 compounds, including major and minor compounds, already known
for their pharmacological activities elsewhere. Elaeocarpus longifolius extract showed inhibitor activity against both gram-positive and
gram-negative bacteria. The findings contribute to bridging traditional knowledge and modern scientific research, offering potential
avenues for the development of drug candidates from indigenous medicinal plants.

Keywords: Elaeocarpus longifolius, ethnopharmacology, pharmacology, phytochemical, Tenggerese community

INTRODUCTION et al. 2014; Heinrich and Jager 2015; Athayde et al. 2017;
Aswani et al. 2018).
National parks are recognized as crucial repositories of In Indonesia, numerous ethnopharmacological studies
the world's remaining biodiversity, encompassing not only have been conducted within national parks over the past
ecologically valuable plants but also those of significant few decades. In Sumatra, Elliott and Brimacombe (1987)
cultural importance to humans (Ong et al. 2018; Wang initiated such studies in Gunung Leuser, followed by
2019). Remarkably, approximately 15% of the Earth's land Setyowati and Wardah (2007) documenting medicinal
area is presently designated as national parks, while around plants in Bukit Tigapuluh while Yudiyanto et al. (2022)
18% is officially acknowledged as being under the usage conducted ethno-pharmacological studies on the Lampung
rights of indigenous peoples and local communities (Jufe- Tribe residing near Way Kambas National Park. Two
Bignoli et al. 2014; Ferretti-Gallon et al. 2021). Indigenous ethnopharmacological studies were conducted on Sulawesi
tribes possess profound knowledge regarding the complex Island, specifically in Bantimurung-Bulusaruang (Husaini
relationship between humans and the surrounding nature, et al. 2022) and Lore-Lindu (Gailea et al. 2016). In
including the utilization of plants for traditional medicine Kalimantan, Susanti and Zuhud (2019) focused on traditional
(van Wyk and Wink 2017; Jamshidi-Kia et al. 2018). knowledge and the conservation of medicinal plants among
Consequently, national parks serve as invaluable starting the Dayak Krayan people in Kayan Mentarang National
points for investigating the harmonious interplay between Park. In Java, within Meru Betiri National Park, studies
traditional plant use and medicinal practices (Kim and have examined the various interests and influences of
Song 2014; Song et al. 2014; Tomasini and Theilade 2019; actors involved in the utilization of medicinal plants
Redouan et al. 2020; Abbas et al. 2021). In this regard, (Nurrochmat et al. 2017), as well as revealing the
ethnopharmacology plays an important role in connecting pharmacological potential and phytochemical components
plant biodiversity, empirical traditional knowledge, and of several medicinal plants (Nugraha et al. 2020; Ratnadewi
medicinal practices in an indigenous community. et al. 2020), meanwhile Susiarti et al. (2018) analyzed the
Ethnopharmacological research assumes particular diversity of medicinal plants in Mount Gede Pangrango,
significance, particularly in tropical countries undergoing while Arbiastutie et al. (2017) uncovered the anti-cancer
rapid environmental and cultural transformations (Sujarwo potential of medicinal plants within this national park.
 BHAGAWAN et al. – Medicinal plants in Bromo Tengger Semeru National Park, Indonesia 5465

Among the national parks in Indonesia, which are rich Therefore, the main objective of this study is to identify
in biodiversity of medicinal plants, Bromo Tengger Semeru and document the important medicinal plants utilized by
is inhabited by a traditional tribe known as the Tengger the Tenggerese people in seven different villages situated
people (Batoro 2017; Huda and Khasanah 2019). The in Bromo Tengger Semeru National Park, shedding light on
Tengger people have a profound understanding and their cultural significance. Additionally, this research
utilization of various medicinal plants, which play a pivotal represents a pioneering effort to explore the
role in their primary healthcare (Bhagawan et al. 2023). ethnopharmacological relevance of the most frequently
Their ethnopharmacological knowledge has been passed cited medicinal plants, analyzing both their
down through generations, upheld by the priesthood of pharmacological activities and phytochemical content for
traditional leaders (dukun pandhita), traditional healers the first time. This comprehensive investigation aims to
(dukun cilik), and the Tengger community itself, actively provide a deeper understanding of the potential therapeutic
engaging in independent traditional medicine (Nugraha et applications of these plants, bridging the gap between
al. 2022; Putri et al. 2022). However, the relentless cultural traditional knowledge and scientific analysis.
influences from external sources have led to rapid
environmental and cultural transformations in the region.
Over the past decade, several researchers have MATERIALS AND METHODS
conducted ethnopharmacological field studies to document
the medicinal plants used by the Tenggerese community Study area
residing around Bromo Tengger Semeru National Park The study area for this research was Bromo Tengger
(Batoro and Siswanto 2017; Bhagawan et al. 2020, 2021; Semeru National Park, situated in East Java Province,
Jadid et al. 2020; Bhagawan and Kusumawati 2021;). Indonesia. This national park is located to the east of the
However, it is important to note that these studies have provincial capital Surabaya and spans between 7°54’ and
focused primarily on specific villages, leaving gaps in 8°55’13’S latitude and 112°5-113°04’E longitude (Figure
coverage across all areas inhabited by the Tenggerese 1). Encompassing an area of 503 km2, it boasts an altitude
community. Despite the valuable insights provided by these range of 750-3676 m above sea level. The landscape
studies, there remains a surprising lack of research in the mainly consists of hilly and steep mountainous terrain, with
field of ethnopharmacology, specifically analyzing the Mount Semeru standing as the highest peak on the island of
phytochemical content and pharmacological activity of Java. Due to its higher altitude, the region experiences
medicinal plants used by the Tenggerese people. Only two cooler temperatures during summer, ranging from 3° to
ethnopharmacological studies have examined the 20°C. Furthermore, the area receives substantial rainfall,
pharmacological activity of Tengger medicinal plants (Aziz with an average of 6.600 mm per year
et al. 2019; Shalas et al. 2021). (https://bromotenggersemeru.org/).

Figure 1. Location of the study area, consisting of seven Tenggerese villages in four different districts around Bromo Tengger Semeru
National Park, East Java, Indonesia
5466 B I O D I V E R S I T A S 24 (10): 5464-5477, October 2023

Bromo Tengger Semeru National Park is a unique Species Use Value (SUV)
amalgamation of various zones, including nature reserves, The species use value was employed to determine the
tourist parks, production forests, and protected forests. The significance of medicinal plant species utilized by the
combined area of the two forests within the park amounts Tengger people in Bromo Tengger Semeru National Park.
to 432 km2 (https://bromotenggersemeru.org/). The Tengger Originally introduced by Phillips and Gentry (1993a,
tribe, the local inhabitants of this national park, constitute a 1993b), the SUV index was adapted for the purpose of this
significant presence in the region. Tengger Hinduism is the study. To compute plant citations in the national park, we
predominant religion among the tribe. The fertile soil in the applied the following formula:
area has facilitated traditional farming, which serves as the
primary occupation for most of the villagers (Batoro 2017).
The research focused on seven principal Tengger villages,
namely (Argosari and Ranupani) in Lumajang District, Where: U denotes the total citation count for a specific
(Ngadas Wetan and Ngadisari) in Probolinggo District, plant species, and ns represents the number of informants
(Ngadas Kidul) in Malang District, and (Podokoyo and participating in the study.
Wonokitri) in Pasuruan District. These locations were
strategically chosen as the research areas, as they provide a Fidelity Level (FL)
comprehensive representation of the Tenggerese The fidelity level originally introduced by Friedman et
community within the broader context of the national park. al. (1986) was employed in this research. FL is calculated
as the ratio between the number of informants who
Ethnopharmacological data collection independently mentioned the use of a specific plant species
The research adhered to the ethical guidelines set out by for the same primary purpose and the total number of
the Code of Ethics of the International Society of informants who cited the plant. The calculation was
Ethnobiology (2006). Ethnopharmacological data were performed using the following equation:
gathered during three distinct periods: 2009-2011, 2017-
2019, and 2021-2023. Prior to conducting any interviews,
formal permissions were sought from the village heads and
tribal chiefs. Additionally, the informed consent of each Where: Np denotes the number of informants who
informant was obtained orally, with a clear explanation of mentioned or claimed the use of a particular plant species
the research objectives. Ethnopharmacological data was for a specific medicinal treatment, and N represents the
collected through interviews and in-depth observations total number of informants who cited the plant species for
with informants selected through a snowball sampling various types of medicinal treatments.
technique. Interviews were conducted using the local
language, namely Javanese Kromo Inggil. To ensure a Preparation of selected medicinal plant
comprehensive ethnopharmacological knowledge, a total of Selected medicinal plants were harvested, dried, and
167 residents from the region were involved in the ground into powder. The choice of these plants was based
interviews. Each village was represented by a minimum of on their high Species Use Value (SUV) and Fidelity Level
20 informants. The informants, predominantly aged above (FL). A remaceration procedure was used to extract the
40 years, comprised a gender-diverse group consisting of plant using 100 g of their dried powder. Following a 24-
103 men and 64 women. hour soak in 5 L of 96% ethanol solvent, the powder was
During the research, local names of medicinal plants filtered through filter paper to remove only the filtrate. The
were gathered alongside information about the specific same 2.5 L of 96% ethanol solvent was used for the second
diseases they are used to treat, the parts of the plants that immersion, and the process was repeated for the third
are utilized, the preparation methods, and the routes of drug immersion and subsequent ones until 10 L of solvent had
administration. In order to ensure accuracy, the scientific been used. Until the extract thickened, the filtrate was
names of the plants were determined using the website evaporated in a rotary evaporator at a temperature of 55 °C
http://www.theplantlist.org/. Photographs were taken of and 120 rpm. The solvent was then evaporated from the
plants that posed identification challenges. These thickened extract in a 50°C oven. The 96% ethanol extract
photographs were subsequently submitted to taxonomists at was ready for phytochemical analysis and in vitro
Herbarium Jemberiense (Universitas Jember) and pharmacology testing.
Purwodadi Botanical Garden (BRIN) for precise scientific
name identification. Phytochemical analysis
Phytochemical analysis of selected plants was
Quantitative ethnopharmacological analysis performed to detect the presence of plants’ secondary
The utilization of quantitative information enhances the metabolites of pharmacological importance. The samples
likelihood of identifying pharmacologically significant underwent analysis using Ultra Performance Liquid
plants. The identification of each important plant holds Chromatography-Quadrupole Time of Flight-Mass
crucial importance for pharmacological screening. In this Spectrometry (UPLC-QTOF-MS/MS) equipped with
study, ethnobotanical data was subjected to analysis using electrospray ionization (ESI) sources. To prepare the
ethnopharmacological indices, namely Fidelity Level (FL) sample, 100 ppm for 96% ethanol extract was dissolved in
and Species Use Value (SUV). methanol. Before injection, a solid-phase filtration process
 BHAGAWAN et al. – Medicinal plants in Bromo Tengger Semeru National Park, Indonesia 5467

