The effect Moringa oleifera Lam in Immune Disorders: A clinical study
The present study was carried out to investigate the efficacy and safety of Moringa oleifera Lam in Immune Disorders.
Moringa oleifera Lam (MO), a frost and drought-resistant plant of the monogeneric family Moringaceae, a native plant of tropical forests of India, is characterized by its versatile applications as a food additive and supplement therapy (Anwar et al., 2007). MO is suitable for food application because of its abundant nutritional ingredients, such as essential amino acids, oleic acids, vitamins, and minerals. MO is recognized for its medicinal uses, such as treating various infections, modulating the immune system, and displaying anti-oxidant, anti-diabetic, or anti-tumor effects (Dhakad et al., 2019).
Moringa tree leaves were mostly used for cattle feed in ancient times (Sun et al., 2017), but were gradually started to be used in the human diet to maintain mental and skin health (Anwar et al., 2007). With its growing popularity, different parts of MO, such as roots, seeds, and pods, were recognized as nutritious and medically valuable. Currently, MO is widely used in food ingredients, nutraceuticals, and medications and has been termed a €œMiracle tree€ (Dhakad et al., 2019).
Bioactive Constituents and General Function of Moringa oleifera
The bioactive constituents of MO have been identified in almost all parts of the plant (Liang et al., 2019). The specific constituents isolated from MO mainly (detailed in Supplementary Table S1) include flavanoids (mainly distributed in the leaves), glucosinolate and isothiocyanate (mainly distributed in the leaves), phenolic acid (all distributed in the leaves), alkaloids and sterols (distributed in the leaves, roots, and seeds), and terpene (all distributed in the pods) (Anwar et al., 2007; Bichi, 2013; Baldisserotto et al., 2018; Dhakad et al., 2019). The constituents of the leaves and seeds were most frequently reported. Based on the phytochemical analysis, phenols and alkaloids are more abundant in the leaves than in the seeds, while flavonoids, saponins, and anthocyanins are more abundant in the seeds (Gupta et al., 2018). Besides, other kinds of nutrients are present in high levels in the processed products of MO, including a number of fatty acids derived from the seed oil (Leone et al., 2016), various kinds of minerals from the dried leaf powder (Witt, 2014), and high-quality carbohydrates from refined gum exudates (Kar et al., 2013; Gupta et al., 2018).
The addition of a small amount of MO is reported to significantly improve the nutritional value of food such as bread, yoghurt, cheese, and soup (Williams, 2013; Stadtlander and Becker, 2017). The diverse parts of MO have been processed into many food products in more than eighty countries, to improve mineral and vitamin deficiencies (Ali et al., 2017). Moreover, few side effects have been reported for the use of MO (Bichi, 2013; Palada et al., 2017; Dhakad et al., 2019).
Current research shows that MO exerts its multiple immune-related effects primarily through directly eliminating pathogens or modulating the balance of pro- and anti-inflammatory mediators released from various kinds of immune cells by regulating the activity of signaling pathways, such as the canonical NF-ÎºB pathway (Figure 1). Significantly, the bioactivity of MO is dependent on its active ingredients, which are related to the different parts of this plant and extraction methods used. Notably, in some experiments, low-dose application of MO might have a better anti-inflammatory effect than higher doses (Ferreira et al., 2008; Almatrafi et al., 2017; Kapse et al., 2017), which suggested the necessity of identifying the appropriate dosage of MO before clinical application.
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