Moringa

Background/Objectives:Moringa oleifera Lam. is traditionally used in African and Asian medicine for its nutritional and therapeutic properties. Rich in (poly)phenols, vitamins, and minerals, various parts of the plant were used to manage metabolic disorders. No systematic research critically evaluated its impact on cardiometabolic outcomes assessed through randomized controlled trials (RCTs), thus this study aimed to do so by synthesizing existing evidence. Methods: A systematic search of PubMed, Scopus, and Web of Science databases was conducted through 7 April 2025. Eligible RCTs with a minimum duration of two weeks that evaluated moringa supplementation in adults (≥18 years) and reported at least one cardiometabolic outcome, including anthropometric measures, lipid profile, glycemic indices, or blood pressure. Random-effects meta-analyses were performed using standardized mean differences, risk of bias was assessed using the Cochrane RoB 2 tool, while the certainty of evidence was evaluated using GRADE assessment. Results: Nine RCTs (12 study arms) involving 341 participants in the intervention and 308 in the control groups met inclusion criteria. Moringa supplementation showed no significant effects on most considered outcomes. A modest reduction in diastolic blood pressure (SMD: -0.41; 95% CI: -0.75 to -0.07; p = 0.02; I2 = 19%) was observed; however, this effect was not robust in sensitivity analyses. Subgroup analyses suggested potential benefits at doses <10 g/day, in participants <50 years old, and in interventions lasting ≥12 weeks. Nevertheless, risk of bias, substantial heterogeneity (I2 frequently >80% for anthropometric and lipid parameters), indirectness, and methodological limitations reduced the overall certainty of evidence to very low for all the evaluated outcomes. Conclusions: Current evidence does not support consistent cardiometabolic benefits of moringa supplementation in adults. Further large-scale, rigorously designed RCTs are warranted to clarify its therapeutic potential and optimal supplementation parameters.

This study aimed to evaluate the effects of Moringa oleifera (moringa) as a feed supplement on the performance and health status of broiler chicken through a meta-analysis. The database was compiled from 35 studies comprising 191 experiments. The literatures from Scopus are screened by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, and the data were analyzed using OpenMEE software. Feed containing moringa was the fixed effects and the different studies as random effects. The results showed that dietary moringa supplementation increased weight gain (p < 0.05), decreased feed intake (p < 0.05), and therefore decreased feed conversion ratio (FCR) of the broiler chicken. Blood lipid parameters were also affected by moringa supplementation. Feed containing moringa decreased cholesterol, triglyceride, and LDL (p < 0.05), while HDL was higher in comparison to that of control (p < 0.05). It can be concluded from the meta-analysis that dietary moringa supplementation effectively improves performance and health status of broiler. © 2025 Japanese Society of Animal Science.

The inclusion of Moringa oleifera leaf meal (MLM) in chicken diets especially in developing countries is on the increase due to scarcity of traditional feedstuffs. Therefore, this investigation aimed to explore the effects of MLM on lipid profiles and production characteristics of laying hens. Twenty-three publications retrieved from Web of Science, PubMed, Scopus and Google Scholar search engines were used for the analysis. Data from the 23 studies were analysed using random-effects model in OpenMEE software. Results were presented as standardised mean difference (SMD) at a 95% confidence interval. The results show significant improvement in feed conversion ratio (SMD = - 0.49; p < .001), egg mass (SMD = 0.35; p = .003), Haugh unit (SMD = 0.39; p < .001), eggshell thickness (SMD = 0.63; p < .001) and eggshell weight (SMD = 0.45; p < .001) at a reduced feed intake. On the other hand, egg weight, hen-day egg production and blood high-density lipoprotein cholesterol were not statistically different from controls. Results reveal that dietary MLM enhanced blood cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides and yolk cholesterol concentrations in laying hens. There is presence of significant heterogeneity and meta-regression revealed that study country, number of hen, housing system, hen age, inclusion level and layer strains were predictors of the treatment effect. In conclusion, the results of this meta-analysis suggest that inclusion of MLM in the diet of laying hens improved feed conversion ratio, aspects of egg quality and blood/yolk cholesterol concentrations in laying hens at a reduced feed intake. © 2023. The Author(s), under exclusive licence to Springer Nature B.V.

Plant-derived phytochemicals have been interested in as nutraceuticals for preventing the onset and progress of diabetes mellitus and its serious complications in recent years. Moringa oleifera Lam. is used in vegetables and in herbal medicine for its health-promoting properties against various diseases including diabetes mellitus. This study aimed to examine an effect of Moringa oleifera on diabetic hyperglycemia and dyslipidemia by meta-analyzing the current evidence of diabetic rodent models. Peer-reviewed studies written in English from two databases, PubMed and Embase, were searched to 30 April 2021. Studies reporting blood glucose or lipid levels in diabetic rodents with and without receiving extracts of Moringa oleifera were included. Forty-four studies enrolling 349 diabetic rodents treated with extracts of Moringa oleifera and 350 diabetic controls reported blood glucose levels. The pooled effect size was -3.92 (95% CI: -4.65 to -3.19) with a substantial heterogeneity. This effect was likely to be, at least in part, modified by the type of diabetic models. Moreover, diabetic hypertriglyceridemia and hypercholesterolemia were also significantly improved in diabetic rodent models treated with Moringa oleifera. Effectiveness of moringa biscuit (Moringa oleifera) and snakehead fish (Channa striata) in improving the nutritional status of pregnant women with chronic energy deficiency. Setyawati E(1)(2), Sumarmi S(3), Nurasmi N(2), Irnawati I(2), Hutagaol IO(2). Author information: (1)Doctoral student of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia. (2)Faculty of Health, Universitas Widya Nusantara, Palu, Central Sulawesi, Indonesia, 94119, Indonesia. (3)Faculty of Public Health, Universitas Airlangga, Surabaya, 60115, Indonesia. The objective of this study was to analyse the effectiveness of moringa biscuits and snakehead fish in improving the nutritional status of pregnant women with chronic energy deficiency (CED). The study was a randomized control trial carried out in two stages. The first stage was carried out in 2020, while the second stage was implemented in 2021 in Sigi Regency, Central Sulawesi Province, Indonesia. Thirty pregn

