Moringa oleifera (Drumstick tree) - Medicinal uses, Adverse effects,Research & Pharmacology
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Scientific classification
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Kingdom:
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Plantae
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Clade:
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Angiosperms
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Clade:
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Eudicots
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Clade:
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Rosids
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Order:
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Brassicales
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Family:
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Moringaceae
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Genus:
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Moringa
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Species:
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M. oleifera
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![Moringa-oleifera-tree]( "Moringa-oleifera-tree")
Moringa oleifera, also known as horseradish tree, ben tree, or drumstick tree, is a small tree from India, Pakistan, and Nepal that has been used for generations in Eastern countries to treat and prevent diseases such as diabetes, heart disease, anemia, arthritis, liver disease, and respiratory, skin, and digestive disorders.
Moringa oleifera is the most widely cultivated species of the genus Moringa, which is the only genus in the family Moringaceae. English common names include: moringa, drumstick tree horseradish tree (from the taste of the roots, which resembles horseradish), ben oil tree, or benzoil tree . It is a fast-growing, drought-resistant tree, native to the southern foothills of the Himalayas in northwestern India, and widely cultivated in tropical and subtropical areas where its young seed pods and leaves are used as vegetables. It can also be used for water purification and hand washing, and is sometimes used in herbal medicine.
Botanical name: Moringa oleifera
Family: Moringaceae
Kannada name: Nugge mara, Nugge kayi
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English
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Horse radish tree, Drum stick tree, The Horse-Radish Tree, Ben Oil Tree
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Assamese
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Sajna, Sajina
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Marathi
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Shevga शेवगा
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Malayalam
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Muringai
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Konkani
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Mashinga मशींग
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Hindi
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Murungakka/ Munuga/ Murung/ Murung-a-kai/ Shewga, Senjana सेंजन
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Tamil
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Moringa, Sohajna, Murungamaram,முறுங்கை Murungai
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French
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Bèn ailé, Benzolive, Moringa, Ben oléifère, Arbre radis du cheval
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German
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Behenbaum, Behenussbaum, Flügelsaniger Bennussbaum, Pferderettichbaum
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Italian
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Sàndalo ceruleo
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Portuguese
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Acácia branca, Cedra (Brazil), Marungo, Moringuiero, Muringa
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Spanish
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Árbol del ben, Ben, Morango, Moringa
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![Moringa-oleifera]( "Moringa-oleifera")
Sanskrit Synonyms:
Shobhanjana – Very auspicious tree
Shigru – has strong, piercing qualities
Teekshnagandha – Strong and pungent odor
Aksheeva – relieves intoxication
Mochaka – helps to cure diseases
Morphology
- oleifera is a fast-growing, deciduous tree that can reach a height of 10–12 m (32–40 ft) and trunk diameter of 45 cm (1.5 ft). The bark has a whitish-grey colour and is surrounded by thick cork. Young shoots have purplish or greenish-white, hairy bark.
Flower
In axillary, divaricate panicles; white. Flowering throughout the year.
Fruit
An elongate, torulose capsule, angled, longitudinally 3-valved; seeds many, 3 angled, 3 winged. Fruiting throughout the year.
Field tips
Bark corky grey, exuding yellowish-white gum.
Leaf Arrangement
Alternate-spiral
Leaf Type
Tri-pinnate
Leaf Shape
Ovate or elliptic
Leaf Apex
Rounded
Leaf Base
Rounded
Leaf Margin
Entire
Classical categorization:
Charaka Samhita , Krimighna , Svedopaga , Shirovirechanopaga , Katuka Skandha
Charaka has also mentioned it as a plant source for oil – Sthavara Sneha Yoni
Sushruta and Vagbhata – Varunadi gana
Medicinal Qualities of drumstick tree:
Rasa – Katu ,Tikta
Guna– Laghu , Rooksha , Teekshna
Vipaka – katu
Veerya – Ushna
Effect on Tridosha – Balances Kapha and Vata.
Parts used: Drumstick’s root bark, stem bark, leaves, fruits and seeds
Health benefits of Moringa:
There are three varieties of Moringa explained in Ayurvedic text books.
- Shyama – black variety
- Shveta – white variety and
- Rakta – red variety. It is also called as Madhu shigru.
benefits Black variety drumstick uses
Katu,Teekshna ,Ushna ,Madhura , Laghu ,Deepana ,Rochana ,Rooksha ,Kshara ,Tikta ,Vidaahakrit ,Sangrahi ,Shukrala ,Hridya , Pittarakta prakopana,Chakshushya, Kaphavataghna,Vidradhi ,Shvayathu , Krimi ,Meda, Apachi, Visha , Pleeha , Gulma ,Ganda Vrana
White variety drumstick uses:
It is quite similar to the black variety.