was utilized. Subsequently, 5 µL of the extract was injected Medicinal plants play a vital role in providing remedies
into the tandem detector MS Xevo G2-S QToF of the for a range of health issues within the local community, as
ACQUITY UPLC® H-Class System (Waters, USA). The outlined in Table 2. These ailments are categorized into six
samples were separated using an ACQUITY BEH C18 (1.7 distinct disease groups, with an effort made to align the
µm, 2.1x50 mm) column with a mobile phase of 0.05% data with customary classifications established by medical
acetonitrile and 0.05% formic acid, flowing at a rate of 0.2 practitioners. These encompass dermatological diseases,
mL/min. The UPLC-MS analysis findings were processed gastrointestinal disorders, internal medical diseases,
using Masslynx version 4.1 to generate the chromatogram reproductive healthcare, respiratory problems, and skeletal-
and spectra of each observed peak. Additionally, chemical muscular disorders. Particularly noteworthy is the category
prediction was performed using the ChemSpider website. of reproductive healthcare, which encompasses the highest
number of diseases (nine in total). These include
Pharmacological activity test antifertility, erectile dysfunction, female fertility,
According to the CLSI (2012) procedure, pharmacological leucorrhea, low breast milk production, menstrual pain,
activity tests were conducted using the agar disk-diffusion postpartum, syphilis, and care for pregnant women. The
method against gram-positive (Staphylococcus aureus) and emergence of diseases in the reproductive health category
gram-negative (Shigella dysenteriae) bacteria. Staphylococcus could be intrinsically linked to the Tenggerese people's
aureus and S. dysenteriae cultures totaling one mL were practice of population control. As elaborated by Laksono
placed on a sterile petri dish. A petri dish holding the (2020), the Tenggerese community's traditions regulate
inoculum was filled with melted Mueller-Hinton Agar family size due to limited available land. The reproductive
(MHA) that had been cooled and swirled thoroughly. After health category was also found in ethnopharmacology
compaction, wells were drilled into the agar plate holding studies, such as those conducted in Tlemcen National Park,
the inoculum using a sterile cork borer (6 mm in diameter). North West Algeria (Zatout et al. 2021) and Queen
Thereafter, each well received 30 µL of each extract Elizabeth National Park, South Western Uganda
concentration (2.5 mg/mL, 5 mg/mL, 10 mg/mL, 20 (Gumisiriza et al. 2019).
mg/mL, and 40 mg/mL). To ensure that the extract mixed
thoroughly with the agar, the plates were chilled for 30 Plant part used, preparation, and administration route
minutes. After that, the plate was incubated for 24 hours at Parts of plants that are commonly used in medication or
37°C. Before applying chloramphenicol at a concentration health treatment by the Tenggerese tribe are roots, leaves,
of 0.5 mg/mL as positive control and DMSO at a dose of barks, stems, flowers, tubers, fruits, seeds, rhizomes, and
10% as negative control, the diameter of the inhibitory all parts. In this research, among the various parts of the
growth zone was evaluated. The antibacterial tests were plant used in therapy, leaves were predominately used
conducted in triplicate for each extract and control (41%), followed by fruit (22%) (Figure 2A). This trend
preparation. The data obtained were subjected to statistical aligns with observations in existing literature (Jadid et al.
analysis using one-way ANOVA to determine the smallest 2020), which notes the accessibility and relatively higher
significant difference at a significance level of P <0.05, abundance of leaves in the natural environment. This
employing statistical software (SPSS 22, IBM Corporation, accessibility might contribute to their prevalent usage in
NY, USA). All results are presented as mean values ± medicinal preparation. The prominence of leaf usage is closely
standard deviation. associated with the survival strategy of the plants. Removing
a reasonable amount of leaf biomass exerts minimal harm
to the plant, unlike the collection of stems, roots, or entire
RESULTS AND DISCUSSION
plants. Additionally, leaves are renowned for producing
diverse secondary metabolites (Zahoor et al. 2017),
Medicinal plant biodiversity and diseases treated rendering them particularly valuable for therapeutic purposes.
An ethnopharmacological survey in this study Among the diverse methods of herbal drug preparation,
documented 124 medicinal plants belonging to 54 families decoction stands as the most predominant (constituting 43%)
used by the Tenggerese community living in seven villages in the surveyed area (Figure 2B). The prevalence of using
in Bromo Tengger Semeru National Park. Detailed decoction as a method for preparing medicinal plants can
information about these medicinal plants can be found in be attributed to its simplicity, user-friendliness, and cost-
Table 1. The species most used ethnopharmacologically effectiveness (Amri et al. 2014). Moreover, this technique
were Zingiberaceae (twelve species), followed by enhances the extraction of a broader spectrum of phytochemical
Compositae, Leguminosae, and Solanaceae (seven species compounds, thus augmenting the plant's pharmacological
each). Other families frequently used include Apiaceae and impact (Barkaoui et al. 2017). The administration route of
Apocynaceae (five species each), Cucurbitaceae, medicinal plant preparations is primarily oral (81%),
Piperaceae, and Poaceae (four species each). The reason although a smaller proportion involves vaginal, topical,
why Zingiberaceae plants are used most often is probably optical, and nasal applications as well (Figure 2C).
due to their habitat and environmental conditions. Interestingly, our findings regarding the methods of preparation,
Zingiberaceae dominance has been found in previous routes of administration, and utilized plant parts are in
ethnopharmacology studies in other Indonesian national close alignment with the results of prior investigations
parks, such as in Mount Gede Pangrango (Susiarti et al. conducted in other Indonesian national parks (Susiarti et al.
2018), Mount Leuser (Elliott and Brimacombe 1987), and 2018; Susanti and Zuhud 2019; Husaini et al. 2022).
Way Kambas (Yudiyanto et al. 2022).
5468 B I O D I V E R S I T A S 24 (10): 5464-5477, October 2023

Table 1. Medicinal plants used in the Bromo Tengger Semeru National Park, East Java, Indonesia, including family, species name, local
name, part used, diseases treated, preparation and administration