BACKGROUND: Many women express concern about their ability to produce enough milk, and insufficient milk is frequently cited as the reason for supplementation and early termination of breastfeeding. When addressing this concern, it is important first to consider the influence of maternal and neonatal health, infant suck, proper latch, and feeding frequency on milk production, and that steps be taken to correct or compensate for any contributing issues. Oral galactagogues are substances that stimulate milk production. They may be pharmacological or non-pharmacological (natural). Natural galactagogues are usually botanical or other food agents. The choice between pharmacological or natural galactagogues is often influenced by familiarity and local customs. Evidence for the possible benefits and harms of galactagogues is important for making an informed decision on their use. OBJECTIVES: To assess the effect of oral galactagogues for increasing milk production in non-hospitalised breastfeeding mother-term infant pairs. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), Health Research and Development Network - Phillippines (HERDIN), Natural Products Alert (Napralert), the personal reference collection of author LM, and reference lists of retrieved studies (4 November 2019). SELECTION CRITERIA: We included randomised controlled trials (RCTs) and quasi-RCTs (including published abstracts) comparing oral galactagogues with placebo, no treatment, or another oral galactagogue in mothers breastfeeding healthy term infants. We also included cluster-randomised trials but excluded cross-over trials. DATA COLLECTION AND ANALYSIS: We used standard Cochrane Pregnancy and Childbirth methods for data collection and analysis. Two to four review authors independently selected the studies, assessed the risk of bias, extracted data for analysis and checked accuracy. Where necessary, we contacted the study authors for clarification. MAIN RESULTS: Forty-one RCTs involving 3005 mothers and 3006 infants from at least 17 countries met th

6. Afr J Reprod Health. 2024 Oct 31;28(10s):41-49. doi: 10.29063/ajrh2024/v28i10s.5. Effectiveness of moringa biscuit (Moringa oleifera) and snakehead fish (Channa striata) in improving the nutritional status of pregnant women with chronic energy deficiency. Setyawati E(1)(2), Sumarmi S(3), Nur

Background: Childhood vitamin A deficiency leads to increased morbidity and mortality. Human milk is the only source of vitamin A for exclusively breastfed infants. Dried Moringa oleifera leaf powder (moringa) is a good food source of provitamin A and other carotenoids. Its effect during lactation on human milk vitamin A and carotenoid content is unclear. Objectives: Our objective was to investigate the effect of maternal moringa consumption on human milk retinol and carotenoid concentrations and maternal and infant vitamin A status. Methods: We conducted a 3-month pilot single-blinded cluster-randomized controlled trial in breastfeeding mother-infant pairs (n = 50) in Kenya. Mothers received corn porridge with (20 g/d) or without moringa with complete breast expressions and maternal and infant serum collected at enrollment (infant <30 days old) and 3 months. Milk was analyzed for retinol and selected carotenoids; maternal/infant serum was analyzed for retinol binding protein (RBP). Results: 88% (n = 44) pairs completed milk and serum samples. Four mothers (9%) had vitamin A deficiency (RBP <0.07 µmol/L); 11 (25%) were vitamin A insufficient (VAI; RBP <1.05 µmol/L). Alpha-carotene concentration in milk was higher in the moringa than the control group at baseline (p = 0.024) and at exit (least squares means, LSM, 95%CI µg/mL 0.003, 0.003-0.004 moringa vs. 0.002, 0.001-0.003 control, n = 22/cluster; p = 0.014). In mothers with VAI, alpha-carotene was higher in the moringa group than controls at exit (LSM, 95%CI µg/mL 0.005, 0.003-0.009 moringa, n = 3, vs. 0.002, 0.000-0.004 control, n = 8, p = 0.027) with no difference at baseline. Milk carotenoids did not correlate with vitamin A status (serum RBP) in infants or mothers. Conclusions: Maternal moringa consumption did not impact concentration of milk vitamin A and resulted in limited increase in milk carotenoids in this cohort.

BACKGROUND: Moringa oleifera leaves are rich in bioactive substances. PURPOSE: The purpose of this study was to evaluate the effects of Moringa oleifera leaf aqueous extract supplements on energy metabolism and antioxidant function in young male adults. METHODS: Forty-four young male adults (26.3 ± 3.5 years) were randomly assigned to two groups: a supplement group (n = 23) receiving aqueous extract of Moringa oleifera leaves and a placebo group (n = 21). The supplementation period lasted for 30 days. Baseline measurements were taken at the beginning of the study, and further measurements were taken at the end of the supplementation period. Changes in upper- and lower-body strength, treadmill endurance, and certain blood biochemical parameters were evaluated. RESULTS: After 30 days of supplementation, participants in the supplement group exhibited enhanced performance in push-ups and treadmill exhaustion tests compared to the placebo group. Levels of glucose, urea, malondialdehyde, and glutathione peroxidase activity in serum were also improved in the supplement group. CONCLUSION: The findings suggest that Moringa oleifera leaf aqueous extracts have the potential to improve post-exercise energy metabolism and antioxidant function in young male adults.