Dahakrut – causes burning sensation
pleehaanaaM vidradhim hanti – useful in splenic abscess
VraNaghna – helps in quick wound healing
pittaraktakrut – Increases Pitta and vitiates blood.
The red variety ( Madhushigru)
Deepana – Increases digestion power.
Sara – promotes proper bowel movements.
Drumstick leaves and bark
The juice extract of drumstick leaves and bark are very useful in relieving pain. They act as natural analgesic. They are used both for oral intake and also for external application as paste.
In Indian household, the leaves are used to prepare Chutney or sambar.
The paste of moringa leaves are applied as paste externally to relieve pain and inflammation.
It is applied over pile mass to relieve pain and itching.
Moringa leaves are used internally to improve eye sight, also for the treatment of Ulcerative colitis.
Drumstick seeds uses
Chakshushya – good for eyes
Vishanashana – anti toxic
Avrushya – do not have aphrodisiac qualities
Nasyena Shiro Artinut – When used for Nasya (in the form of powder or oil), it helps to relieve headache.
Moringa seeds are called as Shweta Maricha.
Moringa for headache:
As explained above, moringa leaves paste applied externally, or used as vegetable helps to relieve headache.
Its seed powder, in the form of nasya treatment cures headache.
Moringa for diabetes Many studies have been conducted to prove the anti diabetic and anti oxidant effect of Moringa.
Moringa flowers are useful in intestinal worms. It balances Pitta and kapha.
Oil prepared with Moringa is useful to relieve headache, pungent, useful in skin diseases and diabetes.
Moringa leaves for balanitis: Leaves are ground to make a paste. It is applied over the inflamed area.
![Moringa-oleifera-seed]( "Moringa-oleifera-seed")
Moringa in Ayurvedic medicines:
Because of its analgesic effects, Moringa is used as an ingredient in many Ayurvedic pain relief oils such as Murivenna, Kottamchukkadi Thailam,
Because of its anti inflammatory effects, it is an ingredient of Shothaghna Lepa – a paste application used to relieve swelling, pain and redness.
Because of its wound healing benefits, and usefulness in abscess etc, it is an ingredient in Aragwadhadi kashayam
Moringa Side Effects:
As explained above, it causes increase in burning sensation and is pungent. Hence,people with gastritis or sensitive stomach should use this vegetable carefully.
It is not ideal to be taken during periods, since it increases Pitta and vitiates blood.
It is also not ideal to be taken during bleeding disorders.
Drumstick during pregnancy and lactation:
Drumstick fruit is rich in protein, vitamins, minerals and anti oxidants. Hence it can be used during pregnancy. But Drumstick leaves, root bark and flowers are not indicated during pregnancy.
It is not ideal to take this soon after delivery. However, a couple of weeks after delivery, this can be used.
Drumstick to increase sperm count:
The drumstick fruit is known to improve sperm count and quality.
Drumstick (Moringa) leaf powder was evaluated m. on male reproductive system of Swiss albino mice Mus musculus. The sperm count, its mobility and mortality, histology of testis and epididymis of normal and hyperglycaemic male Swiss albino mice have been investigated and attempt has been taken to evaluate the efficacy of Moringa leaf powder in repair mechanism in case of hyperglycaemia. In treated mice (Group III), the sperm count significantly increased, sperm mobility also increased but sperm mortality decreased significantly. There was a slight decrease in weight of testis (0.478±0.008gm to 0.33±0.006 gram) respectively when compared to control mice group. (research)
Moringa seeds for colitis:
An experimental study conducted on rats concluded that MSHE (Moringa oleifera seeds hydro-alcoholic extract) and MCF (chloroform fraction ) were both effective to treat experimental colitis and this might be attributed to their similar major components, biophenols and flavonoids. Since the efficacy was evident even in low doses of MSHE, presence of active constituents with high potency in seeds is persuasive. (Source).
![Moringa_flower]( "Moringa_flower")
Cultivation and Production
Moringa oleifera development is achieved in two main ways: sowing and cutting.
Traditionally in Sudan the seeds are preferred while vegetative propagation is common in India, Indonesia and in some areas of West Africa
Sowing requires selection of the seeds, when they are easily available and human labor is limited, while the possibility to transplant seedlings allows flexibility in field planting even if it requires extra labor and costs.
Seeds germinate within two weeks, at a maximum 2 cm depth. When sowing is planned in nursery, the seedlings can be transplanted when they reach about 30 cm (3–6 weeks after germination).
The number of seeds per kilogram ranges from 3000 to 9000, depending on the variety, with a germination rate of 80%–90% for ideal storage conditions (3 °C, 5%–8% moisture). However, the viability decreases if seeds remain at ambient temperature and high relative humidity, their germination rate dropping to 7.5% after three months.
