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Milia, E. Properties of Pistacia lentiscus L.. Encyclopedia. Available online: https://encyclopedia.pub/entry/9331 (accessed on 06 May 2024).
Milia E. Properties of Pistacia lentiscus L.. Encyclopedia. Available at: https://encyclopedia.pub/entry/9331. Accessed May 06, 2024.
Milia, Egle. "Properties of Pistacia lentiscus L." Encyclopedia, https://encyclopedia.pub/entry/9331 (accessed May 06, 2024).
Milia, E. (2021, May 06). Properties of Pistacia lentiscus L.. In Encyclopedia. https://encyclopedia.pub/entry/9331
Milia, Egle. "Properties of Pistacia lentiscus L.." Encyclopedia. Web. 06 May, 2021.
Properties of Pistacia lentiscus L.
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This entry is adapted from the peer-reviewed paper 10.3390/antibiotics10040425

Pistacia lentiscus L. (PlL) is a wild-growing shrub rich in terpenoids and polyphenols, the oil and extracts of which have been widely used against inflammation and infections, and as wound healing agents.

essential oils terpenoids water extracts ethanol extracts natural antimi- crobials natural anti-inflammatory polyphenols Mediterranean plants pharmaceutical plants

1. Introduction

The undesirable side effects of antibiotics in addition to increasing microbial resistance have created a demand for new alternative molecules [1]. Non-steroidal anti-inflammatory drugs (NSAIDs) or even steroids, often inducing toxic side-effects [2] have also gained further interest as molecules presenting an anti-inflammatory character.
On these bases, there is an increasing attention towards revisiting plants for drug discovery, proving scientifically their role as popular remedies to diseases [3][4]. Approved therapeutic agents such as statins, tubulin-binding anticancer drugs and some types of immunosuppressants are examples of molecules originating from natural plants [5].
In the Mediterranean region, folk medicine has used extracts and oils derived, e.g., from Malva species [1], Thymbra capitate (L.) Cav. [2] and Olea europea L. [3] for many years.
The biological activity of essential oils (EOs) and polyphenols from plants and herbs is related to the presence of different chemical classes. In this regard, terpenes and terpenoids in EOs are promising agents in the prevention and treatment of diseases [6][7]. Terpenes are hydrocarbons, and terpenes containing additional functional groups, usually oxygen-containing, are called terpenoids [8]. They are lipophilic, and interact with cell membranes, neuronal and muscle ion channels, neurotransmitter receptors, G-protein coupled receptors, second messenger systems and enzymes [9]. Their beneficial effects and their roles have been evaluated for many decades in human disease, such as inflammatory diseases, tumorigenesis and neurodegeneration using cell and animal models, suggesting terpenes and terpenoids as potential chemopreventive and therapeutic agents [10]. Further interesting capabilities have been ascribed to polyphenols from botanical species, with molecules including tannins, flavonoids and lignin-carbohydrate complexes having been associated with strong antimicrobial, anti-inflammatory and antioxidant properties [11].
In this context, Pistacia lentiscus L. (PlL) is a wild-growing shrub rich in terpenoids and polyphenols [12]. PlL includes numerous wild and cultivated species, distributed in the Mediterranean and Middle Eastern areas. Although there has been broad investigation on the aromatic natural resin and its clinical application [13][14], the scientific data regarding PlL oil or extracts of leaves, fruits and woods have been not summarized yet. Today, the scientific interest in these edible and not-edible parts of PlL is wide-spreading, as some studies underlined the potential benefit against inflammation and infections [12][15][16]. Additionally, the high content of polyphenols found in the extracts make them attractive against chronic and degenerative diseases and as nutraceuticals in human health [15].
Given the above considerations, the purpose of this review was to screen the biological properties of PlL EO and extracts of leaves and fruits. Starting from this, we searched for the phytochemistry of PlL growing in the different geographical areas and reported on the anti-inflammatory and antimicrobial abilities of the plant. For that purpose, a search for the existing literature was made by using data bases such as MEDLINE/PubMed and the Cochrane Library electronic databases.

2. Botany and Taxonomy

PlL Belongs to the Genus Pistacia, Anacardiaceae Family, Order Sapindales

Different classifications have been proposed regarding the Pistacia genus. One of the most known is that of Zohary [16], who classified the genus into four main groups according to the characteristics of the leaf and nut morphology (Table 1).
Table 1. Taxonomy description (groups and species) of the Pistacia genus (adapted from Zohary [16]).
Group Species
Lenticella Pistacia mexicana HBK
  Pistacia texana Swingle
Eu lentiscus Pistacia lentiscus L. (mastic tree)
  Pistacia saporte Burbar
  Pistacia weinmannifolia Poisson
Butmela Pistacia atlantica Desf.
Eu terebintus Pistacia chinensis Bge.
  Pistacia khinjuk Stocks
  Pistacia palaestina Bois.
  Pistacia terebinthus L.
  Pistacia vera L.
In the Mediterranean area (Middle East and Europe), the three most represented species are the following:
  • Pistacia vera L., which is characteristic of the temperate areas of Asia Minor, and grown abundantly in Greece, the Aegean Islands and in Sicily (Italy). This species has been known since ancient times as attested in reports of the Old Testament. Additionally, there have been notices of Pistacia vera by Persian and Greek populations since the 6th and the 3rd century B.C., respectively.
  • Pistacia terebinthus L., originating from the island of Chios, has spread to all the Mediterranean coasts over the centuries. Today, it is mostly present in Portugal, Palestine and North Africa, and in the Middle East of Asia till the western borders of India. In Italy, it is mainly found in the southern part of the peninsula and in Sardinia and Sicily.
  • Pistacia lentiscus L., also known as mastic tree or lentisk (Figure 1).
Antibiotics 10 00425 g001 550
Figure 1. Pistacia lentiscus L., also known as mastic tree or lentisk.
PlL represents one of the most typical shrubs in the Mediterranean maquis (shrubland) of Europe, Morocco, Turkey, Iraq and Iran [17]. In Italy, it is characteristic of the sensitive ecosystem, like that of Sardinia [18], where it grows along the coast up to 700 m above sea level.
PlL is an evergreen environmentally sustainable shrub. It is well-adapted to harsh growing conditions, dryness and a warm environment, which all exercise an influence on the genotype and richness of secondary metabolites [19]. The plant is dioecious, where male and female flowers are on independent trees. The leaves are leathery, bright green and alternate. They are arranged in compound, pinnate whorls. The unisexual flowers are grouped in clusters. The globular fruit is a fleshy drupe, which ripens in August and ranges in color from red to brown in view of the different degrees of maturity [17]. PlL can develop leaf galls due to insect attack, particularly aphid attacks [20]. Common aphid species, such as Slavum wertheimae and Baizongia pistaciae L., manipulate the leaves to form tumorous galls for the safety and nutriment of their larvae [21]. The galls are rich in volatile-like terpenes with an abundance of monoterpenes, α -pinene and limonene [22]. Their chemical composition differs from that of the healthy leaves, which have in general a higher content of sesquiterpenes [22].