BACKGROUND: Initiation of ART among people living with HIV (PLWH) having a CD4 count ≤ 350cells/µl, produces poor immunological recovery, putting them at a high risk of opportunistic infections. To mitigate this, PLWH on ART in Uganda frequently use herbal remedies like Artemisia annua and Moringa oleifera, but their clinical benefits and potential antiretroviral (ARV) interactions remain unknown. This study examined the impact of A. annua and M. oleifera on CD4 count, viral load, and potential ARV interactions among PLWH on ART at an HIV clinic in Uganda. METHODS: 282 HIV-positive participants on antiretroviral therapy (ART) with a CD4 count ≤ 350cells/µl were randomized in a double-blind clinical trial to receive daily, in addition to their routine standard of care either; 1) A. annua leaf powder, 2) A. annua plus M. oleifera, and 3) routine standard of care only. Change in the CD4 count at 12 months was our primary outcome. Secondary outcomes included changes in viral load, complete blood count, and ARV plasma levels. Participants were followed up for a year and outcomes were measured at baseline, 6 and 12 months. RESULTS: At 12 months of patient follow-up, in addition to standard of care, administration of A. annua + M. oleifera resulted in an absolute mean CD4 increment of 105.06 cells/µl, (p < 0.001), while administration of A. annua plus routine standard of care registered an absolute mean CD4 increment of 60.84 cells/µl, (p = 0.001) compared to the control group. The A. annua plus M. oleifera treatment significantly reduced viral load (p = 0.022) and increased platelet count (p = 0.025) and white blood cell counts (p = 0.003) compared to standard care alone, with no significant difference in ARV plasma levels across the groups. CONCLUSION: A combination of A. annua and M. oleifera leaf powders taken once a day together with the routine standard of care produced a significant increase in CD4 count, WBCs, platelets, and viral load suppression among individuals on ART. A. annua and M. oleifera have potential to offer an affordable alternative remedy for managing HIV infection, particularly in low-resource communities lacking ART access. TRIAL REGISTRATION:

We investigate the synergistic effect of Moringa oleifera and Allium sativum on hyperlipidemic patients. It was a randomized controlled trial. The sample size of this study was 60 patients who were divided into four equal groups (n=15) through a random sampling technique. Pre assessment of all participants was conducted at the start of the research. The control group (group A) received atorvastatin 10mg QD as well as placebo capsules. The treatment group 1 (group B) received atorvastatin 10mg QD as well as Moringa oleifera 2g (capsule 1g BID). Treatment group 2 (group C) received atorvastatin 10mg QD as well as Allium sativum 2g (capsule 1g BID). Lastly, treatment group 3 (Group D) received atorvastatin 10mg QD as well as combined Moringa oleifera 2g (capsule 1g BID) and Allium sativum 2g (capsule 1g BID). After an intervention of 45 days, post assessment was conducted. The results showed total cholesterol and triglycerides and low-density lipoprotein of participants of treatment group 3 who received both MO and AS were statistically significant (p<0.05). The group that was on Moringa oleifera supplements alone was found to be statistically significant (p<0.05). This study concluded that Moringa oleifera and Allium sativum considerably improved the BMI and lipid profile of participants.

AIM: The study aims to evaluate and compare the efficacy of Moringa oleifera leaf extract gel (2%) & Retino A cream (0.1%) in reducing the size of lesions in oral leukoplakia. OBJECTIVES: The present study aimed to evaluate the efficacy of two interventions, Moringa oleifera mucoadhesive gel and Retino-A cream, in reducing the size of lesions in patients with oral leukoplakia. Specifically, the objectives were: (1) to assess the efficacy of Moringa oleifera mucoadhesive gel in determining the reduction in lesion size, (2) to assess the efficacy of Retino-A cream in determining the reduction in lesion size, and (3) to compare the efficacy of Moringa oleifera mucoadhesive gel (2%) in determining the change in lesion size in oral leukoplakia patients. METHODS: Clinically diagnosed cases of oral Leukoplakia were included in this study. The sample size is 72. Thirty-six patients had lesion sizes ranging from 2- 4 cm, and 36 patients had lesion sizes ranging from 4.1 - 6 cm that were equally distributed in the case and control groups using the chit system. The case and control groups had 36 patients with an equal size range of lesions. The case and control group participants will be advised topical application of the intervention and Retino-A thrice daily using a sterile cotton bud. RESULTS: M. oleifera gel (2%) was found to be more effective in the reduction in the size of the lesion as compared to Retino-A in the treatment of oral leukoplakia patients. CONCLUSION: This study showed that M. oleifera mucoadhesive gel (2%) is an effective and safe treatment option for oral leukoplakia patients. It demonstrated a significant reduction in lesion size compared to Retino-A cream (0.1%) after 3 months of therapy, without any reported adverse effects. However, long-term follow-up studies are needed to evaluate its long-term effectiveness. The potent antioxidant property of M. oleifera makes it a promising candidate for further studies with concentration variations and in other potentially malignant oral disorders, such as lichen planus and OSMF. The development of chemotherapeutic drugs from M. oleifera for cancer treatment should also be considered. Overall, M. oleifera app