Cutting is preferred when seeds availability is scarce and/or when labor is not a limiting factor. Ramachandran et al. reports that plants raised from seeds produce fruits of poorer quality, while Animashaun et al. suggest that trees grown from seeds develop longer roots (an advantage for stabilization and access to water) compare to that grown from cuttings that have much shorter roots.
When hard woodcuttings (1–2 m long 4–16 cm diameter [8,15]) from adult trees are planted during the rainy season burying one third in the soil, they readily develop roots that in few months reach a considerable size [16]. Moringa oleifera is an exceptionally fast growing tree, in three months it can be 3 m high and in few years reaches 12 m if it is left to growth naturally. Since the tree vigorously re-sprouts after cutting, pruning or pollarding are usually practiced to enhance lateral branching and give the tree a bush shape in order to facilitate the harvest. Nevertheless, since literature reports about the good practice management of Moringa oleifera are scant, practical trials are needed. Leaves and seeds are the parts of the plant of interest. Accordingly, the spatial distribution in planting Moringa oleifera trees is designed to facilitate the relevant harvest and the management practices.
For production of leaves, Moringa oleifera plantation can be designed as follows:
(i) intensive production with spacing ranging from 10 cm × 10 cm to 20 cm × 20 cm, harvest interval between 35 to 45 days, irrigation and fertilization are needed;
(ii) semintensive production with spacing about 50 cm × 100 cm, harvest interval between 50 to 60 days, irrigation and fertilization suggested;
(iii) integrate in an agroforestry system with spacing distance of 2–4 m between rows, harvest interval around 60 days, fertilization and irrigation not strictly necessary.
Production decreases from intensive production to less dense spacing (agroforestry system), although a tremendous variability can be observed for a given spatial distribution and the same cultivation management. For example, the yield of an intensive plantation can range from 580 to 40 m/ha/year , being season dependent with the largest yield in wet or cold season. There is a need for further studies to assess optimum spacing and harvest intervals that comply with the different climates and production systems . Harvest can be mechanical or manual. Shoots are cut at a 0.5–1 m height above the ground; but leaves can be picked directly off the tree; this practice, however, albeit quicker, leads to a less vigorous re-growth.
For the production of seed a low density plantation has a positive effect on yields: typically 2.5 × 2.5 m or 3 × 3 m triangular pattern . Fruits (trilobite capsule), referred as pods (brown color and dry and split longitudinally), ripen about three months after flowering and must be harvested as soon as possible. Each pod usually contains about 26 1-cm diameter seeds lined by three whitish papery leaflets on the edge. Like for leaves, also the production of seed shows a tremendous variability. A single tree can produce from 15.000 to 25.000 seeds with an average weight of 0.3 gr per seed [21]; moreover early flowering varieties produce pods in six month, while other varieties require more than one year. After pruning, branches develop new pods within 6 months
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Moringa oleifera leaf, raw
Nutritional value per 100 g (3.5 oz)
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Energy
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64 kcal (270 kJ)
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Carbohydrates
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8.28 g
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Dietary fiber
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2.0 g
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Fat
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1.40 g
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Protein
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9.40 g
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Vitamins
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(%DV)†
Qty
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Vitamin A equiv.
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(47%)
378 μg
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Thiamine (B1)
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(22%)
0.257 mg
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Riboflavin (B2)
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(55%)
0.660 mg
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Niacin (B3)
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(15%)
2.220 mg
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Pantothenic acid (B5)
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(3%)
0.125 mg
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Vitamin B6
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(92%)
1.200 mg
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Folate (B9)
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(10%)
40 μg
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Vitamin C
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(62%)
51.7 mg
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Minerals
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Calcium
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(19%)
185 mg
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Iron
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(31%)
4.00 mg
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Magnesium
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(41%)
147 mg
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Manganese
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(17%)
0.36 mg
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Phosphorus
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(16%)
112 mg
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Potassium
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(7%)
337 mg
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Sodium
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(1%)
9 mg
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Zinc
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(6%)
0.6 mg
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Water
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78.66 g
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![Moringa_oleifera-pod]( "Moringa_oleifera-pod")
Chemical content in the Moringa
1. Vitamins
Fresh leaves of Moringa oleifera are reported to contain 11,300–23,000 IU of vitamin A . Vitamin A plays key roles in many physiological processes such as vision, reproduction, embryonic growth and development, immune competence, cell differentiation, cell proliferation and apoptosis, maintenance of epithelial tissue, and brain function. Its deficiency is still prevalent in many developing countries, and considered responsible for child and maternal mortality
Fresh leaves of Moringa oleifara are also a good source of carotenoids with pro-vitamin A action. They contain 6.6–6.8 mg/100 g
β-carotene is more concentrated in the dried leaves, with amounts ranging from 17.6 to 39.6 mg/100 g of dry weight (DW) [
Moringa oleifera is an interesting source of vitamin C. Fresh leaves contain approximately 200 mg/100 g
Moringa oleifera fresh leaves are a good source of vitamin E (in particular α-tocopherol) and contain approximately 9.0 mg/100 g
Among vitamins of group B, only thiamine, riboflavin and niacin seem present in Moringa oleifera leaves. These vitamins mainly act as cofactors of many enzymes involved in the metabolism of nutrients and energy production, and their concentration in fresh leaves ranges between 0.06 and 0.6 mg/100 g, 0.05 and 0.17 mg/100 g and 0.8 and 0.82 mg/100 g for thiamine, riboflavin and niacin, respectively
We did not find studies about other vitamin of group B or vitamin D and K in Moringa oleifera leave; therefore further studies on this topic are needed.