3. Historical and Cultural Use

PlL has had a wide range of applications over the centuries. One of the oldest dates back to the Nuragic civilization (1800 to 238 BCE) and was ascribed to the Sardinian population: the oil obtained by cold-pressing the berries was widely used for social purposes, i.e., home or votive lighting lamps, cooking, as well as as a popular remedy [17]. This habit is attested to by the presence of residues of “olium lentiscinum” often found during archaeological excavations in “torcularia” (ancient oil mills) [18].
Today, PlL is considered as an environment phytostabilizer due to the ability to detoxify the soil from harmful pollutants and heavy metals [23]. Furthermore, the plant represents an important source to increase milk quality and dairy products from ruminants browsing the Mediterranean maquis [24].

4. Ethnopharmacology

The ethnopharmacological survey on the medicinal use of PlL is reported in Table 2.
Table 2. Ethnopharmacological uses of Pistacia lentiscus L.
Geographical Area Ailment/Uses Ref.
Sardinia, Italy Oral cavity inflammation and infection, tooth ache, osteoarthritis, bronchitis, cough sedative, antipyretic, allergies, asthma, ulcerations, gastrointestinal disorders, wound healing and haemostatic [19][25][26][27][28][29][30][31]
Southern regions of Italy (Calabria and Campania) Inflammation of the mouth, tooth ache, mycosis, herpes and refreshing feet [27][32]
Central regions of Italy (Abruzzi, Marche and Tuscany), Spain Hypertension and cardiac diseases [27][33]
Spain Analgesic, teeth strengthening, hypertension and cardiac diseases [33][34]
Tunisia Antipyretic, astringent, eczema, paralysis, antimicrobial, throat infections, asthma, hypertension, cardiac diseases, paralysis, diuretic properties, renal stones, jaundice, antiatherogenic effect, antihepatotoxic and gastrointestinal diseases [27][35]
Algeria Stomach ache, dyspepsia, peptic ulcer, diarrhea and rheumatism [36]
Morocco and
North Africa		 Hypertension, cardiac diseases and diabetes [37]
Libya Immuno-stimulant and antimicrobial [23]
Jordan Ameliorate jaundice [38][39]
Israel Heartburn and soothes stomach [40]
Iran Gum tissue strengthened, breath deodorizer, brain and liver tonic and gastrointestinal ailments [41][42]
Turkey Throat infections, asthma, eczema, stomach ache, renal stones, paralysis, diarrhea, jaundice, anti-inflammatory, antimicrobial, antipyretic, stimulant and astringent [43]
As previously referred to, there are few written indications on the medicinal use of the oil as a crude compound, or of the extracts as well. Drinking water extracts and topical application of the extracts or even whole parts of the plant (woods or leaves) have been the most common means of antagonizing gastrointestinal, hepatic, urinary, pulmonary and neurological diseases. In fact, the medicinal value of PlL in popular medicine covers a wide range of diseases, mainly including inflammatory processes and infections.
The Sardinian population has always found the medicinal properties of PlL highly appealing. A large number of publications report PlL oil and water extracts as useful means against a wide variety of inflammatory diseases, infections, allergies [21][27][28][32][33] and gastrointestinal disorders [28][29][30], and as wound healing [31]. It is further interesting to note that the Sardinian population administrated PlL as a smoke obtained by burning or boiling the soft wood and leaves, particularly in the cases of osteoarthritis, bronchitis and allergies [30]. In addition, PlL is still used as a remedy toward tooth ache and gingival inflammation by administering extracts from the leaves as oral mouthwash, beverages or by directly chewing the soft stems and leaves [30].
Similar beneficial effects have been reported by using the plants growing in the Southern (Campania) [32] and in the center (Abruzzo, Marche and Toscana) of Italy, in Tunisia [27] and in Spain [34].
PlL has been one of most used plants in Israeli and neighboring countries’ traditional pharmacology [40]. In Jordan, it was commonly used to antagonize jaundice [38][39]. In Algeria, it is known as antimicrobial, antioxidant, hypotensive and hypoglycemic agent [44]. In Morocco and Tunisia [35][37], PlL has been largely used as a remedy against gastrointestinal, kidney and hepatic disorders, in addition to being used to treat hypertension, diabetes, cardiac diseases, coughs, sore throats and eczema. Similar applications are reported in Turkey [43] and in Iran [41][42]. Meanwhile, in Tunisia, Spain and in the center of Italy, it has emerged as an agent against hypertension and heart diseases [27][37][41][42][43].
Regarding the veterinary use, in Sardinia, domestic animals are still treated by PlL wood to combat gastrointestinal disorders, and by swab bark in wound healing procedures and skin diseases [45]. Meanwhile, in Spain, the leaves are mentioned to treat specifically canine distemper [33].