Part Diseases or health problems Preparation,

Family Species name Local name
used treated administration
Acanthaceae Andrographis paniculata Sambiloto Leaf Cough, fever, postpartum Boiled/decoction,
(Burm.f.) Nees oral
Strobilanthes crispa Blume Keji beling Leaf Kidney stones Decoction, oral
Acoraceae Acorus calamus L. Dringu Leaf Fever Decoction, oral
Aloaceae Aloe vera (L.) Burm. f. Lidah buaya Leaf Hair problems Raw, topical
Amaranthaceae Achyranthes aspera L. Aseman Leaf, Erectile dysfunction, postpartum Decoction/raw, oral
Root
Amaranthus hybridus L. Bayam Leaf High cholesterol, postpartum Boiled, oral
Amarillydaceae Allium fistulosum L. Bawang pre Leaf High cholesterol Decoction, oral
Allium cepa L. Bawang merah Tuber Fever, flatulence Decoction, oral
Allium sativum L. Bawang putih Tuber Cough, high cholesterol, low Raw, oral
breast milk production,
postpartum
Annonaceae Annona muricata L. Sirsak Fruit Diabetes Raw, oral
Annona squamosa L. Srikoyo Fruit Diarrhea Raw, oral
Cananga odorata (Lam.) Hook.f. Kenanga Flower Dry skin, postpartum Powdered/steam,
& Thomson topical/vaginal
Apiaceae Apium graveolens L. Seledri Leaf Hypertension, postpartum Raw, oral
Centella asiatica (L.) Urb. Calingan Leaf Cough, kidney stones Decoction, oral
Coriandrum sativum L. Ketumbar Fruit Diarrhea, flatulence Decoction, oral
Foeniculum vulgare Mill Adas Leaf Cough, fever, leucorrhea, Decoction, oral
menstrual pain, postpartum
Pimpinella pruatjan Molk. Purwoceng Root Erectile dysfunction Decoction, oral
Apocynaceae Alyxia reinwardtii Blume Pulosari Bark Dengue fever, diarrhea, erectile Decoction, oral
dysfunction, fever, postpartum
Alstonia scholaris (L.) R. Br. Pule Bark Fever Decoction, oral
Mandevilla sanderi (Hemsl.) Kembang Flower Fever Decoction, oral
Woodson terompet
Plumeria rubra L. Kamboja Flower Headache Decoction, oral
Araceae Colocasia esculenta (L.) Schott Talas Leaf Diarrhea Decoction, oral
Araliaceae Polyscias scutellaria (Burm.f.) Mangkokan Leaf Wound infection Decoction, oral
Fosberg
Arecaceae Areca catechu L. Jambe Seed Intestinal worms Decoction, oral
Asteraceae Elephantopus scaber L. Tapak liman Leaf Kidney stones, postpartum Decoction/boiled,
oral
Artemisia vulgaris L. Ganjan Leaf Erectile dysfunction Decoction, oral
Tithonia diversifolia (Hemsl.) A. Insulin Leaf Diabetes Decoction, oral
Gray
Athyriaceae Diplazium esculentum (Retz.) Sw. Pakis Leaf Postpartum Raw, oral
Basellaceae Anredera cordifolia (Ten.) Steenis Binahong Leaf Cough, mouth ulcer, postpartum Boiled, oral
Brassicaceae Brassica rapa L. Sawi hijau Leaf Fever, postpartum Raw, oral
Nasturtium officinale R.Br. Selada Leaf Postpartum Raw, oral
Raphanus raphanistrum L. Lobak Tuber Erectile dysfunction, syphilis Decoction, oral
Bromeliaceae Ananas comosus (L.) Merr. Nanas Fruit Antifertility, diarrhea Squeezed, oral
Caricaceae Carica papaya L. Pepaya Leaf Low breast milk production, Boiled, oral
postpartum
Caryophyllaceae Stellaria saxatilis Buch.-Ham. ex Tepung otot All parts Osteoporosis Squeezed, topical
D. Don
Casuarinaceae Casuarina junghuhniana Miq. Cemara Bark Diarrhea Decoction, oral
Compositae Bidens pilosa L. Sempretan Leaf Fever, hypertension Decoction, oral
Blumea balsamifera (L.) DC. Sembung Leaf Postpartum Boiled, oral
Cosmos caudatus Kunth Kenikir Leaf Hypertension, insomnia, Decoction/raw, oral
postpartum, pregnant women
Gynura procumbens (Lour.) Merr. Sambung nyawa Leaf Postpartum Boiled, oral
Helianthus annuus L. Bunga matahari Seed Hypertension Burn, oral
Pluchea indica (L.) Less. Luntas Leaf Postpartum Boiled, oral
Sonchus arvensis L. Tempuyung Leaf Hypertension, kidney stones Decoction, oral
Convolvulaceae Ipomoea batatas (L.) Lam. Telo rambat Leaf Postpartum Boiled, oral
Jacquemontia paniculata (Burm. Tirem Leaf Postpartum Boiled, oral
f.) Hallier f.
Cucurbitaceae Citrullus lanatus (Thunb.) Semangka Fruit Hypertension Raw, oral
Matsum
 BHAGAWAN et al. – Medicinal plants in Bromo Tengger Semeru National Park, Indonesia 5469

Cucumis melo L. Melon Fruit Hypertension Raw, oral

Cucumis sativus L. Timun Fruit Hypertension Raw, oral
Momordica charantia L. Pare Fruit Postpartum Raw, oral
Cluseaceae Garcinia × mangostana L. Manggis Fruit Mouth ulcer Raw, oral
Elaeocarpaceae Elaeocarpus longifolius Blume Jambu Wer Fruit Diarrhea Decoction, oral
Euphorbiaceae Jatropha curcas L. Jarak pagar Stem Mouth ulcer, sprue Decoction, oral
Manihot utilissima Pohl Singkong Leaf Low immune system, postpartum Boiled, oral
Fabaceae Tamarindus indica L. Asem Fruit Cough Decoction, oral
Parkia speciosa Hassk. Petai Seed Menstrual pain, postpartum Raw, oral
Lamiaceae Mentha × piperita L. Min Leaf Asthma, postpartum Burn/raw/decoction,
nasal/oral
Ocimum citriodorum Vis. Kemangi Leaf Diarrhea, postpartum Decoction/raw, oral
Orthosiphon aristatus (Blume) Kumis kucing Leaf Kidney stones, postpartum Decoction/boiled,
Miq. oral
Lauraceae Cinnamomum burmanii Bl. Keningar Bark Diabetes, erectile dysfunction, Decoction, oral
postpartum
Cinnamomum sintoc Bl. Sintok Bark Erectile dysfunction Decoction, oral
Persea americana Mill. Alpukat Fruit High cholesterol, hypertension Raw, oral
Leguminosae Erythrina variegata L. Dadap srep Leaf Fever Raw, topical
Euchresta horsfieldii (Lesch.) Benn. Pronojiwo Fruit Erectile dysfunction, leucorrhea Decoction, oral
Leucaena leucocephala (Lam.) de Wit Lamtoro Seed Postpartum Raw, oral
Psophocarpus tetragonolobus (L.) DC. Kecipir Seed Postpartum Boiled, oral
Sesbania grandiflora (L.) Pers. Turi Flower Low breast milk production, Boiled, oral
postpartum
Trigonella foenum-graecum L. Klabet Leaf Low breast milk production, Boiled, oral
postpartum
Vigna radiata (L.) R.Wilczek Kacang hijau Seed Pregnant women Boiled, oral
Liliaceae Aloe vera Mill. Lidah buaya Leaf Hair problems, skin burn Squeezed, topical
Loranthaceae Dendrophthoe pentandra (L.) Kemladean Leaf Fever Decoction, oral
Miq.
Lycoperdaceae Bovista gigantea (Batsch) Gray Jamur impes All parts External wound Squeezed, topical
Magnoliaceae Magnolia × alba (DC.) Figlar Kanthil Flower Postpartum Steam, vaginal
Marceliaceae Marsilea crenata C. Presl Semanggi Leaf Postpartum Raw, oral
Meliaceae Swietenia mahagoni (L.) Jacq. Mahoni Seed Diabetes Decoction, oral
Menispermaceae Tinospora crispa (L.) Hook. f. & Brotowali Leaf Postpartum, hypertension Decoction, oral
Thomson
Moraceae Morus alba L. Krokot Leaf Hypertension Decoction, oral
Ficus carica L. Buah Lo Fruit Female fertility Raw, oral
Moringaceae Moringa oleifera Lam. Kelor Leaf Low breast milk production, Boiled, oral
postpartum
Muntingiaceae Muntingia calabura L. Kersen Fruit Hypertension Raw, oral
Musaceae Musa × paradisiaca L. Pisang Flower Postpartum Boiled, oral
Myrtaceae Psidium guajava L. Jambu biji Leaf Diarrhea, hemorrhoid Raw, oral
Syzygium polyanthum (Wight) Salam Leaf Diabetes Decoction, oral
Walp.
Oleaceae Jasminum sambac (L.) Aiton Melati Flower Postpartum Steam, vaginal
Oxalidaceae Averrhoa bilimbi L. Blimbing wuluh Fruit Mouth ulcer Raw, oral
Phyllanthaceae Phyllanthus niruri L. Meniran Leaf Low immune system Decoction, oral
Plantaginaceae Digitalis purpurea L. Digitalis Leaf External wound Squeezed, topical
Plantago major L. Suri pandak Leaf Erectile dysfunction, menstrual Decoction, oral
pain, postpartum
Piperaceae Peperomia pellucida (L.) Kunth Suruhan Leaf Menstrual pain, postpartum Decoction/raw, oral
Piper betle L. Sirih Leaf Erectile dysfunction, flatulence, Decoction/steam,
menstrual pain, postpartum, oral/vaginal
wound infection
Piper ornatum N.E.Br. Sirih merah Leaf Low immune system, postpartum Decoction/steam,
oral/vaginal
Piper retrofractum Vahl Cabe jawa Fruit Erectile dysfunction Decoction, oral
Poaceae Cymbopogon citratus (DC.) Stapf Sereh Leaf Diarrhea, postpartum Decoction/steam,
oral/vaginal
Cynodon dactylon (L.) Pers. Grinting Stem External wound Squeezed, topical
Saccharum officinarum L. Tebu merah Stem Cough Squeezed, oral
Imperata cylindrica (L.) Raeusch. Alang-alang Root Erectile dysfunction Decoction, oral
Polypodiaceae Leptochilus buergerianus (Miq.) Pangotan Fruit Diabetes Raw, oral
Bosman
Rosaceae Rosa chinensis Jacq. Mawar Flower Postpartum Steam, vaginal
Rubus rosaefolius Sm. Grunggung Fruit Diarrhea, mouth ulcer
5470 B I O D I V E R S I T A S 24 (10): 5464-5477, October 2023