2. Polyphenols
Moringa oleifera dried leaves are a great source of polyphenols.
3. Flavonoids
Flavonoids are a sub-group of polyphenolic compounds having a benzo-γ-pyrone structure and are ubiquitous in plants, as they are synthesized in response to microbial infections Epidemiological studies have consistently shown that high intake of flavonoids has protective effects against many infectious (bacterial and viral diseases) and degenerative diseases such as cardiovascular diseases, cancers, and other age-related diseases
4. Phenolic Acids
Phenolic acids are a sub-group of phenolic compounds derived from hydroxybenzoic acid and hydroxycinnamic acid, naturally present in plants. Thanks to their documented effects on human health, the contribution of food-supplied phenolic acids is a subject of increasing interest. In particular, these compounds are mainly studied for their documented antioxidant, anti-inflammatory, antimutagenic and anticancer properties . Particularly abundant in fruit and vegetables, phenolic acids were found in great amounts in Moringa oleifera leaves too. In dried leaves, gallic acid seems to be the most abundant, with a concentration of approximately 1.034 mg/g of DW
5. Alkaloids
Alkaloids are a group of naturally occurring chemical compounds that contain mostly basic nitrogen atoms. This nitrogen may occur in the form of a primary amine (RNH2), a secondary amine (R2NH) or a tertiary amine (R3N). In addition to carbon, hydrogen and nitrogen, most alkaloids contain oxygen . Alkaloids are of particular interest thanks to their pharmacological properties. The presence of these compounds has been confirmed in Moringa oleifera leaves [
6. Glucosinolates and Isothiocyanates
Glucosinolates are a group of secondary metabolites in plants. Structurally they are β-S-glucosides of thio-oxime-O-sulfates and synthesized from amino acids. Appreciable amounts of these compounds were found in Moringa oleifera leaves. In particular, around 116 and 63 mg/g of DW in young and older leaves, respectively, are reported and isothiocyanates play an important role in health promoting and prevention of disease
7. Tannins
Tannins are water-soluble phenolic compounds that bind to and precipitate alkaloids, gelatin and other proteins. They exhibit various biological properties: anti-cancer, antiatherosclerotic, anti-inflammatory, anti-hepatoxic, antibacterial and anti-HIV replication activity
8. Saponins
Saponins are a group of natural compounds that consist of an isoprenoidal-derived aglycone, designated genin or sapogenin, covalently linked to one or more sugar moieties
9. Oxalates and Phytates
Oxalates and phytates are anti-nutritional compounds as they bind minerals inhibiting the intestinal absorption. Moringa oleifera leaves present high contents of these compounds
![Moringa-oleifera-Drumstick-Flower]( "Moringa-oleifera-Drumstick-Flower.jpg")
Pharmacology
1. Antioxidant Properties
Moringa oleifera leaves are a rich source of antioxidant compounds
Many in vitro studies on antioxidant activity of Moringa oleifera leaves are available in literature Siddhuraju and Becker examined the radical scavenging capacities and antioxidant activities of the aqueous, aqueous methanol, and aqueous ethanol extracts of freeze-dried leaves of Moringa oleifera from different agro-climatic regions. The authors found that different leaves extracts inhibited 89.7%–92.0% peroxidation of linoleic acid and had a scavenging activity on superoxide radicals in a dose-dependent manner (EC50 within the range of 0.08–0.2 mg/mL, with the exception of water extract from Indian leaves which has an EC50 > 0.3 mg/mL). All of the solvent extracts of leaf samples had a very high radical scavenging activity, however better results were obtained in methanol and ethanol extracts. Both methanol and ethanol extracts of Indian origins showed the highest antioxidant activities
In conclusion, many in vitro and in vivo studies have shown antioxidant properties of Moringa oleiferaleaves. These findings may be explained by the abundant amounts of antioxidant compounds in the leaves. However further studies in human are needed to confirm the results obtained in animals.