BackgroundThere is a paucity of information on the antidiabetic potential of graded amounts of Moringa leaves on diabetes human subjects.AimTo ascertain the effeccts of Moringa leaves on type 2 diabetic subjects' blood glucose, blood pressure, and lipid profile levels in a rural Nigerian community.MethodsThis study adopted a parallel group randomized control design. Participants included 40 adult male and female diabetic subjects who met the inclusion criteria and consented to participate in the study. The participants were randomly assigned to four groups. The control group was fed diets without Moringa oleifera leaves while the experimental groups received 20, 40, and 60 g of Moringa leaves respectively daily for 14 days in addition to the diets. The subjects' baseline data and post-intervention data were collected before and after the intervention, respectively. Data were analyzed using paired-sample t-test and analysis of covariance. Significance was accepted at p < 0.05.ResultsThe mean fasting blood glucose levels in all the groups did not differ significantly from one another. Group 3 had significantly (p = 0.01) lower mean systolic pressure (from 136.40 ± 7.66 to 123.90 ± 13.82) after the intervention. Group 3 subjects had a significant (p = 0.04) increase in their triglyceride values (from 123.80 ± 53.69 before intervention to 151.20 ± 41.47) after intervention. After adjusting for the pre-intervention values, there was no significant (p > 0.05) difference in all the parameters at the end of the intervention.ConclusionThere were marginal improvements in the parameters assessed which were not dose-dependent.

Different parts of the Moringa oleifera Lam. (MO) tree are consumed as food or food supplements for their nutritional and medicinal value; however, very few human studies have been published on the topic. The current work was aimed to provide ancillary analysis to the antidiabetic effects previously reported in a double-blind, randomized, placebo-controlled, parallel group intervention conducted in patients with prediabetes. Thus, the effect of MO leaves on blood and fecal inflammatory markers, serum lipid profile, plasma antioxidant capacity and blood pressure was studied in participants who consumed 6 × 400 mg capsule/day of MO dry leaf powder (MO, n = 31) or placebo (PLC, n = 34) over 12 weeks. Differences between groups were assessed using each biomarker's change score with, adjustment for fat status and the baseline value. In addition, a decision tree analysis was performed to find individual characteristics influencing the glycemic response to MO supplementation. No differences in the biomarker's change scores were found between the groups; however, the decision tree analysis revealed that plasma TNF-α was a significant predictor of the subject's HbA1c response (improvement YES/NO; 77% correct classification) in the MO group. In conclusion, TNF-α seems to be a key factor to identify potential respondents to MO leaf powder.

Moringa oleifera (MO) is a multipurpose plant with a high polyphenol content, which is being increasingly consumed to lessen the risk of chronic metabolic diseases such as Type 2 diabetes; however, scientific evidence from clinical trials is scarce. A double-blind, randomized, placebo-controlled, parallel group intervention study with MO leaves as a food supplement was conducted in subjects with prediabetes. They consumed six daily capsules of MO dry leaf powder (2400 mg/day) (MO, n = 31) or placebo (PLC, n = 34) over 12 weeks. Glycemia, appetite-controlling hormones and gut microbiota composition were studied. ANCOVA with the fixed factor "treatment" and the basal value as covariate was used to compare the change score between the groups. The results showed significant differences between groups in the rate of change of fasting blood glucose (FBG) and glycated hemoglobin (HbA1c), which showed opposite directions during the intervention, decreasing in MO and increasing in PLC. No different change scores were found between the groups in microbiota, hepatic and renal function markers or the appetite-controlling hormones measured. In conclusion, MO supplementation resulted in favorable changes in glycaemia markers compared to placebo in the subjects with prediabetes studied, suggesting that MO might act as a natural antihyperglycemic agent.

BACKGROUND: People living with HIV (PLHIV) in resource-limited settings are vulnerable to malnutrition. Nutritional interventions aimed at improving food insecurity and malnutrition, together with antiretroviral therapy (ART), could improve treatment outcomes. In Nigeria, there is a high awareness of the nutraceutical benefits of Moringa oleifera. Thus, this study aimed to evaluate the effects of Moringa oleifera leaf supplementation on the CD4 counts, viral load and anthropometric of HIV-positive adults on ART. METHODS: This was a double-blind, randomized study. Two hundred HIV-positive patients were randomly allocated to either the Moringa Oleifera group (MOG) given Moringa oleifera leaf powder or the control group (COG) given a placebo. Changes in anthropometric parameters [weight; body mass index (BMI)] and CD4 cell counts were measured monthly for six months, while HIV-1 viral loads were measured at baseline and the end of the study for both groups. RESULTS: Over the study period, the treatment by time interaction shows a significant difference in CD4 counts by treatment group (p<0.0001). A further estimate of fixed effects showed that the CD4 counts among MOG were 10.33 folds greater than COG over the study period. However, the viral load (p = 0.9558) and all the anthropometric parameters (weight; p = 0.5556 and BMI; p = 0.5145) between the two groups were not significantly different over time. All tests were conducted at 95CI. CONCLUSION: This study revealed that Moringa oleifera leaf supplementation was associated with increased CD4 cell counts of PLHIV on ART in a resource-limited setting. Programs in low-resource settings, such as Nigeria, should consider nutritional supplementation as part of a comprehensive approach to ensure optimal treatment outcomes in PLHIV.