Rubiaceae Coffea arabica L. Kopi Seed Erectile dysfunction, headache Decoction, oral
Morinda citrifolia L. Bentis Fruit Diabetes, high cholesterol Decoction, oral
Paederia foetida L. Sembukan Leaf Leucorrhea, menstrual pain, Decoction/boiled,
postpartum oral
Rutaceae Citrus aurantiifolia (Christm.) Jeruk nipis Fruit Cough Raw, oral
Swingle
Citrus hystrix DC. Jeruk purut Fruit Cough, postpartum Raw/steam, oral/
vaginal
Solanaceae Datura metel L. Kecubung Flower Eye irritation Raw, optical
Physalis angulata L. Ceplukan Fruit Diarrhea Raw, oral
Solanum betaceum Cav. Terong belanda Fruit Pneumonia, sprue Raw, oral
Solanum melongena L. Terong Fruit High cholesterol, postpartum Raw, oral
Solanum muricatum Aiton Buah melodi Fruit Hypertension Raw, oral
Solanum nigrum L. Ranti Fruit, Postpartum Raw, oral
Leaf
Solanum tuberosum L. Kentang Tuber Dry skin Powdered, topical
Usneaceae Usnea barbata Fries Jenggot wesi All parts
Erectile dysfunction Decoction, oral
Zingiberaceae Alpinia galanga (L.) SW. Laos Rhizome Erectile dysfunction, low Decoction, oral
immune system, menstrual pain,
postpartum
Amomum cardamomum L. Kapulaga Fruit Erectile dysfunction Decoction, oral
Boesenbergia rotunda (L.) Mansf. Temu ireng Rhizome Postpartum Steam, vaginal
Curcuma alba L. Kunir putih Rhizome Dry skin Powdered, topical
Curcuma heyneana Valeton & Temu giring Rhizome Rheumatoid arthritis Decoction, oral
Zijp
Curcuma longa L. Kunir Rhizome Fever, headache, menstrual pain, Decoction, oral
postpartum
Curcuma xanthorrhiza Roxb. Temulawak Rhizome Erectile dysfunction, hepatitis, Decoction, oral
low immune system, menstrual
pain, postpartum
Kaempferia galanga L. Kencur Rhizome Cough, postpartum Decoction/steam,
oral/vaginal
Kaempferia rotunda L. Kunci Rhizome Erectile dysfunction, postpartum Decoction/steam,
oral/vaginal
Zingiber cassumunar Roxb. Bangle Rhizome Fever, headache, menstrual pain, Decoction, oral
postpartum
Zingiber officinale Roscoe Jahe Rhizome Cough, leucorrhea, menstrual Decoction, oral
pain, postpartum
Zingiber zerumbet (L.) Roscoe ex Lempuyang Rhizome Leucorrhea, hypertension, Decoction/steam,
Sm. menstrual pain, postpartum oral/vaginal

Table 2. Group of diseases and health-related problems treated by medicinal plants in Bromo Tengger Semeru National Park

Disease categories Specified disease name

Dermatological diseases Dry skin, external wound, eye irritation, hair problems, nose bleeding, skin burn, wound infection
Gastro-intestinal disorders Diarrhea, flatulence, hemorrhoid, intestinal worms, sprue
Internal medical diseases Dengue fever, diabetes, fever, high cholesterol, hypertension, insomnia, kidney stones, low immune
system
Reproductive healthcare Antifertility, erectile dysfunction, female fertility, leucorrhea, low breast milk production, menstrual pain,
postpartum, syphilis, pregnant women
Respiratory problems Asthma, cough, mouth ulcer, pneumonia
Skeleto-muscular disorders Headache, osteoporosis, rheumatoid arthritis
 BHAGAWAN et al. – Medicinal plants in Bromo Tengger Semeru National Park, Indonesia 5471

A B C
Figure 2. A) Plant part used, B) preparation, and C) administration route of medicinal plants in Bromo Tengger Semeru National Park

Most important medicinal plants recognized as substantial biopharmacological assets

The utilization of ranking and scoring methodologies is (Saudah et al. 2022), often prompting further exploration
instrumental in evaluating the extensive therapeutic into their pharmacological properties and phytochemical
potential of medicinal plants, which is substantiated by composition (Bhagawan et al. 2022). Hence, based on the
their frequent references. The ranking outcomes are derived discernment gleaned from SUV and FL analyses, the
from quantitative ethnopharmacological analysis (SUV and current study has identified E. longifolius as a prime
FL) for the five most extensively cited medicinal plants. candidate warranting thorough investigation into its
We found five plant species have demonstrated notable pharmacological attributes and phytochemical constituents.
high SUV values, specifically F. vulgare (1.29), E. This strategic selection aligns with the broader trends
longifolius (0.92), P. bettle (0.78), B. pilosa (0.75), and A. observed in ethnopharmacological research, ensuring that
calamus (0.59) (Figure 3). Concurrently, we have recorded efforts are concentrated on the most promising avenues of
five plant species with high FL values that exhibit distinct medicinal exploration.
efficacy against particular diseases. Notably, E. longifolius
emerges as a prominent candidate for addressing diarrhea Phytochemical compounds of E. longifolius
(92%), while A. calamus is a potent contender against fever Our investigation centered on the ethanol extract of
(59%). Additional noteworthy species encompass Psidium immature E. longifolius fruit. A comprehensive analysis
guajava for diarrhea (47%), Pimpinella pruatjan for unveiled the presence of twenty-five distinct compounds
erectile dysfunction (35%), and A. fistulosum for high encompassing diverse chemical classes. Among these,
cholesterol (32%) (Figure 4). twenty-two compounds have been confidently identified
Plant species exhibiting high SUV values inherently and their chemical names elucidated. However, a subset of
signify their pivotal pharmacological relevance within local three compounds remains unidentified. The fundamental
communities, as underscored by Kayani et al. (2015). peak chromatograms generated through UPLC-QTOF-
Moreover, the research by Utaminingrum et al. (2022) MS/MS analysis are visually represented in Figure 5,
emphatically underscores the utility of relative frequency providing a snapshot of the detected constituents. Table 3
of citation, as gauged through FL, in determining species' shows the details of all the compounds identified based on
pivotal roles in specific medicinal contexts. Previous their high-resolution mass spectrometry values and their
investigations have consistently highlighted that plant pharmacological activities.
species commanding dominant SUV and FL are notably

Figure 3. Five plant species with high SUV values by the Figure 4. Five plant species with high FL values by the
Tenggerese tribe in Bromo Tengger Semeru National Park Tenggerese tribe in Bromo Tengger Semeru National Park
5472 B I O D I V E R S I T A S 24 (10): 5464-5477, October 2023

Table 3. Phytochemical profile of E. longifolius fruit extract using the UPLC-QToF-MS/MS