5. Phytochemical Constituents

Mainly leaves and fruits are used for preparations of EO and also of water and alcoholic extracts. In Table 3, the major compounds of the EO and the extracts are listed. Hydro-distillation using Clevenger-type devices, and ethanol solvent have been the more common methods to obtain, respectively, the oil and extracts from leaves and fruits. However, the oil obtained by hydro-distillation and the extracts by solvents can have different organoleptic profiles and chemical compositions. These differences, in turn, will affect some properties, among which is the antimicrobial capacity, which is reported to be higher in a material solvent extract in comparison to a hydro-distilled [46]. Additionally, gas chromatography-mass spectroscopy (GC/MS) and high-performance liquid chromatography (HPLC) have been the most useful means to quantify phytochemically the oils and extracts, respectively [47].
Table 3. Chemical profiles of Pistacia lentiscus L.
Plant Material Origin Main Components of Essential Oils or Plant Extracts Test Assays Ref.
Essential oils from        
Leaves Spain β-myrcene (19%), α-terpineol + terpinen-4-ol (15%), α-pinene (11%) GC-MS [48]
Unripe fruit   β-myrcene (54%), α-pinene (22%), GC-MS  
Ripe fruit   β-myrcene (19%), α-pinene (11%), δ-3-carene GC-MS  
Leaves Egypt δ-3-carene (65%), sesquiterpene alcohols (4%) GC-MS [49]
Leaves Greece Myrcene (20.6%), germacrene D (13.3%), E-caryophyllene (8.3%), α-cadinol (7.3%), t5-cadinene (7.0%) GC-MS [50]
Leaves Turkey Terpinen-4-ol (29.9%), α-terpineol, (11.6%), limonene (10.6%), (Z)-3-Hex-1-enyl benzoate (6.7%), α-pinene (4.2%), β-caryophyllene (3.2%) GC-MS [51]
Leaves Morocco Myrcene (39.2%), limonene (10.3%), β-gurjunene (7.8), germacrene (4.3%), α-pinene (2.9%), muurolene (2.9%) GC-FID; GC-MS [52]
Leaves Tunisia α-pinene (16.8%), 4-terpinenol (11.9%), β-phellandrene (8.9%), sabinene (5.7%9, γ-terpinene (5.5%) and β-pinene (4.3%) GC–MS [53]
Aerial parts Algeria (Algiers) Longifolene (12.8%), γ-cadinene (6.2%), trans-β-terpineol (5%), α-acorneol (4.6%), γ-muurolene (4.2%), β-pinene (3.7%) GC, GC-MS [54]
  Algeria
(Tizi-Ouzou)		 Longifolene (16.4%), trans-β-terpineol (15.6%), terpinen-4-ol (7%), γ-muurolene (5.7%), β-pinene (3.3%), α-pinene (2.8%) GC, GC-MS  
  Algeria (Oran) α-pinene (19%), trans-β-terpineol (13.1%), sabinene (12.6%), β-pinene, (6.5%), (E)-β-ocimene (5.5%), longifolene (5.2%) GC, GC-MS  
Leaves Sardinia (Italy) α-pinene (14.8–22.6%), terpinen-4-ol (14.2–28.3%), β-myrcene (1.0–18.3%), p-cymene (14.8–16.2%), sabinene (2.5–8.1%), limonene (0.9–3.8%) GC-MS [19]
Leaves Greece α-pinene (9.4–24.9%), terpinen-4-ol (6.8–10.6%), p-cymene (0.5–7.5%), limonene (9.0–17.8%), γ-terpinene (3.1–3.6%) GC-MS [55]
Leaves Sardinia (Italy) α-pinene, α-thujene, camphene, sabinene, β-pinene, myrcene, α-phellandrene, α-terpinene, para-cymene, β-phellandrene, trans-ocemene, γ-terpene, terpinolene, 2-nonanone, linalool, isopentyl isovalerate, terpin-4-ol, α-terpiniol and others. GC-MS [29]
Leaves Algeria β-caryophyllene (54–198 μg g−1 dw), δ-cadinene (15–186 μg g−1 dw), cubebol (15–117 μg g−1 dw), β-bisabolene (22.1- 105 μg g−1 dw), α-pinene (1.9–105 μg g−1 dw), γ-muurolene (29.7–67.3 μg g−1 dw) GC-MS [56]
Leaves Sardinia (Italy) Germacrene D (19.9%), β-caryophyllene (6.6%), α-pinene (6.3%), myrcene (3.9%), β-phellandrene (3.7%), α-humulene (2.4%) GC-MS [12]
Leaves Eastern Morocco Taforalt and Saidia areas: limonene, α-pinene, α-terpineol and β-caryophyllene;Laayoune and Jerada areas: myrcene and
β-caryophyllene.		 GC-MS [57]
Fresh leaves Greece δ-germacrene (24.78%), myrcene (19.5%), α-cadinol (9.53%), γ-cadinene (5.59%), trans-caryophyllene (5.03%), limonene (4.84%) GC-MS [58]
Dried leaves   δ-cadinene (17.04%), α-amorphene (10.32%), δ-germacrene (9.01%), trans-caryophyllene (6.32%), α-cubebene (5.55%), naphthalene (4.13%) GC-MS  
Ripe fruits Tunisia Phenolic composition of seed oil (concentrations not shown) GC-MS [59]
Leaves Tunisia Germacrene D (11.9%), pinene (9.9%), limonene (8.5%), δ-cadinene (8.5%), β-caryophyllene (8.2%), terpinen 4-ol (5.1%) GC-FID, GC-MS [60]
Fruits Tunisia α-pinene (13.35%), α-phellandrene (10.12%), β-phellandrene (10.45%), sabinene (7.01%), germacrene-D (6.86%), β-caryophyllene (4.58%) GC-MS [61]
Leaves Tuscany (Italy) α-pinene (24.6–9.2%), 1–4 terpineol (14.9–7.1%), β-phellandrene (11.4–4.7%), β-pinene (8.6–1.2%), β-mircene (9.2–0.7%), α-terpineol (8.4–4.9%) GC-MS [62]
Leaves and twigs Sardinia (Italy) Terpinen-4-ol (25.2%), α-phellandrene (11.9%), β-phellandrene (10.2%), γ-terpinene (10.1%), α-pinene (7.6%) GC-FID, GC-MS [63]
Fruits Tunisia 4-{3-[(2hydroxybenzoyl) amino] anilino}4-oxobut-2-enoic acid (28.96%), β-myrcene (11.47%), 3-pentadecylphenol (8.51%), p-tolyl ester (8.36%), amino formic acid (7.51%) GC–MS [64]
Male flowers Tunisia β-caryophyllene (12.8%), germacrene-D (9.6%), elemol (8.9%), α-terpineol (7.8%), γ-cadinene (7.1%), bornyl acetate (6.2%) GC-MS [65]
Female flowers   α-limonene (28.7%), germacrene-D (23.7%), elemol (6.7%), β-caryophyllene (6.6%), α-pinene (6.0%), bornyl acetate (3.7%) GC-MS  
Leaves of male plants at flowering   α-limonene (18.8%), germacrene-D (13.1%), β-caryophyllene (8.8%), δ-cadinene (8.7%), γ-cadinene (6.2%), α-pinene (4.8%) GC-MS  
Leaves of female plants at flowering   Germacrene-D (20.7%), δ-cadinene (15.6%), β-caryophyllene (12.1%), γ-cadinene (6.6%), δ-cadinol (6.1%), α-limonene (5%) GC-MS  
Ripe fruits   β-myrcene (75.6%), α-pinene (12.6%), α-limonene (3.2%), α-terpineol (1.4%), camphene (0.8%) GC-MS  
Leaves Morocco Myrcene (33.5%), α-pinene (19.2%), limonene (6.6%), α-phellandrene (4.6%), γ-terpineol (3.7%), α-terpineol (3.6%) GC-MS B [66]
Leaves Sardinia (Italy) α-pinene (16.9%), terpinen-4-ol (16.5%), sabinene (7.8%), α-phellandrene (7.4%), γ-terpinene (6.3%), β-pinene (4.3%) GC-MS [67]
Plant extracts/solvent used        
Leaves/ethyl acetate and methanol Italy 3,5-O-digalloyl quinic acid (26.8 ± 0.15 mg/g DW), 3,4,5-O-trigalloyl quinic acid (10.3 ± 2.45 mg/g DW), 5-O- galloyl quinic acid (9.6 ± 2.45 mg/g DW), myricetin 3-O-rhamnoside (6.8 ± 1.04 mg/g DW), myricetin 3-O-rutinoside (4.5 ± 0.18 mg/g DW), myricetin glucuronide (3.9 ± 0.65 mg/g DW) HPLC-DAD, HPLC-MS, NMR [68]