This study evaluated the effects of methanolic extracts of Moringa oleifera (MO) and Thymus vulgaris (TV), administered alone or in combination via drinking water, on growth performance, carcass traits, gut health, immune response, lymphoid organ development, liver and kidney function, and nutrient digestibility in broiler chickens. A total of 540 one-day-old Ross 308 broiler chicks were randomly allocated to six dietary treatments for a 42-day experimental period, including a basal diet control, a basal diet supplemented with a standard antibiotic growth promoter, MO extract alone, TV extract alone, and two combined MO-TV extract treatments. The combined treatments consisted of graded inclusion levels, with the most effective group receiving M50T50 (100mg/L MO + 150mg/L TV). The results demonstrated that combined MO and TV supplementation, particularly M50T50, significantly improved feed intake, body weight gain, and feed conversion ratio compared with the control and single-extract groups (p = 0.01). Dressing percentage and breast and thigh yields were highest in the combined extract groups (p = 0.01). Intestinal pH was significantly reduced, indicating an improved gut environment (p < 0.05), while antibody titers against infectious bronchitis (IB), Newcastle disease (ND), and infectious bursal disease (IBD) viruses were markedly elevated (p < 0.01). Lymphoid organ development, particularly bursal weight, was enhanced, whereas liver and kidney function markers remained within normal physiological ranges. Crude protein digestibility was also significantly increased (p = 0.01). These findings demonstrate that combined MO and TV methanolic extracts exert synergistic effects on growth performance, immunity, gut health, and protein utilization in broilers without adverse effects, highlighting their potential as a natural and effective phytogenic alternative to antibiotic growth promoters in poultry production.

CONTEXT: The use of herbal products in Malawi remains widespread and culturally significant, often occurring alongside pharmaceutical medicine treatments. As the burden of non-communicable diseases such as diabetes and hypertension continues to rise, the potential for herbal-drug interactions (HDIs) represents an underexamined public health concern. OBJECTIVE: Evaluate the concurrent use of herbal products and pharmaceutical medicines among patients with diabetes or hypertension in a large health care facility in Malawi and identify potential adverse HDIs. MATERIALS & METHODS: An exploratory mixed-methods, cross-sectional study was conducted with 301 patients attending a diabetes or hypertension clinic at Queen Elizabeth Central Hospital in Blantyre, Malawi. Participants self-reported herbal and pharmaceutical use, and a targeted literature review was undertaken to assess potential pharmacokinetic and pharmacodynamic interactions between commonly reported herbal products and prescribed medications. RESULTS: Participants reported concurrent use of a wide variety of herbal products (e.g., garlic, ginger, okra, lemon, mango, moringa) with prescription medicines (e.g., metformin, insulin, glibenclamide, hydrochlorothiazide, enalapril, amlodipine). While clinical outcomes were not independently verified, literature review findings, in some cases, indicated meaningful potential for HDIs. DISCUSSION AND CONCLUSION: This study provides foundational data on herbal-pharmaceutical co-use in Malawi and highlights the need for expanded research, improved documentation of herbal use in healthcare settings, and improved education for patients and providers. Integrating awareness of herbal product use into clinical care is essential, and the methodology and findings may inform future hypothesis-driven studies across Africa and other regions where traditional and modern medicine use overlaps.

This work evaluated the antibacterial properties of aqueous extract (AE), protein-rich fraction (PF), and isolated water-soluble lectin (WSMoL) from Moringa oleifera Lam. seeds against the gram-positive bacterium Listeria monocytogenes, which causes listeriosis. Foodborne bacterial infections, which are facilitated by biofilm formation, pose significant public health threats. Listeriosis is an infection that involves bacteremia, meningitis, or meningoencephalitis. The strains N53-1 and EGD-e were assessed in this work. Bacteriostatic and bactericidal effects on planktonic cells were assessed by broth microdilution assay and flow cytometry. Possible combined effects with antibiotics (ciprofloxacin and cephalexin) were also determined, as well as the impact of all preparations on bacterial aggregation and biofilm formation. AE, PF and WSMoL presented minimum inhibitory concentration (MIC) ranging from 250 to 300 μg/mL for N53-1, and between 150 and 250 μg/mL for EGD-e. AE and WSMoL did not show bactericidal action but PF was bactericidal to EGD-e (minimal bactericidal concentration: 1500 μg/mL). AE, PF, and WSMoL demonstrated synergistic effects with ciprofloxacin, while AE and PF were synergic together with cephalexin. Moreover, AE, PF and WSMoL showed an inhibitory effect on aggregation of cells of both strains. At 0.97 μg/mL, WSMoL inhibited 95 % the biofilm formation by N53-1, while PF at 4.68 μg/mL elicited a biofilm inhibition of 87 % on the same strain. The data stimulate more studies assessing the potential of crude and purified preparations from M. oleifera containing the lectin WSMoL to combat the causer of listeriosis, as synergistic agents and as aggregation inhibitors.

To enhance the clinical effect of antifungal medications for treating deadly fungal infections there is an increasing demand for novel treatments. Exploration of multiple-drug targeting in antifungal therapeutics is the need of the present era. In this pursuit, we identified potent antifungal compounds that were directed towards the multiple virulent targets in Rhizopus arrhizus. Quinoxaline di-N-oxide and piperazine derivatives were identified to exhibit antifungal activities. 03 bioactive compounds were identified from the docking results and antifungal activity. Furthermore, these compounds which were combined with the alkaline extract of M. olifera to make the aqueous phase, an oil phase containing cinnamon oil or clove oil and a combination of surfactants was made to prepare a bioactive composite emulsion. A significant antimycotic activity was seen for the bioactive composite emulsion when compared with the clinically used antifungal drugs. Our results indicate the synergy and potentiation of antimycotic drugs based on integrative medicine.