7.2. Anti-Inflammatory and Immunomodulatory Properties
Inflammation is a protective immunovascular response that involves immune cells, blood vessels, and molecular mediators. The purpose of inflammation is to eliminate the initial cause of cell injury, clear out necrotic cells and tissues damaged from the original insult and the inflammatory process, and to initiate tissue repair.
The anti-inflammatory properties of Moringa oleifera seeds have been so far reported in a number of studies, while only few studies on anti-inflammatory effect of leaves are available in the literature.
7.3. Hypoglycemic Properties
Hypoglycemic effects of Moringa oleifera leaves are reported in literature.
In the study of Ndong et al. male spontaneously diabetic Goto-Kakizaki (GK) rats and non-diabetic male Wistar rats received a single dose of glucose solution and a dose Moringa oleifera leaves (2 g/kg BW and 200 mg/kg BW, respectively), whereas control groups of both animals only received a single dose of glucose solution. Blood glucose concentration was measured at 0, 10, 20, 30, 45, 60, 90 and 120 min. Results from OGTT shown that Moringa oleifera significantly decreased blood glucose at 20, 30, 45, and 60 min in GK rats compared to the control and at 10, 30 and 45 min Wistar rats compared to the control after glucose administration. Moreover, in GK rats, the treatment with Moringa oleifera leaves reduced AUC values by 23%, whereas it did not significantly affect these values in control rats. These results suggest that Moringa oleifera has a glucose intolerance ameliorating effect in both GK and Wistar rats, with a greater action in diabetic than in normoglycemic rats. Kar et al. tested hypoglycaemic activity of ethanol extract (95%) of some Indian medicinal plants, including Moringa oleifera, in alloxan-induced diabetic rats. The authors found that a single dose of 250 mg/kg BW of leaves extract determined a halving of serum glucose in a week. In the study of Jaiswal et al. [135], the effect of the aqueous extract of Moringa oleifera leaves on glucose homeostasis was tested in healthy and streptozotocin-induced sub, mild and severely diabetic Wistar rats (STZ, a cytotoxic drug that selectively destroys islet β cells). The dose of 200 mg/kg BW of leaves extract determined a maximum fall of 26.7% in fasting blood glucose concentration and a maximum fall of 29.9% in OGGT at 3 h after glucose administration. The same dose determined a maximum fall of 31.1% and 32.8% in OGGT in sub and mild diabetic rats, respectively. Severely diabetic rat were, instead, long treated (21 days) with aqueous extract of Moringa oleifera leaves. The experiment revealed a fall of 25.9%, 53.5%, 69.2% in fasting blood glucose at 7, 14 and 21 days treatment with leaf extract. Interestingly, results obtained in sub, mild and severely diabetic rats were similar to those obtained in Glipizide treated rats (2.5 mg/kg BW, reference drug). Similar results were obtained by Edoga et al. . In this study, the aqueous extract produced a dose-dependent reduction in blood glucose levels of normoglycemic and hyperglycemic rats. In normoglycemic rats, the aqueous extract of Moringa oleifera (100, 200 and 300 mg/kg) exhibited a reduction of 23.14%, 27.05% and 33.18% respectively of the blood glucose levels within 6 hours of administration, while in alloxan-induced diabetic rats the reduction were of 33.29%, 40.69% and 44.06% respectively. Interestingly, also in this study, similar results were obtained using 200 mg/kg of tolbutamide (reference drug). Divi et al. tested the antidiabetic properties of aqueous extract of Moringa oleifera leaves in fructose-induced insulin-resistant (IR) and STZ-induced diabetic rats. After administration of 200 mg/kg BW of aqueous extract of Moringa oleifera leaves for 60 days the authors observed a decrease in blood glucose concentration in both groups and a decrease of insulin in IR group compared to respectively control. The hypoglycemic effect of aqueous extract of Moringa oleifera leaves in STZ-induced diabetic rats was also confirmed by Yassa et al. Moreover, in this study histopathological damage of islet cells was also markedly reversed. Moringa oleifera treatment significantly increased the areas of positive purple modified Gomori stained β-cells (from 60% to 91%) and decreased the area percentage of collagen fibers (from 199% to 120%) compared to control values. All these findings were confirmed by other studies using similar approach