Measured Compound
RT (min) % Area Compound name Pharmacological activity
m/z formula
1.055 6.93% 150.0279 C3H6N2O5 L-serine Neurological dysfunction (De Koning et al. 2003;
Maugard et al. 2021), antibacterial (Duan et al.
2016), antioxidant, cytoprotective (Maralani et al.
2012), antifungi (Hua et al. 2021), antiproliferative
(Rathgeb et al. 2014)
1.971 2.67% 293.1487 C13H19N5O3 N-diethyl-acetamide Antioxidant (Sribalan et al. 2015).
3.278 2.12% 143.0580 C6H9NO3 Methyl pyroglutamate Epithelial cancer (Stefanucci et al. 2014).
3,837 0.69% 354.0948 C16H18O9 Scopolin Antioxidant (Lee et al. 2013), antiosteoporotic (Park
et al. 2020), antihepatocellular carcinoma (Wang et
al. 2022)
4.258 0.71% 354.0936 C13H10N10O3 1,2,4-triazine-6-carboxamide -
4.595 2,32% 419.1807 C19H25N5O6 1H-purine-2,6-dione Analgesic (Zygmunt et al. 2015), anti-inflammatory
(Abou-ghadir et al. 2014)
5.069 2.98% 312.1336 C15H16N6O2 1,3,5-triazine Antibacterial, fungicidal, antimalarial, anticancer,
antiviral, antimicrobial, anti-inflammatory,
antiamoebic, antitubercular activities (Singh et al.
2021).
6.090 0.26% 539.2339 C22H33N7O9 L-Histidine Coagulation (He et al. 2018), anticancer (Mahmoud
et al. 2018), antitumor (Abolmaali et al. 2016),
antioxidant (Ruszkiewicz and Albrecht 2015)
6.502 0.53% 308.0881 C12H8N10O N-9H-Purin-3- -
pyridazinecarboxamide
6.860 0.26% 350.1005 C17H18O8 3-propanoic acid
7.281 0.05% 502.3279 C27H38N10 1,1'-bis-1,3,5-triazine-2,4- -
diamine
8.040 0.26% 673.2167 C29H35N7O10S Unknown -
8.493 0.99% 501.3431 C34H47NS 1-cyclohexyl ethyl benzene -
8.893 0.60% 715.2321 C44H33N3O7 2,2,4-trimethylquinolin-2- -
phenylacetate
9.251 0.08% 501.3457 C30H47NO5 3-Hydroxy-2-nitrolup-2-en- -
28-oic acid
9.472 0.11% 307.2054 C20H25N3 4-piperidinyl-1,2,3,4- -
tetrahydroisoquinoline
10.031 0.70% 484.3186 C30H44O5 Fupenzic acid Lipid-lowering activity (Zhu et al. 2022), antifungal
(Xing et al. 2019), cytotoxic activity (Zhang et al.
2022)
10.347 0.01% 502.3294 C30H46O6 Medicagenic acid Cytotoxic, antioxidant, antimicrobial activities
(Wang et al. 2021)
10.642 14.52% 276.1725 C17H24O3 6-Shogaol Anticancer, antimicrobials, antioxidants,
cardiovascular, anti-ulcer, antiemetic, anti-
inflamatory antiviral, neuroprotective (Kou et al.
2018; Roli et al. 2020; Bischoff-Kont and Fürst
2021; Rahaman et al. 2023), myelodysplastic
syndrome (Ooi et al. 2021)
11.105 11.65% 285.1367 C17H19NO3 Piperine Antiproliferative, antitumor, antiangiogenesis,
antioxidant, antidiabetic, anti-obesity, anti-
ashmatic, cardioprotective, antimicrobial,
antiaging, and immunomodulatory activities
(Meghwal and Goswami 2013; Derosa et al. 2016;
Haq et al. 2020; Tiwari et al. 2020)
11.938 7.15% 517.3162 C29H39N7O2 Piperidine Analgesic, antipsychotic, antihistamine, local
anastetic, anticholinergic, CNS stimulant,
antiemetic, immunosuppresant (Vardanyan 2017).
12.433 1.97% 519.3334 C7H37N25OS Unknown -
12.675 21.91% 519.3347 C28H33O16 Peonidin Antioxidant and prebiotic activity (Sun et al. 2018),
anticancer (Laksmiani et al. 2017), anti-
inflammatory (Sari et al. 2019)
13.192 15.89% 495.3352 C31H45NO4 D‑phenylalanine- Antitubercular activity (Pepi et al. 2022, 2023)
benzoxazole
13.908 4.11% 618.3916 C31H58N2O8S Unknown -
 BHAGAWAN et al. – Medicinal plants in Bromo Tengger Semeru National Park, Indonesia 5473

Figure 5. Chromatogram profile of E. longifolius extract using the UPLC-QToF-MS/MS

An in-depth analysis of the E. longifolius extract Antibacterial activity of E. longifolius

revealed several major phytochemical compounds, each The study examined the antibacterial potential of the
contributing significantly to the overall composition. 96% ethanol extract of Elaeocarpus longifolius against
Notably, Peonidin (21.91%), D‑phenylalanine-benzoxazole Staphylococcus aureus and Shigella dysenteriae (Figure 6
(15.89%), 6-Shogaol (14.52%), and Piperine (11.65%) and Table 4). The results revealed a significant suppression
emerged as dominant constituents, constituting more than of bacterial growth, indicating the extract's potent
10% of the extract. The pivotal role of these compounds in antibacterial attributes against both gram-positive and
the overall phytochemical profile is further magnified by gram-negative bacteria. The inhibition zones against S.
their pharmacological activities, as gleaned from aureus ranged from 11.48±0.26 mm to an impressive
contemporary literature. Peonidin, D‑phenylalanine- 19.17±0.31 mm across concentrations of 2.5 mg/mL to 40
benzoxazole, 6-Shogaol, and Piperine each exhibit diverse mg/mL, surpassing the positive control (9.91±0.43 mm).
pharmacological potential, positioning them as promising Similarly, against S. dysenteriae, the extract exhibited
candidates for therapeutic applications. Of noteworthy inhibition zones ranging from 14.67±0.53 mm to an
mention, D-phenylalanine-benzoxazole, as underscored by impressive 23.78±0.57 mm, outperforming the
recent studies by Pepi et al. (2022, 2023), has garnered chloramphenicol as positive control (10.27±0.75 mm). In
attention for its robust antitubercular properties. general, it is noteworthy that the antibacterial activity of the
While major phytochemical constituents often take the extracts against gram-negative bacteria exhibited higher
limelight, the significance of minor compounds in driving potency compared to their effect on gram-positive bacteria.
pharmacological activity should not be underestimated. Based on the statistical analysis conducted on the
Among these, Piperidine and L-Serine stand out as antibacterial activity of E. longifolius extract against S.
compelling examples, demonstrating a wide range of aureus at concentrations ranging from 2.5 mg/mL to 40
pharmacological activities. Piperidine has demonstrated its mg/mL, as well as the positive control group, no significant
utility as an analgesic, antipsychotic, antihistamine, local differences were observed among these groups. Likewise,
anesthetic, anticholinergic, CNS stimulant, antiemetic, and the statistical analysis for S. dysenteriae yielded similar
immunosuppressant, as reported by Vardanyan (2017). L- results, indicating the absence of significant differences
Serine influence spans across multiple domains of among the groups tested.
pharmacology, rendering it a versatile agent for various These outcomes underscore the potent antibacterial
health concerns. Notably, it exhibits profound potential in attributes of E. longifolius extract against both gram-
obstructing neurological dysfunction, as highlighted in positive and gram-negative bacteria. As elucidated by
studies by De Koning et al. (2003) and Maugard et al. Balouiri et al. (2016), the in vitro antibacterial method
(2021). Furthermore, L-Serine has shown efficacy as an serves as a practical and cost-effective tool for the
antibacterial agent (Duan et al. 2016), and it holds promise preliminary assessment of plant extract pharmacology.
as an antioxidant and cytoprotective entity (Maralani et al. Notably, this research validates the substantial
2012). Its multifaceted nature extends to antifungal pharmacological promise harbored by E. longifolius,
activities (Hua et al. 2021) and antiproliferative effects thereby establishing a strong foundation for its potential
(Rathgeb et al. 2014). utilization in antimicrobial applications. It is important to
5474 B I O D I V E R S I T A S 24 (10): 5464-5477, October 2023

note that these results represent the initial pharmacological Elaeocarpaceae family showcase diverse pharmacological
confirmation conducted on E. longifolius. Two major activities, often corroborated by their phytochemical
constituents, specifically 6-Shogaol and Piperine, have compositions. These findings, coupled with the validation
exhibited antibacterial efficacy. To date, no existing of the traditional use of E. longifolius as an anti-diarrheal
publication has presented evidence of its pharmacological agent, can serve as a broader platform for the potential
activity or the analysis of its phytochemical compounds. development of this plant as a promising plant-based
However, it is noteworthy that other species within the medicinal resource.

Table 4. Antimicrobial screening test of E. longifolius ethanolic extract against S. aureus and S. dysenteriae

Inhibition zones (mm)

Concentration
Samples Gram positive bacteria Gram negative bacteria
(mg/mL)
S. aureus S. dysenteriae
E. longifolius extract 2.5 11.48 ± 0.26 14.67 ± 0.53
5 12.31 ± 0.42 16.18 ± 0.22
10 13.42 ± 0.76 17.25 ± 0.89
20 16.46 ± 0.10 18.11 ± 0.72
40 19.17 ± 0.31 23.78 ± 0.57
Positive control (chloramphenicol) 0.5 9.91 ± 0.43 10.27 ± 0.75
Negative control (DMSO) 10 0 ± 0.00 0 ± 0.00
Note: Data are means of three replicates (n=3) ± standard deviation

Figure 6. Antibacterial activity assessment using E. longifolius extract against S. aureus at concentrations of 2.5 mg/mL (A1), 5 mg/mL
(A2), 10 mg/mL (A3), 20 mg/mL (A4), 40 mg/mL (A5), with corresponding negative control (A6) and positive control (A7). It also
illustrates the results of the antibacterial activity test against S. dysenteriae at concentrations of 2.5 mg/mL (B1), 5 mg/mL (B2), 10
mg/mL (B3), 20 mg/mL (B4), 40 mg/mL (B5), alongside the negative control (B6) and positive control (B7)
 BHAGAWAN et al. – Medicinal plants in Bromo Tengger Semeru National Park, Indonesia 5475