Berries/methanol Apulia (Italy) Cyanidin 3-O-glucoside (71%), delphinidin 3-O-glucoside, cyanidin 3- O arabinoside (28–31%) HPLC-DAD-MS [69]
Fruits during maturation/petroleum ether Tunisia Oils, fatty acids and sterols GC-MS [35]
Leaves/methanol Algeria 46 compounds (most abundant flavonoids, phenolic acids and their derivatives) HPLC-ESI-QTOF [70]
Leaves/methanol Italy 46 secondary metabolites LC-ESI-MS/MS [71]
Fruits/methanol-water Tunisia Total phenolic acids 436.4–2762.7 mg/kg; total flavones 75.3–1222.9 mg/kg; total flavonols 24.2–377.4 mg/kg; total secoiridoids 12.6–366.8 mg/kg; total phenols 538.0–4260.6 mg/kg HPLC-DAD/MSD [72]
Leaves/ethanol Italy Tannin derivatives (70.5%), myricetin derivatives (22%), quercetin derivatives (7.2%) HPLC-DAD [73]
Leaves/methanol Egypt α-pinene (38.1%), 3,5-O-digalloyl quinic acid (13.5%), D-limonene (11.9%), α-phellandrene (10.1%), β-pinene (9.5%), γ muurolene (8.0%), luteolin-3-O-rutinoside (7.8%), quercetin 3-O-di-hexose O-pentose (7.6%), 3,4,5-O-trigalloyl quinic acid (6.1%), quercetin 3-O-glucuronide (4.6%), epicatechin 3-gallate (4.5%), camphene (3.8%) UHPLC-ESI-MS, GC-MS [74]
PlL EO is constituted by a mixture of terpenes and terpenoids, mainly monoterpenes and sesquiterpenes, which are also responsible for the characteristic smell and flavoring of the plant [12][16][21][31]. It has been reported that terpenes in PlL are more genetically than environmentally related [75]. Nevertheless, the environment of growing, seasonability of harvesting and kind of material (edible or not-edible parts of the plant) have to be considered when explaining the differences in chemistry of the oils and extracts [19]. Up to 64 chemical constituents have been reported in the PlL EO fingerprint, in addition to other fractions that cannot be quantified by the assays [67]. Some of these terpenoids are constituent fractions of cannabis sativa [9], and called “non-cannabinoids terpenoids”. In PlL oil, non-cannabinoid terpenoids are more likely to be represented by α-pinene, myrcene, limonene, (E)-β-caryophyllene and γ- terpinene (Table 3). They are also included in the list of “terpene super classes” [9]. Furthermore, it is appealing to report that when non-cannabinoid terpenoids reach a concentration equal to or higher than 0.05% in an oil, they can confer pharmacological properties to such an oil, which can be classified as pharmaceutically active [76].
In view of the prevalent fractions of monoterpenes and oxygenated sesquiterpenes, the EO can be grouped into different chemotypes [17]. In this regard, the recurrent higher amount of α-pinene (16.9–19.5%) and terpinen-4-ol (7.7–16.5%) in comparison to the other compounds, allowed the classification of the oil from the leaves of PlL growing in Sardinia as the α-pinene/terpinen-4-ol chemotype [19][67]. Similarly, the Greek oil from PlL leaves is the α-pinene/terpinen-4-ol chemotype [55][55]. Nevertheless, the simultaneous existence of different chemotypes in a place can be justified by dissimilar geographical sites of harvesting in that country. An example is represented by the Corsican chemotype, which is expressed by three main phenotypes: the first is α-pinene/terpinen-4-ol; the second is terpinen-4-ol/limonene; and the third is myrcene-rich (88%) [19]. Very characteristic is the high content of δ-3-carene (65%) in the Egyptian oil [49], while the monoterpene terpinen-4-ol, together with α-pinene and the sesquiterpene myrcene, are among the higher represented fractions in the chemistry of PlL EO from Spain, Morocco and Turkey [48][52][53]. Conversely, α-pinene (65–86%) and β-myrcene (3%) are the major fractions which characterize the oils of mastic from plants growing in Spain [48].
Regarding the sesquiterpenes, limonene, α- and β-caryophyllene, D-germacrene, δ-cadinene and α-cadinol, β-bisabolene, β-bourbonene and caryophyllene oxide, they have shown extremely variable concentrations in PlL EO [16][21][48][77]. With respect to PlL leaves oil, the fruits oil changes significantly in its chemistry: limonene, sabinene and myrcene have been identified as the main representative fractions, in addition to α-pinene [77]. Additionally, the oil from the berries is rich in anthocyanins [78], which in addition to the concentration of fatty acids, such as oleic acid and linoleic acid [79], are precious as antioxidant compounds [80].
Furthermore, comprehensive studies have been conducted analyzing methanol and alcohol extracts of PlL leaves, while at the same time investigating their chemical profile, where a high concentration of phenolproponoids is reported (Table 3).
In this regard, an interesting study was carried out by Romani and co-workers [68]. Using ethyl acetate and methanol fractions of PlL leaves, the authors identified a high polyphenol content in the extracts, which represented 7.5% of the leaf dry-weight. In this content, three major classes of secondary metabolites were identified: (i) gallic acid and galloyl derivatives of both glucose and quinic acid; (ii) flavonol glycosides, i.e., myricetin and quercetin glycosides; and (iii) anthocyanins, namely delphinidin 3-O-glucoside and cyanidin 3-O-glucoside. All of these represent strong antioxidant polyphenols, which have implications in the prevention of chronic and inflammatory diseases [80]. Additionally, 46 different compounds were identified in the methanol extracts of PlL leaves from plants growing in Algeria [70].
Among the compounds in PlL extracts there were discovered to be relevant antioxidant agents, which may attest not only to the activity of PlL in preventing diabetic complications, cholesterol absorption and lipid metabolism [81][82], but also the remarkable capacity of PlL in managing intestinal inflammatory diseases as reported in the ethnopharmacological survey (Table 2). In fact, recent studies validated the capacity of polyphenols in managing the microbial and metabolomic patterns in the body [83][84][85][86]. Particularly, at the intestinal tract, these compounds can stimulate the multiplication of beneficial microorganisms and prevent the adhesion or directly disrupt the membrane ions flux of pathogens [87][88].