William et al. examined the effects of Moringa oleifera leaves added to a standardized meal on serum post-prandial glucose concentration at 1 and 2 h from the consumption, compared to the standard meal alone or a 75 g oral glucose load in type 2 diabetes mellitus patients. Compared to the glucose load, standard meals with or without vegetable supplements induced a significantly lower post-prandial glucose response as derived from AUCs. However, leaf-supplemented meals caused a lower response (−21%) compared to standard meals alone. Moreover, plasma insulin AUCs did not differ significantly between the two meals, suggesting that the hypoglycemic effect of Moringa oleifera leaves supplementation was not due to increased insulin secretion. Kumari examined the hypoglycemic effect of 40-days administration of Moringa oleifera leaves in non-insulin dependent type 2 diabetes mellitus subjects aged 30–60 years old. Recruited subjects were divided in experimental and control group: the first received 8 g of dried Moringa oleifera leaves for 40 days, whereas the control group didn’t receive any treatment. Daily meals were comparable between the two groups in terms of relative food type consumption, nutrients and calories as well. Fasting and post-prandial blood glucose concentrations were taken at baseline and at the end of the experiment. Fasting and post-prandial blood glucose did not differ much from baseline in the control group, while they were significantly reduced in the experimental group (−28% and −26%, respectively). Finally, Ghiridhari et al. recruited a group of 60 normal weight type 2 diabetes mellitus patients, aged 40–58 years old, on sulfonylurea medication and a standardized calorie-restricted diet (1500 to 1800 Kcal). The patients were equally divided into an experimental and a control groups. Patients in the experimental group were prescribed an unspecified amount of Moringa oleifera leaf for 90 days. The results showed that post prandial blood glucose of experimental group initially was 210 mg/dL and it reduced to 191, 174 and 150 mg/dL respectively after the first, second and third month of supplementation (with a significant decrease of 9%, 17% and 29%, respectively). In control group post prandial blood glucose level of 179 mg/dL was substantially maintained during the whole experiment. Similar trends were observed for glycated hemoglobin (HbA 1c). In the experimental group initial value of 7.81% significantly decreased to 7.4% after the supplementation period, whereas it did not change in the control group. The results indicated that Moringa oleifera leaves are a suitable to reduce the diabetic complications in diabetic patients. However, it should be noted that treatment allocation to patients appear to have not been randomized as baseline values for the two parameters were higher in the experimental group than in the control group, 7.8% ± 0.5% vs. 7.4% ± 0.6% for HbA1c and 210 ± 49 vs. 179 ± 36 mg/dL for post-prandial glucose response Finally, it has been suggested that isothicyanates isolated from Moringa oleiferaleaves reduced glucose production in liver cells, showing activity at very low concentrations and being close to two orders of magnitude more active than metformin. These compounds were able to decrease phosphoenolpyruvate carboxykinase and glucose-6-phosphatase gene expression suggesting that they act via blocking these rate-limiting steps in liver gluconeogenesis
In conclusion, scientific evidences suggest a potential use of Moringa oleifera leaves in the treatment of diabetes. Many compounds isolated in Moringa oleifera leaves may be involved in the glucose homeostasis. Among theme, isothiocyanates seem to reduce insulin resistance and hepatic gluconeogenesis. However, also polyphenol compounds abundant in Moringa oleifera leaves, such as phenolic acids and flavonoids, may contribute to its effects on glucose homeostasis. These compounds exert, indeed, anti-diabetic effects targeting various cellular signaling pathways in pancreas, liver, skeletal muscle and white adipose tissue. In particular, they influence β-cell mass and function, as well as energy metabolism and insulin sensitivity in peripheral tissues. Their effects may be due to antioxidant, enzyme inhibition, receptor agonist or antagonist activity or through novel mechanisms yet to be elucidated . Phenolic compounds, flavonoids and tannins may be also involved in the ability of Moringa oleifera leaves extract to inhibit the intestinal sucrase and, slightly, the pancreatic α-amylase actions Finally, even though studies on human being highlight the hypoglycemic effects of Moringa oleifera leaves, further larger randomized studies controlled for potential confounders, such as sex, age, race, nutritional status and dietary habits in human are required before using the leaves as herbal drug for the treatment of diabetes.