In conclusion, the area of Bromo Tengger Semeru Aziz YS, Peranginangin JM, Sunarni T. 2019. Ethnomedicinal studies and
antimicrobial activity tests of plants used in the Tengger Tribal
National Park inhabited by the Tenggerese people, is rich
Community. 1st International Conference of Health, Science &
in medicinal plants and requires further exploration. Technology (ICOHETECH). Universitas Duta Bangsa, Surakarta, 16
Medicinal plants still play an important role in this region, November 2019. DOI: 10.47701/icohetech.v1i1.792.
but traditional medicine used in this national park lacks Balouiri M, Sadiki M, Ibnsouda SK. 2016. Methods for in vitro evaluating
antimicrobial activity: A review. J Pharm Anal 6 (2): 71-79. DOI:
ethnopharmacological evidence. Our ethnopharmacological
10.1016/j.jpha.2015.11.005.
exploration led us to document a remarkable array of 124 Barkaoui M, Katiri A, Boubaker H, Msanda F. 2017. Ethnobotanical
medicinal plant species spanning 54 families. Notably, survey of medicinal plants used in the traditional treatment of diabetes
Zingiberaceae emerged as the most prominent family in in Chtouka Ait Baha and Tiznit (Western Anti-Atlas), Morocco. J
Ethnopharmacol 198: 338-350. DOI: 10.1016/j.jep.2017.01.023.
this regard. The prevalence of the reproductive healthcare
Batoro J, Siswanto D. 2017. Ethnomedicinal survey of plants used by
category, followed by internal medical diseases, underlines local society in Poncokusumo district, Malang, East Java Province,
the specific health concerns that traditional medicine seeks Indonesia. Asian J Med Biol Res 3 (2): 158-167. DOI:
to address in this community. The part of the plant that is 10.3329/ajmbr.v3i2.33563.
Batoro J. 2017. Keajaiban Bromo Tengger Semeru: Analisis Kehidupan
commonly used is the leaf, followed by the fruit. The most
Suku Tengger-Antropologi-Biologi di Lingkungan Bromo Tengger
frequent form of preparation is the decoction, followed by Semeru Jawa Timur. Universitas Brawijaya Press, Malang. [Indonesian]
the raw material. We found a species Elaeocarpus Bhagawan WS, Aziz YS, Pamungkas RPT. 2020. Pendekatan etnofarmasi
longifolius, that has a combination of high SUV and FL tumbuhan obat imunomodulator suku Tengger, Desa Ngadas,
Kabupaten Malang, Indonesia. J Islamic Med 4 (2): 98-105. DOI:
values. Thus, these plant species should be further
10.18860/jim.v4i2.10290. [Indonesian]
considered for phytochemical and pharmacological studies. Bhagawan WS, Barsyaif UA, Hidayat MA. 2021. Pendekatan etnobotani
We found 25 phytochemical compounds and obtained tumbuhan obat untuk permasalahan seksual suku Tengger di Desa
information about their high pharmacological activity. Argosari, Lumajang, Indonesia. Jurnal Tumbuhan Obat Indonesia 14
(2): 99-110. DOI: 10.22435/jtoi.v14i2.4169. [Indonesian]
Ultimately, these findings hold promise for the
Bhagawan WS, Ekasari W, Agil M. 2023. Education system and
development of novel plant-derived therapeutic solutions traditional knowledge of medicinal plants for healthcare in Tengger
that could benefit both the Tengger community and broader tribe, Argosari Village, East Java, Indonesia. In: Striełkowski W,
healthcare perspectives. Black JM, Butterfield SA, Chang C-C, Cheng J, Dumanig FP, Al-
Mabuk R, Urban M, Webb S (eds). Proceedings of the 3rd
International Conference on Education and Technology (ICETECH
2022). Universitas PGRI Madiun, Madiun, 26-27 October 2022. DOI:
ACKNOWLEDGEMENTS 10.2991/978-2-38476-056-5_76.
Bhagawan WS, Kusumawati D. 2021. Ethnobotanical medicinal plant
study of Tengger tribe in Ranu Pani Village, Indonesia. SSRN
We extend our heartfelt gratitude to the local Electron J 2021: 1-17. DOI: 10.2139/ssrn.3865725.
informants whose invaluable insights and knowledge Bhagawan WS, Suproborini A, Putri DLP, Nurfatma A, Putra RT. 2022.
greatly contributed to the success of this study. Ethnomedicinal study, phytochemical characterization, and
pharmacological confirmation of selected medicinal plant on the
northern slope of Mount Wilis, East Java, Indonesia. Biodiversitas 23
(8): 4303-4313. DOI: 10.13057/biodiv/d230855.
REFERENCES Bischoff-Kont I, Fürst R. 2021. Benefits of ginger and its constituent 6-
Shogaol in inhibiting inflammatory processes. Pharmaceuticals 14
Abbas Z, Kousar S, Aziz MA, Pieroni A, Aldosari AA, Bussmann RW, (6): 571. DOI: 10.3390/ph14060571.
Raza G, Abbasi AM. 2021. Comparative assessment of medicinal CLSI. 2012. Performance Standards for Antimicrobial Disk Susceptibility
plant utilization among balti and shina communities in the periphery Tests: Approved Standard, 11th eds. Clinical and Laboratory
of Deosai National Park, Pakistan. Biology 10 (5): 434. DOI: Standards Institute, Pennsylvania, USA. DOI: M02-A11.
10.3390/biology10050434. De Koning TJ, Snell K, Duran M, Berger R, Poll-The B-T, Surtees R.
Abolmaali SS, Tamaddon AM, Mohammadi S, Amoozgar Z, Dinarvand 2003. L-serine in disease and development. Biochem J 371: 653-661.
R. 2016. Chemically crosslinked nanogels of PEGylated poly DOI: 10.1042/BJ20021785.
ethyleneimine (L-histidine substituted) synthesized via metal ion Derosa G, Maffioli P, Sahebkar A. 2016. Piperine and its role in chronic
coordinated self-assembly for delivery of methotrexate: diseases. Adv Exp Med Biol 928: 173-184. DOI: 10.1007/978-3-319-
Cytocompatibility, cellular delivery and antitumor activity in resistant 41334-1_8.
cells. Mater Sci Eng C Mater Biol Appl 62: 897-907. DOI: Duan X, Huang X, Wang X, Yan S, Guo S, Abdalla AE, Huang C, Xie J.
10.1016/j.msec.2016.02.045. 2016. L-Serine potentiates fluoroquinolone activity against Escherichia
Abou-Ghadir OF, Hayallah AM, Abdel-Moty SG, Hussein MA. 2014. coli by enhancing endogenous reactive oxygen species production. J
Design and synthesis of some new purine-dione derivatives of Antimicrob Chemother 71 (8): 2192-2199. DOI: 10.1093/jac/dkw114.
potential anti-inflammatory activity. Der Pharma Chem 6 (2): 199- Elliott S, Brimacombe J. 1987. The medicinal plants of Gunung Leuser
211. National Park, Indonesia. J Ethnopharmacol 19 (3): 285-317. DOI:
Amri J, El Badaoui K, El Zair T, Bouharb H, Chakir S, Alaoui TEM. 10.1016/0378-8741(87)90006-7.
2014. Ethnobotanical study of medicinal plants in the region El Hajeb Ferretti-Gallon K, Griggs E, Shrestha A, Wang G. 2021. National parks
(Central Morocco). J Res Biol 4: 1568-1580. best practices: Lessons from a century’s worth of national parks
Arbiastutie Y, Marsono D, Hartati MS, Purwanto R. 2017. The potential management. Intl J Geoheritage Parks 9 (3): 335-346. DOI:
of understorey plants from Gunung Gede Pangrango National Park 10.1016/j.ijgeop.2021.05.004.
(West Java, Indonesia) as cervixs anticancer agents. Biodiversitas 18 Friedman J, Yaniv Z, Dafni A, Palewitch D. 1986. A preliminary
(1): 109-115. DOI: 10.13057/biodiv/d180116. classification of the healing potential of medicinal plants, based on a
Aswani S, Lemahieu A, Sauer WHH. 2018. Global trends of local rational analysis of an ethnopharmacological field survey among
ecological knowledge and future implications. PLoS One 13 (4): Bedouins in the Negev Desert, Israel. J Ethnopharmacol 16: 275-287.
e0195440. DOI: 10.1371/journal.pone.0195440. DOI: 10.1016/0378-8741(86)90094-2.
Athayde S, Silva-Lugo J, Schmink M, Heckenberger M. 2017. The same, Gailea R, Bratawinata AA, Pitopang R, Kusuma IW. 2016. The use of
but different: Indigenous knowledge retention, erosion, and various plant types as medicines by local community in the enclave of
innovation in the Brazilian Amazon. Hum Ecol 45: 533-544. DOI: the Lore-Lindu National Park of Central Sulawesi, Indonesia. Glob J
10.1007/s10745-017-9919-0. Res Med Plants Indig Med 5 (1): 29-40.
5476 B I O D I V E R S I T A S 24 (10): 5464-5477, October 2023