In this study, hydroethanolic extracts of 30 top-selling botanicals (herbs) commonly used as ingredients of herbal dietary supplements in the US were screened for their potential to activate the human pregnane X receptor (hPXR) and human aryl hydrocarbon receptor (hAhR) and to increase the activities of hPXR- and hAhR-regulated drug metabolizing cytochrome P450 enzymes (i.e., CYP3A4 and CYP1A2, respectively). Of the 30 botanicals tested, 21 induced PXR and 29 induced AhR transcriptional activities. Out of the 21 botanicals that induced hPXR transcriptional activity, 14 yielded >50% induction in CYP3A4 activity at concentrations ranging from 6 to 60 µg/mL and 16 out of the 29 botanicals that activated hAhR yielded >50% induction in CYP1A2 activity at concentrations ranging from 3 to 30 µg/mL. Moreover, eight botanicals (G. gummi-gutta [garcinia], Hemp [low and high CBD content], H. perforatum [St. John's wort], M. vulgare [horehound], M. oleifera [moringa], O. vulgare [oregano], P. johimbe [yohimbe] and W. somnifera [ashwagandha]) yielded >50% induction in both CYP3A4 and CYP1A2 activity. Herbal products are mixtures of phytoconstituents, any of which could modulate drug metabolism. Our data reveals that several top-selling botanicals may pose herb-drug interaction (HDI) risks via CYP450 induction. While in vitro experiments can provide useful guidance in assessing a botanical's HDI potential, their clinical relevance needs to be investigated in vivo. Botanicals whose effects on hPXR/CYP3A4, and hAhR/CYP1A2 activity were most pronounced will be slated for further clinical investigation.

INTRODUCTION: The antibiotic resistance has become a major threat to global health. The combinatorial use of two or more compounds to develop a new formulation may overcome the emerging cases of drug resistance. Moringa oleifera has been utilized as a strong nutritional, immunomodulator and therapeutic agent for decades. In this study, different parts of Moringa oleifera were screened for bioactive compounds that can act as a resistance modifying agent for multi-drug resistant organisms (MDROs). METHODOLOGY: Initially, the combined effect of stem bark extracts and ampicillin was calculated by checkerboard assay. Active compounds of effective extract were assessed by High Performance Liquid Chromatography (HPLC). Minimal Inhibitory Concentration (MIC) and Fractional Inhibitory Concentration Index (FICI) were calculated to evaluate the synergistic behavior of stem bark extract with ampicillin. To study the blocking of resistance pathways of Methicillin-Resistant Staphylococcus aureus (MRSA) western blot was performed. RESULTS: The results revealed that stem bark has significant anti-MRSA activity. The methanolic extract of stem bark in combination with ampicillin showed the highest synergistic effect (FICI value ≤ 0.237) against MRSA. Killing kinetics and membrane potential of ampicillin alone and in combination revealed an increase in the inhibitory potential of ampicillin against MRSA. Decolourization in iodometric assay confirmed the inhibition of β-lactamase, western blot results confirmed the blocking of penicillin-binding protein (PBP2a) expression with the restoration of MRSA sensitivity against β-lactams. CONCLUSION: It can be concluded that methanolic extract of Moringa oleifera stem bark has bioactive compounds and can be used as an adjuvant with antibiotics to modify the resistance of MDROs. © 2021. The Author(s), under exclusive licence to Springer Nature B.V.

Moringa oleifera, Tropaeolum tuberosum and Annona cherimola are medicinal plants traditionally used in Ecuador. However, their therapeutic properties are not completely known. We analyzed chromatographically ethanolic extracts of the seeds of M. oleifera, A. cherimola and the tubers of T. tuberosum; all presented a high content of polyphenols. The extract of A. cherimola showed the highest antioxidant activity and M. oleifera had the highest capacity to enhance the activity of detoxifying enzymes such as glutathione S-transferase and quinone oxidoreductase. The antitumor effect of these extracts was evaluated in vitro with colorectal cancer (CRC) cell lines T84, HCT-15, SW480 and HT-29, as well as with cancer stem cells (CSCs). A. cherimola and M. oleifera extracts presented the lowest IC50 in T-84 and HCT-15 (resistant) cells, respectively, as well as the highest level of inhibition of proliferation in multicellular tumor spheroids of HCT-15 cells. The inhibitory effect on CSCs is noteworthy because in vivo, these cells are often responsible for cancer recurrences and resistance to chemotherapy. Moreover, all extracts showed a synergistic activity with 5-Fu. The antiproliferative mechanism of the extracts was related to overexpression of caspases 9, 8 and 3 and increased production of reactive oxygen species. In addition, we observed cell death by autophagy in M. oleifera and T. tuberosum extracts. Therefore, these ethanolic extracts are excellent candidates for future molecular analysis of the presence of bioactive compounds and in vivo studies which could improve colon cancer therapy.

The management of neuropsychiatric disorders relies heavily on pharmacotherapy. The use of herbal products as complimentary medicine, often concomitantly, is common among patients taking prescription neuropsychiatric drugs. Herb-drug interaction, a clinical consequence of this practice, may jeopardize the success of pharmacotherapy in neuropsychiatry. Besides the wellknown ability of phytochemicals to inhibit and/or induce drug-metabolizing enzymes and transport proteins, several phytoconstituents are capable of exerting pharmacological effects on the central nervous system. This study reviewed the relevant literature and identified 13 commonly used herbal products - celery, echinacea, ginkgo, ginseng, hydroxycut, kava, kratom, moringa, piperine, rhodiola, St. John's wort, terminalia/commiphora ayurvedic mixture and valerian - which have shown clinically relevant interactions with prescription drugs used in the management of neuropsychiatric disorders. The consequent pharmacokinetic and pharmacodynamic interactions with orthodox medications often result in deleterious clinical consequences. This underscores the importance of caution in herb-drug co-medication.