6. Anti-Inflammatory and Antioxidative Activities

As mentioned above, the anti-inflammatory effect of PlL is of high relevance in ethnopharmacology. The presence of important anti-inflammatory terpenes in the composition of PlL EO can explain its efficacy. It is well-demonstrated that terpenes are capable of inhibiting several inflammatory molecules, e.g., IL-1β, IL-6, TNFα and COX-2 [6][7][10], thus disrupting the amplification of inflammatory mechanisms. Meanwhile, the anti-inflammatory properties of PlL extracts can be related to the richness of polyphenols, the interplay of which in the inflammatory cascade is mainly demonstrated toward macrophages by inhibiting multiple key regulators of the inflammatory response [89]. Additionally, polyphenols reduce the release of arachidonic acid, prostaglandins and leukotrienes directly related to the inhibition of COX and LOX [90]. Other considerations regard several flavonoids in polyphenols, which can directly modulate the expression of pro-inflammatory cytokines and chemokines [91]. The ability of these natural compounds to modify the expression of several pro-inflammatory genes in addition to their antioxidant characteristics, such as reactive oxygen species (ROS) scavenging, contributes to the regulation of inflammatory signaling [92][93].
To clarify scientifically the anti-inflammatory character of PlL EO and extracts, they have undergone investigations by in vitro and in animal model studies with the intent to elucidate any selective interaction toward proteins and enzymes participating in the inflammatory pathway (Table 4).
Table 4. Antioxidant and anti-inflammatory activity of Pistacia lentiscus.
Exp. Setting Origin Model Plant Material Model Exp. Protocol Results Ref.
Antioxidant activity Sardinia, Italy Leaves oil Cells free DPPH as Trolox equivalent antioxidant capacity (TEAC) Great seasonal variability inhibition [19]
Algeria Leaves extract Cells free FRAP ↑ High [86]
    H2O2 scavenging activity ↓ Low  
Algeria Leaves extract Cells free Ferric reducing antioxidant power
(FRAP)		 ↑ High and dose dependent [94]
      DPPH ↑↑ Very high  
      H2O2 scavenging activity ↑↑ Very high  
      Linoleic acid peroxidation inhibition ↑↑↑ Outstanding  
Zakynthos (Greece) Leaves extract Cells free DPPH ↑↑ Very high [55]
  Ferric reducing antioxidant power (FRAP) ↑ High  
Sardinia, Italy Leaves extract Cells free DPPH as Trolox equivalents ↑↑ High [95]
  ABTS as Trolox equivalents ↑↑ High  
Algeria Leaves extract Cells free DPPH (%) ↑ High [35]
    Ferric reducing antioxidant power
(FRAP)		 ↑ High  
    β-carotene bleaching method (%) ↑↑ Very high  
Morocco Fruits oil, leaves oil Cells free DPPH Fruits oil: ↑↑ high
Leaves oil: ↑ high		 [66]
    FRAP Fruits oil: ↑↑ high Leaves oil: ↑ high  
    ABTS Fruits oil: ↑↑ high Leaves oil: ↑ high  
Campania (Italy) Leaves extract Cell lines Lipid peroxidation ↑↑ Very high [15]
Intracellular ROS ↑↑Very high  
Oxidized glutathione ↑↑ Very high  
Sardinia, Italy Leaves oil Animals DHA ↑↑ High protection [12]
Algeria Fruits extract, leaves extract Cells free and cell lines Intracellular ROS in THP-1 monocytic cells Fruits extract: dose-dependent protection [96]
    ORAC as μmol Trolox Equivalents Fruits extract:
↑ High;
Leaves extract:
↑↑ Very high		  
Sardinia, Italy Leaves oil Cells free and cell lines, human fibroblasts H2O2 scavenging activity ↓ Low [67]
    ECC ↓ Low  
Anti-inflammatory activity Sardinia, Italy Leaves oil Animals COX-2 ↑↑ High inhibition [12]
Sardinia, Italy Leaves oil Animals TNF-α ↓↓ High decrease [29]
  IL-6 ↓↓↓ High decrease  
Algeria Fruits extract, leaves extract Cells free and cell lines IL-1β inhibition by ATP stimulated THP-1 Fruit extract:
no reduction;
Leaves extract:
↑↑ high		 [96]
    IL-1β inhibition by H2O2 stimulated THP-1 Fruit extract:
↓ low;
Leaves extract: dose-dependent		  
Sardinia, Italy Leaves oil Cells free and cell lines, Human fibroblasts COX-1 Inhibition [67]
COX-2 ↑ high inhibition  
LOX no inhibition