Gumisiriza H, Birungi G, Olet EA, Sesaazi CD. 2019. Medicinal plant Nugraha AS, Agustina RP, Mirza S, Rani DM, Winarto NB, Triatmoko B,
species used by local communities around Queen Elizabeth National Pratama ANW, Keller PA, Wangchuk P. 2022. Phytochemistry and
Park, Maramagambo Central Forest Reserve and Ihimbo Central pharmacology of medicinal plants used by the Tenggerese society in
Forest Reserve, South Western Uganda. J Ethnopharmacol 239: Java Island of Indonesia. Molecules 27 (21): 7532. DOI:
111926. DOI: 10.1016/j.jep.2019.111926. 10.3390/molecules27217532.
Haq I-U, Imran M, Nadeem M, Tufail T, Gondal TA, Mubarak MS. 2020. Nugraha AS, Permatasari AEN, Kadarwenny CP, Pratoko DK, Triatmoko
Piperine: A review of its biological effects. Phytother Res 35 (2): 680- B, Rosyidi VA, Norcahyanti I, Dewi IP, Dianasari D, Sary IP,
700. DOI: 10.1002/ptr.6855. Wangchuk P. 2020. Phytochemical screening and the antimicrobial
He W, Zhao A, Zou J, Luo X, Lin X, Wang L, Lin C. 2018. Synthesis, in and antioxidant activities of medicinal plants of Meru Betiri National
vitro coagulation activities and molecular docking studies on three L- Park-Indonesia. J Herbs Spices Med Plants 26 (3): 303-314. DOI:
Histidine amide derivatives. Chem Res Chin Univ 34: 90-94. DOI: 10.1080/10496475.2020.1734136.
10.1007/s40242-018-7184-4. Nurrochmat DR, Nugroho IA, Hardjanto, Purwadianto A, Maryudi A,
Heinrich M, Jager AK. 2015. Ethnopharmacology. John Wiley & Sons Erbaugh JT. 2017. Shifting contestation into cooperation: Strategy to
Ltd, Oxford, UK. incorporate different interest of actors in medicinal plants in Meru
Hua X, Liu W, Chen Y, Ru J, Guo S, Yu X, Cui Y, Liu X, Gu Y, Xue C, Betiri National Park, Indonesia. For Policy Econ 83: 162-168. DOI:
Liu Y, Sui J, Wang G. 2021. Synthesis, fungicidal activity, and 10.1016/j.forpol.2017.08.005.
mechanism of action of pyrazole amide and ester derivatives based on Ong HG, Ling SM, Win TTM, Kang D-H, Lee J-H, Kim Y-D. 2018.
natural products L-Serine and waltherione alkaloids. J Agric Food Ethnomedicinal plants and traditional knowledge among three Chin
Chem 69 (38): 11470-11484. DOI: 10.1021/acs.jafc.1c01346. indigenous groups in Natma Taung National Park (Myanmar). J
Huda MT, Khasanah I. 2019. The relationship between religious tribes in Ethnopharmacol 225: 136-158. DOI: 10.1016/j.jep.2018.07.006.
Tengger (Hindu, Islam and Budha). Vidyottama Sanatana Intl J Hindu Ooi SL, Campbell R, Pak SC, Golombick T, Manoharan A, Ramakrishna
Sci Relig Stud 3 (2): 284. DOI: 10.25078/ijhsrs.v3i2.748. R, Badmaev V, Schloss J. 2021. Is 6-Shogaol an effective
Husaini IPA, Maulany RI, Nasri N, Ngakan PO. 2022. Diversity and use phytochemical for patients with lower-risk myelodysplastic syndrome ?
of traditional medicinal plant species in Bantimurung-Bulusaraung A narrative review. Integr Cancer Ther 20: 15347354211065038.
National Park, Indonesia. Biodiversitas 23 (11): 5539-5550. DOI: DOI: 10.1177/15347354211065038.
10.13057/biodiv/d231101. Park E, Kim J, Jin H-S, Choi CW, Choi TH, Choi S, Huh D, Jeong S-Y.
International Society of Ethnobiology. 2006. ISE Code of Ethics (with 2020. Scopolin attenuates osteoporotic bone loss in ovariectomized
2008 additions). mice. Nutrients 12 (11): 3565. DOI: 10.3390/nu12113565.
Jadid N, Kurniawan E, Himayani CES, Andriyani, Prasetyowati I, Pepi MJ, Chacko S, Kopetz N, Boshoff HIM, Cuny GD, Hedstrom L.
Purwani KI, Muslihatin W, Hidayati D, Tjahjaningrum ITD. 2020. An 2023. Nonhydrolyzable d‑phenylalanine-benzoxazole derivatives
ethnobotanical study of medicinal plants used by the Tengger tribe in retain antitubercular activity. Bioorg Med Chem Lett 80: 129116.
Ngadisari village, Indonesia. PLoS One 15 (7): e0235886. DOI: DOI: 10.1016/j.bmcl.2022.129116.
10.1371/journal.pone.0235886. Pepi MJ, Chacko S, Marqus GM, Singh V, Wang Z, Planck K, Cullinane
Jamshidi-Kia F, Lorigooini Z, Amini-Khoei H. 2018. Medicinal plants: RT, Meka PN, Gollapalli DR, Ioerger TR, Rhee KY, Cuny GD,
Past history and future perspective. J HerbMed Pharmacol 7: 1-7. Boshoff HIM, Hedstrom L. 2022. A d-phenylalanine-benzoxazole
DOI: 10.15171/jhp.2018.01. derivative reveals the role of the essential enzyme Rv3603c in the
Jufe-Bignoli D, Burgess N, Bingham H, Belle E, de Lima M, Deguignet pantothenate biosynthetic pathway of Mycobacterium tuberculosis.
M, Bertzky B, Milam A, Martinez-Lopez J, Lewis E, Eassom A, ACS Infect Dis 8 (2): 330-342. DOI: 10.1021/acsinfecdis.1c00461.
Wicander S, Geldmann J, van Soesbergen A, Arnell A, O’Connor B, Phillips O, Gentry AH. 1993a. The useful plants of Tambopata, Peru: I.
Park S, Shi Y, Danks F, MacSharry B, Kingston N. 2014. Protected Statistical hypotheses tests with a new quantitative technique. Econ
Planet Report 2014. UNEP-WCMC, Cambridge, UK. Bot 47: 15-32. DOI: 10.1007/BF02862203.
Kayani S, Ahmad M, Sultana S, Khan Shinwari Z, Zafar M, Yaseen G, Phillips O, Gentry AH. 1993b. The useful plants of Tambopata, Peru: II.
Hussain M, Bibi T. 2015. Ethnobotany of medicinal plants among the Additional hypothesis testing in quantitative ethnobotany. Econ Bot
communities of Alpine and Sub-alpine regions of Pakistan. J 47: 33-43. DOI: 10.1007/BF02862204.
Ethnopharmacol 164: 186-202. DOI: 10.1016/j.jep.2015.02.004. Putri FK, Noven HJ, Nurcahyati M, Irfan AN, Septiasari A, Batoro J,
Kim H, Song MJ. 2014. Analysis of traditional knowledge about medicinal Setyawan AD. 2022. Review: Local wisdom of the Tengger tribe,
plants utilized in communities of Jirisan National Park (Korea). J East Java, Indonesia in environmental conservation. Asian J
Ethnopharmacol 153 (1): 85-89. DOI: 10.1016/j.jep.2013.10.047. Ethnobiol 5 (1): 20-34. DOI: 10.13057/asianjethnobiol/y050203.
Kou X, Wang X, Ji R, Liu L, Qiao Y, Lou Z, Ma C, Li S, Wang H, Ho C- Rahaman MZ, Tanim TI, Islam MT. 2023. A short review on 6-Shogaol.
T. 2018. Occurrence, biological activity and metabolism of 6-shogaol. Clin Res Notes 4 (1): 4-7. DOI: 10.31579/2690-8816/078.
Food Funct 9 (3): 1310-1327. DOI: 10.1039/C7FO01354J. Rathgeb A, Böhm A, Novak MS, Gavriluta A, Dömötör O, Tommasino
Laksmiani NPL, Widiastari MI, Reynaldi KR. 2017. The inhibitory JB, Enyedy ÉA, Shova S, Meier S, Jakupec MA, Luneau D, Arion
activity of peonidin purple sweet potato in human epidermal receptor- VB. 2014. Ruthenium-nitrosyl complexes with Glycine, L‑Alanine,
2 receptor (her-2) expression by in silico study. J Phys Conf Ser 1040: L‑Valine, L‑Proline, D‑Proline, L‑Serine, L‑Threonine, and
012010. DOI: 10.1088/1742-6596/1040/1/012010. L‑Tyrosine: Synthesis, x‑ray diffraction structures, spectroscopic and
Laksono AD. 2020. Tengger Bertahan dalam Adat: Studi Konstruksi electrochemical properties, and antiproliferative activity. Inorg Chem
Sosial Ukuran Keluarga Suku Tengger. Health Advocacy, Surabaya. 53 (5): 2718-2729. DOI: 10.1021/ic4031359.
[Indonesian] Ratnadewi AAI, Wahyudi LD, Rochman J, Susilowati, Nugraha AS,
Lee S-H, Ding Y, Yan XT, Kim Y-H, Jang H-D. 2013. Scopoletin and Siswoyo TA. 2020. Revealing anti-diabetic potency of medicinal
scopolin isolated from Artemisia iwayomogi suppress differentiation plants of Meru Betiri National Park, Jember - Indonesia. Arab J Chem
of osteoclastic macrophage RAW 264.7 cells by scavenging reactive 13 (1): 1831-1836. DOI: 10.1016/j.arabjc.2018.01.017.
oxygen species. J Nat Prod 76 (4): 615-620. DOI: 10.1021/np300824h. Redouan FZ, Benítez G, Picone RM, Crisafulli A, Yebouk C, Bouhbal M,
Mahmoud WH, Omar MM, Sayed FN, Mohamed GG. 2018. Synthesis, Ben Driss A, Kadiri M, Molero-Mesa J, Merzouki A. 2020.
characterization, spectroscopic, and theoretical studies of transition Traditional medicinal knowledge of Apiaceae at Talassemtane
metal complexes of new nano schiff base derived from L‐histidine National Park (Northern Morocco). S Afr J Bot 131: 118-130. DOI:
and 2‐acetylferrocene and evaluation of biological and anticancer 10.1016/j.sajb.2020.02.004.
activities. Appl Organomet Chem 32 (7): e4386. DOI: 10.1002/aoc.4386. Roli OI, Adetunji CO, Mishra RR, Adetunji JB, Mishra P, Fatoki TH.
Maralani MN, Movahedian A, Javanmard SH. 2012. Antioxidant and 2020. Rediscovering Medicinal Activity and Food Significance of
cytoprotective effects of L-serine on human endothelial cells. Res Shogaol (4, 6, 8, 10, and 12): Comprehensive Review. In: Mishra P,
Pharm Sci 7 (4): 209-215. Mishra RR, Adetunji CO (eds). Innovations in Food Technology.
Maugard M, Vigneron P-A, Bolaños JP, Bonvento G. 2021. L-Serine links Springer, Singapore. DOI: 10.1007/978-981-15-6121-4_9.
metabolism with neurotransmission. Prog Neurobiol 197: 101896. Ruszkiewicz J, Albrecht J. 2015. Changes of the thioredoxin system,
DOI: 10.1016/j.pneurobio.2020.101896. glutathione peroxidase activity and total antioxidant capacity in rat
Meghwal M, Goswami TK. 2013. Piper nigrum and piperine : An update. brain cortex during acute liver failure: Modulation by L-histidine.
Phytother Res 27: 1121-1130. DOI: 10.1002/ptr.4972. Neurochem Res 40: 293-300. DOI: 10.1007/s11064-014-1417-9.
 BHAGAWAN et al. – Medicinal plants in Bromo Tengger Semeru National Park, Indonesia 5477