4. Hypolipidemic Properties
Hypolipidemic effects of Moringa oleifera leaves are reported in literature
Chumark et al. [114] examined the hypolidipemic effects of Moringa oleifera leaves in rabbits fed with high-cholesterol diet (5%) for 12 weeks. A group was concomitantly treated with Moringa oleifera leaves extract (0.1 g/kg BW/day). At the end of the experiment, rabbits treated with Moringa oleifera leaves presented a total cholesterol, LDL, HDL and triglycerides significantly reduced of 52%, 42.7%, 44.2% and 75.4% respectively, compared to rabbits only fed with high-cholesterol diet, with consequent reduction of 86.52% of internal carotid atherosclerotic plaque formation. Similar trends were observed in the group treated with 5 mg/kg BW of simvastatin (reference drug). The anti-dyslipidemic effects of Moringa oleifera leaves were also examined in rats fed with a high-fat diet [151]. In this study, Wistar rats were fed for 30 days with a high-fat diet containing 20% (w/w) fat. Animals were divided in two groups, one of which received a daily dose of 1 g/kg BW of aqueous extract of Moringa oleifera leaves. The authors observed a significant lower increasing of serum cholesterol in treated compared to untreated rats, but not in liver and kidney. The percentage decrease in serum, liver and kidney was 14.35%, 6.40% and 11.09%, respectively. Similarly, Jain et al. [152], fed albino rats, for 30 days, with a high-fat diet containing 26% fat. In this case, three groups received different doses of methanolic extracts of Moringa oleifera leaves (150, 300, or 600 mg/kg bw/die), one group was treated with 4 mg/kg of simvastatin, whereas another group didn’t receive any supplementation. Treatment with methanolic extract, at three different doses significantly decreased the levels of total cholesterol and LDL as compare to the controls. The same was true for VLDL treating rats with the medium and the highest doses of methanolic extracts. Interestingly, the medium and the highest doses of methanolic extracts determined a significant increment of HDL. Similar results were obtained treating rats with simvastatin. In addition, Bais et al. [153] has recently shown that a supplementation of 200 and 400 mg/kg bw/die of Moringa oleifera leaves extract exhibited anti-obesity effects in high-fat fed mice. Lower food intake was observed in the groups treated with Moringa oleiferaleaves extract when compared to the group feed with only high-fat diet. Subsequently, the body weight gain in these groups was significantly lower than the rats feed with only high-fat diet. All these findings were confirmed by other studies using similar approaches [130,153,154].
Other studies evaluated the hypolipidemic effects of Moringa oleifera leaves supplementation in diabetes-induced rats. Diabetes is indeed a risk condition to develop dyslipidemia. Oyedepo et al. [140] evaluated the effect of aqueous extract of Moringa oleifera leaves on plasma total cholesterol, triglycerides, HDL and LDL in alloxan-induced diabetic male rats. Diabetic rats were feed with 400 mg/kg BW of aqueous extract of Moringa oleifera leaves for 28 day. At the end of the experiment diabetic rats presented lower plasma total cholesterol, triglycerides and LDL, but not higher HDL, than diabetic rats untreated. Divi et al. [137] observed a decrease of triglycerides (60.1% and 56.4%), total cholesterol (28.8% and 18.0%), LDL (31.2% and 13.9%) and VLDL (60.4% and 56.5%) in both fructose-induced insulin resistant and stz-induced diabetic rats treated with Moringa oleifera leaves extract compared to respectively untreated control. Interestingly, an increment of HDL was observed only in diabetic rats (40.4%), but in IR rats in which a decrement (10.3%) was observed. Similar results were obtained by other studies [141].
Nambiar et al. [155] firstly examined the potential anti-dyslipidemic effect of Moringa oleifera leaves in 35 hyperlipidemic subjects. Subjects were divided control (18 subjects) and experimental (17 subjects) groups. Groups were similar for anthropometric values (age, height, weight, body mass index, waist/hip ratio) and their daily nutrient intake. The experimental group was treated with 4.4 g of dehydrated Moringa oleifera leaves, as four 550 mg tablets twice daily, for 50 days. Plasma lipid profiles were determined at the beginning and at the end of the experiment. The authors observed a significant decrease of 1.6% in plasma total cholesterol and an increment of 6.3% of HDL in experimental group compared to control group. Not significant trends were observed for LDL, VLDL, and triglycerides. However, the TC/HDL ratio significantly decreased by 6.6%, indicating that the treatment induced a lesser atherogenic lipid profile. Kumari [143] observed a significant decrease of total cholesterol (14%), LDL (29%), VLDL (15%) and triglycerides (14%) in diabetic subjects treated with 8 g of Moringa oleifera leaves for 40 days compared to untreated subjects. However, not significant increase of HDL was observed.
In conclusion, scientific evidences suggest a positive effect of Moringa oleifera leaves on lipid homeostasis. Many bioactive compounds may contribute to these effects. It has been suggested that phenolic compounds, in particular flavonoids, play important roles on lipid regulation [156]. Moreover, phenolic compounds of Moringa oleifera leaves extract seem to be involved in the inhibition of pancreatic cholesterol esterase activity reducing and delaying the cholesterol absorption, and binding bile acids by forming insoluble complexes and increasing their fecal excretion with theoretical decreasing of plasma cholesterol level . However, studies on this topic are needed to confirm these hypotheses. Moreover, human are still few, and generally conducted on a restricted number of subjects. Therefore, further larger randomized studies controlled for potential confounders, such as sex, age, race, nutritional status and dietary habits in human are required before using the leaves as hypolipidemic and hypocholesterolemic herbal drug.