6.1. Inhibitory Activity against Proinflammatory Cytokines and against Arachidonic Acid Cascade

Remila and co-workers [96] examined the anti-inflammatory activity of leaves and fruits extracts by measuring the secretion of IL-1β by macrophages exposed to adenosin triphosphate (ATP) or H2O2. The authors found PlL leaves extract significantly reduced the production of IL-1β from ATP- or H2O2-activated cells. The inhibitory capacity of the leaves extract was higher in comparison to that of the fruits and of quercetin and gallic acid (tested as isolated fractions of the polyphenol mixture). The data was explained by the higher content of the total phenols and flavonoids in the leaves compared to the fruits and by the synergy between the pharmacological biomolecules of PlL extract. Similar considerations and a dose-dependent anti-inflammatory effect of the leaves extract was reported in other studies, which further strengthened the capacity of flavonoids and tannins [97].
Comparable anti-inflammatory values were reported in regard to PlL EO using the carrageenan-induced paw edema and cotton pellet-induced granuloma in a rat model [29]. Particularly, it was evidenced that when applied topically, PlL EO from leaves significantly inhibited the development of granuloma and the serum level of TNF-α and IL-6 in reply to the irritants. The result was mainly related to the activity of α-pinene, β-pinene, α- phellandrene and sabinene, which were highly represented in the chemistry of the hydrodistilled oil.
Only one study has investigated the inhibitory activity of the whole PlL EO. It was obtained from the leaves of plants growing in Sardinia and tested against COXs and LOX [67]. The IC50 values were 10.3 ± 4.4 μg/mL and 6.1 ± 2.5 μg/mL PlL EO for COX-1 and COX-2, respectively, with higher inhibitory activity toward COX-2 in comparison to that produced towards COX-1. Additionally, COX-2 inhibition by the EO was similar to that recorded using ibuprofen as a positive control. The activity of the oil against LOX did not reach the IC50 value, as PlL EO lowered LOX activity by 30% compared to the control. Despite the low LOX inhibition, the study strengthens the oil as a potential dual inhibitory compound, which was intensively researched in pharmacology to antagonize a great number of inflammatory processes where these enzymes sustain and amplify the disease [59][72]. The data obtained in that investigation were addressed to the mixture of terpenoids comprising the oil, with particular regard to α-pinene and terpinen-4-ol (33.38%), enriched by the non-cannabinoid terpenoid limonene (3.4%), β-myrcene (0.9%), (Z)-caryophyllene (1.4%) and (E)-β-caryophyllene (0.1%). The mixture allowed the classification of the oil as pharmacologically active [76].