BACKGROUND AND OBJECTIVE: The use of herbal medicines is common in Africa, and patients often use a combination of herbs and drugs. Concurrent herbal and pharmaceuticals treatments can cause adverse effects through herb-drug interactions (HDI). This study evaluated the potential risk of HDI for five medicinal plants, Vernonia amygdalina, Ocimum gratissimum, Moringa oleifera, Azadirachta indica, and Picralima nitida, using in vitro assays. Patients with diabetes and some other disease conditions commonly use these medicinal plants in Nigeria, and little is known regarding their potential for drug interaction, despite their enormous use. METHODS: Crude extracts of the medicinal plants were evaluated for reversible and time-dependent inhibition (TDI) activity of six cytochrome P450 (CYP) enzymes using pooled human liver microsomes and cocktail probe-based assays. Enzyme activity was determined by quantifying marker metabolites' formation using liquid chromatography-mass spectrometry/mass spectrometry. The drug interaction potential was predicted for each herbal extract using the in vitro half-maximal inhibitory concentration (IC50) values and the percentage yield. RESULTS: O. gratissimum methanol extracts reversibly inhibited CYP 1A2, 2C8, 2C9 and 2C19 enzymes (IC50: 6.21 µg/ml, 2.96 µg/ml, 3.33 µg/ml and 1.37 µg/ml, respectively). Additionally, V. amygdalina methanol extract inhibited CYP2C8 activity (IC50: 5.71 µg/ml); P. nitida methanol and aqueous extracts inhibited CYP2D6 activity (IC50: 1.99 µg/ml and 2.36 µg/ml, respectively) while A. indica methanol extract inhibited CYP 3A4/5, 2C8 and 2C9 activity (IC50: 7.31 µg/ml, 9.97 µg/ml and 9.20 µg/ml, respectively). The extracts showed a potential for TDI of the enzymes when incubated at 200 µg/ml; V. amygdalina and A. indica methanol extracts exhibited TDI potential for all the major CYPs. CONCLUSIONS: The medicinal plants inhibited CYP activity in vitro, with the potential to cause in vivo HDI. Clinical risk assessment and proactive monitoring are recommended for patients who use these medicinal plants concurrently with drugs that are cleared through CYP metabolism.

Despite the success of antibiotic discovery, infectious diseases remain the second leading source of death worldwide, while the resistance to antibiotics is among the significant problems in the twenty-first century. Medicinal plants are very rich in phytochemicals which can be structurally optimized and processed into new drugs. Nigeria enjoys a diverse collection of medicinal plants, and joint research has ascertained the efficacy of these plants. Plants such as guava (Psidium guajava), ginger (Zingiber officinale), neem (Azadirachta indica), and moringa (Moringa oleifera) have been found to exhibit broad range of antimicrobial activities. Studies on Nigerian plants have shown that they contain alkaloids, polyphenols, terpenes, glycosides, and others with possible therapeutic potentials. The antimicrobial activities of some new compounds such as alloeudesmenol, hanocokinoside, orosunol, and 8-demethylorosunol, identified from medicinal plants in Nigeria, are not yet explored. Further investigation and optimization of these compounds will facilitate the development of new sets of pharmacologically acceptable antimicrobial agents. This review study revealed the efficacy of medicinal plants as an alternative therapy in combating and curtailing the development and survival of multidrug-resistant pathogens coupled with the toxic effects of some antibiotics. Due to enormous therapeutic possibilities buried in medicinal plants, there is a need for more research into unique fingerprints and novel compounds that can provide cure to the neglected tropical diseases (NTDs) of humans and animals facing Africa, especially Nigeria.

Moringa oleifera Lamk. a highly valued multipurpose plant, has gained increasing attention owing to its diverse pharmacological properties, including immunomodulatory, antioxidant, and antidiabetic effects. This narrative review evaluates published human studies and case reports from 2015 to 2025 to assess the efficacy and safety of M. oleifera and the underlying mechanisms of its pharmacological effects. A narrative review was chosen over a systematic review because it is flexible, broad-focused, and interpretive, and thus is suitable for mapping emerging fields. A total of 22 clinical trials and nine case reports met the inclusion criteria. This review focuses on five major clinical themes: immunological and nutritional effects, metabolic and endocrine disorders, inflammatory and oxidative stress-related diseases, maternal and child health outcomes, and other clinical applications. Evidence from human studies indicates consistent improvements in immune function, glycemic control, and antioxidant status, particularly among individuals with HIV infection, prediabetes, and malnutrition. Maternal supplementation also enhances the vitamin A content and nutritional outcomes in infants. Mechanistically, these effects are linked to the immune system (modulation of cytokine activity, activation of AMP-activated protein kinase, and antioxidant activity) and to metabolic pathways (inhibition of α-glucosidase and dipeptidyl peptidase IV). Although it is generally well tolerated, rare hypersensitivity and thrombotic events have been reported. Collectively, M. oleifera shows promising potential as a safe and accessible functional food and a nutraceutical or adjunct therapeutic candidate for immune and metabolic disorders, thus warranting further standardized, large-scale randomized controlled trials to confirm its long-term efficacy and safety. © 2026 Sianipar et al.