5. Hepato and Kidney Protective Properties
Controversial results about the effects of Moringa oleifera leaves on liver and kidney health are reported. Oyagbemi et al. and Asiedu-Gyekye et al. observed an increment in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), blood urea nitrose (BUN) and creatinine following an administration of the extract of Moringa oleifera leaves in mice. Being biomarkers of liver and kidney injury, the authors speculated that leaves might predispose to hepatic and kidney damage. However, histopathological examinations did not reveal any histological lesions in the sinusoids or central vein On the other hand, other studies reported hepatic and kidney protective properties against several drugs, such as isoniazid, rifampicin, pyrazinamide, acetaminophen and gentamicin, attributable to Moringa oleifera leaves. The authors observed a reduction of serum ALT, AST, ALP and BUN and creatinine in animals treated with the extract of Moringa oleifera leaves. These findings were confirmed by histological examinations, which revealed an amelioration of the hepatic and kidney damages induced by drugs, in animals treated with Moringa oleifera leaves. Similar results were obtained by Adeyemi and Elebiyo in rats co-treated with Moringa oleifera leaves and NiSO4 in order to induce nephrotoxicity. Finally, Das et alobserved a reduction of ALT, AST and ALP and a lower liver damage in rats fed with high fat diet and co-treated with Moringa oleifera leaves, suggesting a potential role of the leaves in the prevention of nonalcoholic fatty liver disease (NAFLD).
In conclusion, scientific evidences suggest a potential role of Moringa oleifera leaves in the amelioration of the hepatic and kidney damages induced by drugs in animals. However, further studies on human beings are required before using Moringa as herbal medication.
6. Anticancer Properties
Experimental evidences showed the capacity of Moringa oleifera leaves to protect organism and cell from oxidative DNA damage associated with cancer and degenerative diseases .
Many in Vitro studies evaluated the anticancer properties of both water and alcoholic extracts of Moringa oleifera leaves on different types of tumor cells lines. Sreelatha et al. found that the aqueous extract of Moringa oleifera leaves exhibited a dose-dependent inhibition of cell proliferation of KB human tumor (KB) cells line. This antiproliferative effect was also associated with an induction of apoptosis, morphological changes and DNA fragmentation. Tiloke et al. observed a significant increment in reactive oxygen species (ROS) with a concomitant decrease in intracellular GSH levels caused by a reduction in Nrf2 protein (1.89-fold) and mRNA expression (1.44-fold) in human lung cancer cells treated with Moringa oleifera leaves extract compared to untreated cells. These oxidants can react with DNA in the cell determining a DNA fragmentation with consequent death of cell itself. The pro-apoptotic properties of Moringa oleifera leaves extract were also confirmed by the significant increase in p53 protein (1.02-fold) and mRNA expression (1.59-fold), in caspase-9 (1.28-fold) and caspase-3/7 (1.52-fold) activities and an enhanced expression of Smac/DIABLO in cells treated with the extract. Moringa oleiferaleaves extract also caused the cleavage and activation of PARP-1 into 89 and 24 KDa fragments
7. Anti-convulsant
Experiments to discern the effects of M. concanensis leaf ethanol extract on the maximal electroshock seizure test and the pentylene tetrazole-induced convulsion test were conducted on Swiss albino mice (Joy et al., 2013). For both of the tests, M. concanensis inhibited mortality compared to control group in which deaths resulted. The study reported that the extract might block either calcium channels, sodium channels, or NMDA receptors, or has GABA agonist activity.
8. Antimicrobial
Various research has been conducted on Moringa species for their antimicrobial activity. Table summarizes the antimicrobial activity of each species. Moringa species have been widely used as water purifiers and antiseptics for water treatment because of their high antimicrobial activity. Hexane and methanol seed extracts of both M. oleifera and M. stenopetala showed inhibition against waterborne pathogens, particularly against Salmonella typhii, Vibrio cholera, and Escherichia coli (Walter et al., 2011). Most of the extracts showed better inhibition in lower concentrations.
9. Anti-inflammation
A study reported that an ethanolic extract of the M. concanensis flower and fruit inhibited inflammation by 78.4 and 44.08%, respectively (Rao et al., 2008; Jayabharathi and Chitra, 2011). An extract of the aerial part of M. peregrina decreased the effect of peritorial inflammation and reduced the permeability of small blood vessels (Elbatran et al., 2005). Ethanolic and aqueous extracts of M. peregrina seeds inhibited fresh egg albumin-induced acute inflammation in rats at doses of 100–300 mg/kg p.o (Koheil et al., 2011).
The major anti-inflammation mechanism reported for M. oleifera was the inhibition of the NF-κB pathway. Four fractions of M. oleifera leaf (hexane, chloroform, ethyl acetate, and butanol) reduced IL-1β, IL-6, PGE2, TNF-α, and nitric oxide production in LPS macrophages
Reference
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490473/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820334/
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