6.2. Inhibiting Activity against ROS Molecules

The protective effect of PlL EO and extracts against ROS has been deeply documented in the literature (Table 5). From a scientific point of view, this capacity can be related to the terpenes and polyphenols of the EO and of the extracts, respectively [10][80]. As the accumulation of ROS directly affects the healthy tissue systems, including cellular lipids, nucleic acids and proteins [98], the capacity of the EO and the extracts was studied directly using cell lines and intracellular ROS evaluation assays, or by chemical methods, particularly using the 2,20-azinobis(3-ethylbenzothiazoline-6-sulphonic acid) diammonium salt (ABTS) and the 1,1-diphenyl-2- picrylhydrazyl (DPPH) chemical assays, and more recently using electron chemical devices.
Table 5. (a) Antibacterial activity of Pistacia lentiscus L. determined by agar diffusion test (ADD) or minimal inhibitory concentration (MIC). (b) Antifungal activity of Pistacia lentiscus L. determined by agar diffusion test (ADD) or minimal inhibitory concentration (MIC).
(a)
Origin Plant Material Bacteria Origin of Strain Antimicrobial Activity Ref.
Sicily (Italy) Aerial parts ethanol extract, aerial parts water extracts Staphylococcus aureus ATCC 29213 Yes [99]
    Escherichia coli ATCC 35218 Yes  
Tunisia Leaves essential oil S. aureus ATCC 25923 Yes [53]
    Enterococcus faecalis ATCC 29212 Yes  
    Salmonella enteritidis ATCC 13076 Yes  
    Salmonella typhimurium NRRLB 4420 Yes  
    E. coli ATCC 25922 Yes  
    Pseudomonas aeruginosa ATCC 27853 Yes  
Algeria Leaves ethanol extract S.aureus ATCC 601 Yes [86]
    Listeria monocytogenes ATCC 19111 Yes  
  Klebsiella pneumoniae 5215773 Yes  
  P. aeruginosa 22212004 Yes  
  S. typhi 4404540 Yes  
  Proteus mirabilis 0536040 Yes  
  E. coli 5044172 Yes  
  Enterobacter cloacae 1305573 Yes  
    444 Yes  
Eastern Morocco Aerial parts from different areas of Morocco essential oils S.aureus Not given Yes [57]
    Streptococcus spp. Not given Yes  
E. coli Not given Yes  
K. pneumoniae Not given Yes  
Pseudomonas spp. Not given Yes  
Salmonella spp. Not given Yes  
Tunisia Fruits essential oil, phenolic extract S.aureus Not given Yes [59]
    Bacillus subtilis Not given Yes  
  L. monocytogens Not given Yes  
  E. coli Not given Yes  
  P. aeruginosa Not given Yes  
  Aeromonas hydrophila Not given Yes  
  Salmonellatyphimurium Not given Yes  
Algeria Aerial part methanol extract S.aureus Not given Yes [36]
    E. coli Not given Yes  
  P. aeruginosa Not given Yes  
Algeria Leaves and stems methanol extract, leaves and stems aqueous extracts S.aureus
E. coli		 Not given
Not given		 No
No		 [44]
Sardinia (Italy) Fruits essential oil Bacillus clausii Probiotic No [79]
    Staphylococcushominis Clinical No  
S.aureus ATCC 6538 No  
Streptococcus pyogenes Clinical No  
Streptococcus agalactiae Clinical Yes  
Streptococcus salivarius Probiotic
(n = 2)		 No  
Streptococcus mitis Clinical No  
Streptococcus mutans Collection No  
Streptococcus intermedius Collection Yes  
Sardinia (Italy) Fruit methanol extract, leaves methanol extract, S. aureus ATCC 25293 Yes [100]
    Staphylococcusepidermidis ATCC 12,228 Yes  
  E. coli ATCC 25,922 In part  
  K. pneumoniae ATCC 9591 In part  
Sardinia (Italy) Leaves essential oil Streptococcus gordonii ATCC 10,558 Yes [67]
    Actinomyces naeslundii ATCC 12104 Yes  
    Fusobacterium nucleatum ATCC 25586 Yes  
    Porphyromonas gingivalis ATCC 33277 Yes  
    P. gingivalis Clinical (n = 2) Yes  
    Tannerella forsythia ATCC 43300 Yes  
    T. forsythia Clinical (n = 2) Yes  
(b)
Origin Plant Material Fungi Origin of Strain Antifungal Activity Ref.
Sicily (Italy) Aerial parts ethanol extract, aerial parts water extracts
Leaves ethyl acetate and methanol extract		 Candida albicans
Candida parapsilosis
Candida glabrata
Cryptococcus neoformans		 Clinical (n = 18)
Clinical (n = 9)
Clinical (n = 11)
Clinical (n = 5)		 Yes
Yes
Yes
Yes		 [99]
Tuscany (Italy) Leaves ethyl acetate and methanol extract C.albicans Clinical No [101]
  C.glabrata Clinical No  
  C.parapsilosis Clinical No  
  C. tropicalis Clinical No  
  C. zeylanoides Clinical No  
Algeria Leaves ethanol extract C.albicans 444 Yes [86]
Tunisia Fruits essential oil, phenolic extract Aspergillus flavus Not given No [59]
  Aspergillus niger Not given No  
  C.albicans Not given In part  
Sardinia (Italy) Fruits essential oil C. albicans Clinical No [79]
C.glabrata Clinical No  
C.krusei Clinical No  
Sardinia (Italy) Leaves essential oil C.albicans Laboratory Yes [67]
    C.albicans Clinical (n = 2) Yes  
    C.glabrata Laboratory Yes  
    C.glabrata Clinical (n = 2) Yes  
As it is shown in Table 4, the anti-ROS ability has been mainly investigated in PlL extracts. Scientifically, this ability has been addressed to the richness in polyphenols the extracts possess, which not only inhibits the production of ROS by the direct involvement of specific molecules [102], but also can modulate the Keap1-Nrf2/ARE pathway [103]. This is a powerful oxidation-reduction defense system, where polyphenols act to degrade specifically the Keap1 protein and regulate the Nrf2-related pathway [80][104].
Remila and co-workers [96] proved the high antioxidant capacity of PlL leaves extract using the oxygen radical absorbance capacity in macrophages, melanoma and mammary mouse cell lines. Furthermore, due to the activation of apoptosis mechanisms, the extracts significantly inhibited the growth of melanoma cells. The data was related to the richness in phenolics, flavonoids and tannins in the extracts. Similar conclusions were obtained by Atmani [94], who examined hexane and chloroform aqueous extracts of PlL leaves containing highly concentrated flavonoids. In relation to the peak of hydroxyl groups, the aqueous formulations strongly inhibited lipid peroxidation. The mechanism was explained by the scavenging of peroxyl radicals by the extracts. Radicals play a role in the development of cardiovascular disease and cancer. In this regard, the scavenger activity of gallic acid and galloylquinic derivatives, isolated from PlL leaves, is particularly attractive. Notably, a progressive increase in the anti-radical activity associated with the number of galloyl groups in quinic acid was found [105]. Furthermore, all the tested metabolites strongly reduced the oxidation of low-density lipoproteins, thus strengthening the protection of PlL against the lipid peroxidation.
In addition to having a preventive capacity, a potential ability to halt or reverse oxidative stress-related diseases has been attributed to PlL. In fact, the ability to fight aggressive tumors, i.e., neuro-blastoma [19], and other important tumor cell lines has been proved by in vitro studies [106][107].
Animal testing further explored the anti-ROS efficacy of PlL derivates. Ben Khedir and co-workers [61] determined the scavenger and anti-inflammatory activity of the fruits oil using the carrageenan-induced paw edema in a rat model. In that study, PlL oil demonstrated significantly better anti-inflammatory activity with edema inhibition, in comparison to those produced by the control NADPH. Moreover, PlL oil was able to increase the expression of superoxide dismutase, catalase and glutathione peroxidase, which are released as a response to the oxidative stress in the inflamed tissue. The effects were interpreted as a consequence of the content of humulene, caryophyllene and polyunsaturated fatty acid in the oil. Humulene and caryophyllene have been shown to inhibit the nuclear factor kappa B (NF-kB) pathway, responsible for the transcription of several proinflammatory cytokines, i.e., TNF-α, IL-1β, IL-6 and iNOS and COX-2 enzymes [108]. The polyunsaturated fatty acid in the oil might have partially replaced the arachidonic acid in the inflamed cell membranes [78], consequently lowering COX-2 production, the local inflammation and ROS generation.
Other in vivo studies demonstrated that an administration of PlL oil before the induction of the Bilateral Common Carotid Artery Occlusion followed by Reperfusion (BCCAO/R) was able to prevent the oxidative stress challenge in the nervous tissue due to the ischemic insult [12][109]. In the cerebral tissue, PlL oil restored the membrane phospholipid DHA and decreased the activity of the COX-2 enzyme. Additionally, PlL oil increased the concentration of the anti-inflammatory endocannabinoid congeners palmitoylethanolamide (PEA) and oleoylethanolamide (OEA) [12]. The outcomes were related to the high presence of the phytocannabinoid (E)-β-caryophyllene, which worked synergistically with the other compounds in the oil, expanding the levels of cannabinoid receptor type 2 (CB2) and PPAR-alpha receptors. Further studies attest to the role of β-caryophyllene as CB2 agonists, demonstrating its capacity to antagonize the release of cytokines from LPS-stimulated monocytes (TNF-α and IL-1 β) [7].