Sari DRT, Cairns JRK, Safitri A, Fatchiyah F. 2019. Virtual prediction of Tomasini S, Theilade I. 2019. Local knowledge of past and present uses of
the Delphinidin-3-O-glucoside and Peonidin-3-O-glucoside as anti- medicinal plants in Prespa National Park, Albania. Econ Bot 73: 217-
inflammatory of TNF- α signaling. Acta Inform Med 27 (3): 152-157. 232. DOI: 10.1007/s12231-019-09454-3.
DOI: 10.5455/aim.2019.27.152-157. Utaminingrum W, Nofrianti, Hartanti D. 2022. Diversity and use of
Saudah, Zumaidar, Darusman, Fitmawati, Roslim DI, Ernilasari. 2022. medicinal plants for traditional women’s health care in Northern
Ethnobotanical knowledge of Etlingera elatior for medicinal and food Banyumas, Indonesia. Biodiversitas 23 (4): 1970-1976. DOI:
uses among ethnic groups in Aceh Province, Indonesia. Biodiversitas 10.13057/biodiv/d230431.
23 (8): 4361-4370. DOI: 10.13057/biodiv/d230862. van Wyk B, Wink M. 2017. Medicinal Plants of the World, 2nd eds.
Setyowati FM, Wardah W. 2007. Diversity of medicinal plant by Talang CABI, Boston. DOI: 10.1079/9781786393258.0000.
Mamak tribe in surrounding of Bukit Tiga Puluh National Park, Riau. Vardanyan R. 2017. Piperidine-Based Drug Discovery. Elsevier Ltd,
Biodiversitas 8 (3): 228-232. DOI: 10.13057/biodiv/d080313. Amsterdam. DOI: 10.1016/B978-0-12-805157-3.00010-7.
[Indonesian] Wang C, Zhou Q, Wu S-T. 2022. Scopolin obtained from Smilax china L.
Shalas AF, Khasanah U, Adianingsih OR, Raharjaa KR, Khansa N, Maula against hepatocellular carcinoma by inhibiting glycolysis: A network
RA, Destian NC, Lestari SW. 2021. Ethnomedicine study of Tengger pharmacology and experimental study. J Ethnopharmacol 296:
people of Ngadas Village in Malang, East Java, Indonesia: In search 115469. DOI: 10.1016/j.jep.2022.115469.
of antimicrobial plants. J Young Pharm 13 (2): 97-106. DOI: Wang G, Wang J, Liu W, Nisar MF, El-Esawi MA, Wan C. 2021.
10.5530/jyp.2021.13.22. Biological activities and chemistry of triterpene saponins from
Singh S, Mandal MK, Masih A, Saha A, Ghosh SK, Bhat HR, Singh UP. Medicago species: An update review. Evid-Based Complement Altern
2021. 1, 3, 5‐Triazine: A versatile pharmacophore with diverse biological Med 2021: 6617916. DOI: 10.1155/2021/6617916.
activities. Arch Pharm 354: e2000363. DOI: 10.1002/ardp.202000363. Wang J-HZ. 2019. National parks in China: Parks for people or for the
Song M-J, Kim H, Lee B-Y, Brian H, Park C-H, Hyun C-W. 2014. nation?. Land Use Policy 81: 825-833. DOI:
Analysis of traditional knowledge of medicinal plants from residents 10.1016/j.landusepol.2018.10.034.
in Gayasan National Park (Korea). J Ethnobiol Ethnomed 10: 74. Xing L, Liang L, Yun Z, Lei H, Jian Y, Dong Z, Ping G. 2019. Chemical
DOI: 10.1186/1746-4269-10-74. constituents from Sorbus aucuparia cell suspension treated with yeast
Sribalan R, Kirubavathi M, Banuppriya G, Padmini V. 2015. Synthesis and their antifungal activity. Nat Prod Res Dev 31: 2071-2076.
and biological evaluation of new symmetric curcumin derivatives. Yudiyanto Y, Hakim N, Wakhidah AZ. 2022. Ethnobotany of medicinal
Bioorg Med Chem Lett 25 (19): 4282-4286. DOI: plants from Lampung Tribe around Way Kambas National Park,
10.1016/j.bmcl.2015.07.088. Indonesia. Nusantara Biosci 14 (1): 84-94. DOI:
Stefanucci A, Novellino E, Costante R, Mollica A. 2014. Pyroglutamic 10.13057/nusbiosci/n140111.
acid derivatives: Building blocks for drug discovery. Heterocycles 89: Zahoor M, Yousaf Z, Aqsa T, Haroon M, Saleh N, Aftab A, Javed S,
1801-1825. DOI: 10.3987/REV-14-800. Qadeer M, Ramazan H. 2017. An ethnopharmacological evaluation of
Sujarwo W, Arinasa IBK, Salomone F, Caneva G, Fattorini S. 2014. Navapind and Shahpur Virkanin district Sheikupura, Pakistan for
Cultural erosion of Balinese indigenous knowledge of food and their herbal medicines. J Ethnobiol Ethnomed 13:1. DOI:
nutraceutical plants. Econ Bot 68: 426-437. DOI: 10.1007/s12231- 10.1186/s13002-017-0151-1.
014-9288-1. Zatout F, Benarba B, Bouazza A, Babali B, Bey NN, Morsli A. 2021.
Sun H, Zhang P, Zhu Y, Lou Q, He S. 2018. Antioxidant and prebiotic Ethnobotanical investigation on medicinal plants used by local
activity of five peonidin-based anthocyanins extracted from purple populations in Tlemcen National Park (extreme North West Algeria).
sweet potato (Ipomoea batatas (L.) Lam.). Sci Rep 8 (1): 5018. DOI: Mediterr Bot 42: 1-12. DOI: 10.5209/mbot.69396.
10.1038/s41598-018-23397-0. Zhang J, Yang Y-N, Feng Z-M, Yuan X, Zhang X, Jiang J-S, Zhang P-C.
Susanti R, Zuhud EAM. 2019. Traditional ecological knowledge and 2022. The triterpenoids and sesquiterpenoids from the plant of
biodiversity conservation: The medicinal plants of the Dayak Krayan Agrimonia pilosa. Fitoterapia 157: 105104. DOI:
people in Kayan Mentarang National Park, Indonesia. Biodiversitas 10.1016/j.fitote.2021.105104.
20 (9): 2764-2779. DOI: 10.13057/biodiv/d200943. Zhu Q-J, Lang L-J, Wang Y, Zhang D-Q, Jiang B, Xiao C-J. 2022.
Susiarti S, Rahayu M, Rugayah. 2018. Diversity of Indonesian medicinal Triterpenoids from the fruits of wild species of Crataegus scabrifolia
plant in the lowland forest, Bodogol and its surrounding of Mount and their lipid-lowering activities. Russ J Bioorg Chem 48: 1291-
Gede-Pangrango National Park, West Java. IOP Conf Ser: Earth 1298. DOI: 10.1134/S1068162022060292.
Environ Sci 166: 012021. DOI: 10.1088/1755-1315/166/1/012021. Zygmunt M, Chłon-Rzepa G, Sapa J, Pawłowski M. 2015. Analgesic
Tiwari A, Mahadik KR, Gabhe SY. 2020. Medicine in drug discovery activity of new 8-methoxy-1,3-dimethyl-2,6-dioxo-purin-7-yl derivatives
Piperine: A comprehensive review of methods of isolation, purification, with carboxylic, ester or amide moieties. Pharmacol Rep 67 (1): 9-16.
and biological properties. Med Drug Discov 7: 100027. DOI: DOI: 10.1016/j.pharep.2014.07.018.
10.1016/j.medidd.2020.100027.