The gasotransmitter hydrogen sulfide (H2S) and its natural donor isothiocyanates have been suggested by emerging evidence to play a significant role in the therapeutic management of several conditions like metabolic syndrome, neurodegeneration, inflammation, and so forth. In particular, isothiocyanates from Moringa oleifera Lam have been found to be more stable than those from cruciferous vegetables and Alliaceae, although they are less studied. For this reason, the present review aims to conduct a systematic literature search to outline the potential clinical applications of isothiocyanates, as a source of H2S, formed from glucosinolates present in M. oleifera. The systematic search was performed on Scopus and PubMed using wide-ranging keywords such as "Isothiocyanates" and "Moringa," "Isothiocyanates," and "Moringin," and "Moringin" alone. The selection was limited to publications written in English. All articles containing information on the biological activity of M. oleifera's isothiocyanates were considered for selecting articles for analysis. Review articles, letters, book chapters, editorials, conference papers, systematic reviews, and short surveys were not considered. This allowed the selection of 42 papers, which were analyzed per pathologies and evaluated for the risk of biases using the QUIN tool. Hence, this review gives an overview of the potential health benefits linked to M. oleifera's isothiocyanates as a natural source of H2S. © 2025 John Wiley & Sons Ltd.

Oral diseases pose a major public health challenge, especially in low-income countries where dental care is limited due to high costs. In this context, phytotherapy has gained attention as a complementary approach due to its bacteriostatic, anti-inflammatory, healing, and analgesic properties. These therapeutic effects are mainly attributed to plant-derived bioactive metabolites, which interact with cellular structures, especially the plasma membrane, to modulate inflammation, stimulate tissue regeneration, and support antimicrobial defense. This review systematically examined the scientific literature to identify Latin American medicinal plants with therapeutic potential in dentistry. Based on their clinical and ethnobotanical applications, the analysis focused on species with anti-inflammatory, healing, analgesic, and relaxing effects, particularly in conditions such as dental pain, gingivitis, and periodontitis. Given the close relationship between pain, inflammation, and periodontal disease, these conditions cannot be studied in isolation. Gingivitis and periodontitis often present with painful symptoms and inflammatory responses that overlap with mechanisms of tissue damage and repair. Therefore, broadening the scope of this review allows for a more comprehensive understanding of how Latin American medicinal plants can contribute not only to pain relief but also to periodontal health, inflammation control, and wound healing. Fifty plant species were identified. Among these, 35 exhibited anti-inflammatory activity, 28 had healing properties, 20 showed analgesic effects, and 12 were associated with relaxing properties. Mexico accounted for the highest proportion of species (60%), followed by Colombia and Peru (54%) and then Brazil (32%). These percentages represent the proportion of plant species reported in studies originating from each country, relative to the total number of species identified in the review. The most studied species were Salvia rosmarinus Spenn. (Lamiaceae), Moringa oleifera Lam. (Moringaceae), Aloe vera (L.) Burm.f. (Asphodelaceae), and Ocimum basilicum L. (Lamiaceae). Latin American medicinal plants demonstrate strong potential not only

Premature infants suffer from conditions such as necrotising enterocolitis and sepsis, whose risk is reduced by breastmilk. Rates of breastfeeding are lower in premature infants compared to term infants. Insufficient breastmilk is the most commonly cited reason for breastfeeding termination. Herbal medicines are commonly used for promoting breastmilk production, but their safety and efficacy are unclear. We wanted to assess whether specific herbal galactagogues can safely and effectively increase lactation in mothers who delivered prematurely. Six databases were searched (Medline, Embase, CINAHL, AMED, COCHRANE library, ProQuest Dissertations and Theses Global) with no language or date restrictions. We included randomised controlled trials (RCTs) of herbal galactagogue use in preterm infant mothers. Ten RCTs were included, each investigating a different galactagogue or mixture. Two scored 'high' for risk of bias, the remainder scored 'some concerns'. There was low certainty evidence of an increase in milk volumes by day 7 of the intervention period with barley malt and lemon balm (mean difference 149 ml, 95% CI: 38-260); silymarin in combination with phosphatidylserine and Galega (mean difference 105 ml, 95% CI: 27-183); Pimpinella anisum seed tea (mean difference 98 ml, 95% CI: 63-133); and Latuca sativa (lettuce) syrup (mean difference 82 ml, 95% CI: 60-105). There is a lack of high-quality RCTs on herbal galactagogues within the preterm population. There is low certainty evidence that Barley malt with lemon balm, silymarin phytosomes with Galega, Pimpinella anisum seed tea, Moringa oleifera leaf capsules and Latuca sativa (lettuce) syrup increase breastmilk production. Higher-quality trials are needed to confirm this effect. © 2025. The Author(s).

Contamination of private wells poses a public health concern, especially in Low- and Middle-Income Countries (LMIC) where access to water treatment is limited. This systematic review evaluated 23 studies that investigated interventions in reducing E. coli, Cryptosporidium spp., and Giardia spp. in private wells, including shallow wells, boreholes, and tubewells. Interventions assessed included plant-based coagulants, chlorination, filtration systems, reverse osmosis (RO), ultraviolet (UV) disinfection, and protective barriers to prevent contamination from surface runoff and nearby contamination sources. The effectiveness of the interventions varied depending on geographic, socio-economic, and infrastructural factors. Plant extracts like Moringa oleifera demonstrated success in rural settings, while advanced technologies were more effective in high-income countries. The review stressed the importance of tailoring interventions to specific contexts, emphasizing the need for community engagement, ongoing monitoring, and preventive approaches. This review underscores the need for integrating technical, social, and economic strategies to improve water quality in private wells, particularly for vulnerable communities. © 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.