7. Potential Cytotoxicity

Starting from Paracelsus’ statement “the right dose differentiates a poison to a remedy”, investigations have been conducted with the intent to validate pharmaceutically PlL derivatives. For this reason, many studies have been conducted, in particular using in vitro and cell lines models testing different doses of PlL oil and extracts (Table 4). As a measure of risk versus benefit, many of them also applied enzymes testing, looking for the capacity of the EO and extracts to interact with the proteins and their involvement in inflammation and oxidative stress. In fact, it is well-known that the in vitro and cell lines systems are largely recommended to elucidate the safety of herbal products and propose the natural agents as nutraceuticals or xenobiotics [110]. Although such models lack the complexity of animals, and the compounds in testing should not exert in vivo the same effects as reported in isolated cell tissues [111], they have a significant role in predicting of risks and toxicology.
As a result of this work, it can be stated that not any published laboratory study reported cytotoxic effects which could be connected to PlL oil or extracts. Conversely, the experiments demonstrated direct or indirect biocompatibility of PlL derivatives to humans and non-human animals.
Notably, a wide range of biocompatibility was documented in oral cells. It was remarked specifically in oral human fibroblast cell lines using the EO from leaves and the MTT reduction assay [67]. That fact was further validated in the periodontal ligament fibroblasts, the gingival fibroblasts, the gingival keratinocytes and dysplastic oral keratinocytes applying the WST-1 metabolic activity assay [67].
The absence of side effects to oral cells is strengthened concerning the polyphenol extracts. In detail, the fruits extract showed high biocompatibility and a selecting index (SI) of cytotoxicity equal to > 256 toward the human gingival cells, at the same time demonstrating a strong response against periodontal bacteria [112].

8. Antimicrobial Activity

Several studies reported the antimicrobial activity of PlL oils and extracts, trying to clarify scientifically their popular use in infectious diseases.
Commonly studied pathogens comprise bacteria known for antibiotic resistance (Staphylococcus aureus incl. methicillin-resistant strains (MRSA), Escherichia coli and Pseudomonas aeruginosa), and other bacteria associated with the oral diseases, as well as yeasts, with particular regard to Candida albicans (Table 5a,b).
Different antimicrobial activity was reported in the studies testing PlL EO and extracts. A high capacity against both bacteria and yeasts was demonstrated in regard to the leaves EO from plants growing in different regions [16][78][58]. Whereas the fruits EO from Tunisia [59] and Sardinia [79] were found to have a limited effect against bacteria and yeasts, the ethanol and water extracts of leaves from plants growing in Sicily inhibited the growth of S. aureus, E. coli and yeasts [99]. Additionally, the leaves ethanol or methanol extracts showed activity against several Gram-positive and Gram-negative bacteria [38][87][113]. However, leaves and stems methanolic or water extracts prepared in Algeria were inactive against S. aureus and E. coli [44], and leaves alcoholic extracts from Tuscany did not act against yeasts [101].
The research started from the fact that terpenoids in EO exert a wide-spectrum of antibacterial, antifungal and even anti-viral activity, and have been demonstrated to inhibit the growth of drug-resistant microbial strains, which are difficult to be treated even by conventional antibiotics [113]. Although α-pinene together with the monoterpenes terpinene and myrcene are among the most represented fractions in the Mediterranean oils showing antimicrobial capacity (Table 5), it is of general interest if higher activity could be related to specific PlL chemotypes [114]. In this context, as reported regarding the anti-inflammatory capacity, synergy between the chemical fractions of terpenes is proposed to explain PlL EO antimicrobial activities. Synergy was recently claimed to explain the inhibitory activity of the EO against Porphyromonas gingivalis, Tannerella forsythia and Fusobacterium nucleatum [67]. The result was related to the pharmacological interplay of the terpenes characterizing the oil chemotype from North Sardinia, which was α-pinene-terpinen-4-ol, further augmented by the non-cannabinoid terpenoids limonene and β-myrcene, the sesquiterpenes (Z)-caryophyllene and (E)- β- caryophyllene. Similarly, the antimicrobial efficacy of extracts can be attributed to the richness of polyphenols [25][38][46][60][61][69][111], in particular in regard to the concentrations of tannins, flavonoids, and lignin-carbohydrate complexes in the polyphenols mixture [11]. This is also the case with the ethanol extract of fruits, which showed the highest inhibition potential against P. gingivalis in comparison to 20 other extracts of pharmaceutical plants [112]. Furthermore, the potency of the fruits extract were higher than that of the leaves and woody parts, with MIC values against P. gingivalis of 8 μg/mL.
Recently, Mandrone and co-workers [100] related the antimicrobial activity of aqueous MeOH extracts of fruits and leaves to the concentration of phenolic components. That research further attested to the fact that phenols are active against multi-resistant bacteria, among them MRSA and carbapenemase-producing Klebsiella pneumoniae.
Concerning Candida spp., the activity of PlL derivates is reportedly controversial (Table 5). Low or no susceptibility of the yeasts to the leaves extract, or to the fruits oil, was found. Despite this, PlL leaves EO from Sardinia had low MIC values against C. glabrata and C. albicans [67]. The results were explained as a consequence of the recurrence of pharmacological concentrations of six terpenes, which were above 0.05% in the fingerprint. Additionally, the EO documented the ability to inhibit COX-2 and LOX, which are very important proteins for the development of Candida virulence [115].
Furthermore, a high inhibition of C. albicans was reported when using PlL extracts. The activity of water or ethanol extracts has been attributed to the flavonoid contents. Notably, the phenolic compound tannic acid was reported as more active against the yeast than the antifungals nystatin and amphotericin [59][66].

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