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International Journal of Green Pharmacy • Jan-Mar 2018 (Suppl) • 12 (1)| S51
Nutraceutical, therapeutic, and
pharmaceutical potential of
Aloe vera: A review
Ravi Kant Upadhyay
Department of Zoology, D D U Gorakhpur University, Gorakhpur, Uttar Pradesh, India
Abstract
The present review explains therapeutic and pharmaceutical potential of Aloe vera a well-known plant grows
in semi-arid climate of tropical and subtropical regions. This article emphasizes important uses of A. vera
constituents as dietary nutraceutical, medicinal, and therapeutic potential. Plant is cultivated for agricultural
and medicinal and decoration purposes for indoors as a potted plant. Plant is a good depository of chemical
constituents which display a very wide array of biological activities such as anticancer, antiparasitic, antidiabetic,
anti-inflammatory, anti-arthritic, antiparasitic, antitumor, antioxidant, chemopreventive, hepatoprotective, and
gastroprotective. Plant is used to prepare skin protective/care gels mainly for soothing, moisturizing, and wound
healing. Thick watery plant sap works are added as key ingredient in many beauty products. Plant leaves are
used to generate aroma, beverages, skin lotion, cosmetics, or ointments for minor burns. Plant contains vitamins,
enzymes, minerals, sugars, lignin, saponins, salicylic acids, and amino acids as main ingredients. Plant is a good
source of Vitamins A, C, and E, which are antioxidants. It also contains Vitamin B12, folic acid, and choline
watery juicy of A. vera leaf which contains important minerals such as calcium, chromium, copper, selenium,
magnesium, manganese, and potassium. Plant ingredients were found active against gingivitis, psoriasis, and used
for herbal therapy in inflammatory bowel disease. A. vera contains important fatty acids mainly steroids such as
cholesterol, campesterol, β-sitosterol, and lupeol. Aloin and emodin act as analgesics, antibacterials, and antivirals
while lupeol shows antiseptic and analgesic properties. It also contains auxins and gibberellin hormones that help
in wound healing and have anti-inflammatory action. Saponins that are the soapy substances display cleansing
and antiseptic properties.
Key words: Aloe vera, natural products, nutritional, pharmaceutical potential, therapeutic
Address for correspondence:
Ravi Kant Upadhyay, Department of Zoology,
D D U Gorakhpur University, Gorakhpur - 273 009,
Uttar Pradesh, India. E-mail: rkupadhya@yahoo.com
Received: 08-02-2018
Revised: 18-02-2018
Accepted: 24-02-2018
INTRODUCTION
Aloe vera is a short-stemmed plant which
belongs to genus aloe. The name A. vera
derives from the Arabic word “Alloeh”
meaning “shining bitter substance,” while
“vera” in Latin means “true,” 2000 years ago.
Plant attains a smaller height 60–100 cm, spread
by fleshy leaf offsets [Figure 1]. It belongs to
Asphodelaceae (Liliaceae) family. It is a wild,
shrubby or arborescent, perennial, xerophytic,
succulent, pea-green color plant grown in a
tropical climate. Plant possesses small leaves
which are thick and fleshy, green to gray–green.
It has some varieties that show white flecks on
the upper and lower side of stem surface. Margin
of the leaf is serrated and possesses small white
teeth. The flowers are produced in summer on
a spike up to 70–90 cm tall, each flower being
pedulus, with a yellow tubular corolla. Plant is
used in the preparation of consumer products
including beverages, skin lotion, cosmetics, or ointments for
minor burns and sunburns. Plant is cultivated for agricultural
and medicinal uses. This is also grown in small pots for the
decoration of houses and for ornamental purposes.[1] Plant
is basically grown for its juice, preparation of gel and face
creams, and other cosmetic purposes. A. vera plant forms
arbuscular mycorrhiza, a symbiosis that allows the plant
better access to mineral nutrients in soil.[2] It grows mainly
in the dry regions of Africa, Asia, Europe, and America. In
India, it is found in Rajasthan, Andhra Pradesh, Gujarat,
Maharashtra, and Tamil Nadu. Plant is grown at larger scale
REVIEW ARTICLE
Upadhyay: Alea vera: A review
International Journal of Green Pharmacy • Jan-Mar 2018 (Suppl) • 12 (1)| S52
for medicinal use in A. vera in Australia,[3] Bangladesh,
Cuba,[4] the Dominican Republic, China, Mexico,[5] India,[6]
Jamaica,[7] Kenya, Tanzania, and South Africa,[8] along with
the USA.[9] Plant has its larger use in both medicinal and
cosmetics production industries. Plant succulence forms can
grow in low rainfall zones and rocky and sloppy lands. Plant
can grow in warmer climates but susceptible and intolerant
of heavy frost and snow.[2,10] The species is relatively resistant
to most insect pests though spider, mites, mealy bugs, scale
insects, and aphid species may cause a decline in plant
health.[11,12] This plant has gained the Royal Horticultural
Society’s Award of Garden Merit.[13] Aloe plants can burn
under too much sun or shrivel when the pot does not drain
water.
Medicinal Uses
A. vera is used in traditional medicine as a skin treatment.
Plant is documented in Ebers Papyrus from the 16th century
BC and in dioscorides’ De Materia Medica and Pliny the
Elder’s Natural History - both written in the mid-first century
AD.[15] The plant is used widely in the traditional herbal
medicine of many countries. Despite this, the cosmetic
and alternative medicine industries regularly make claims
regarding the soothing, moisturizing, and healing properties
of A. vera.[16,17] Aloe juice and gel provide protection for
humans from sunburn.[18] A. vera gel is used commercially as
an ingredient in yogurts, beverages, and some desserts,[19-21]
although at certain doses, its toxic properties could be severe
whether ingested or topically applied.[22] The same is true
for aloe latex, which was taken orally for conditions ranging
from glaucoma to multiple sclerosis.[23] Anthraquinones
present in latex are a potent laxative. It increases intestinal
water content, stimulates mucus secretion, and increases
intestinal peristalsis.[15] There is no good evidence. A. vera
is of use in treating wounds or burns.[24,25] There is no good
evidence that topical application of A. vera is effective for
treating genital herpes or psoriasis.[26] Topical application of
A. vera is provided to treat or prevent phlebitis caused by
intravenous infusion.[27]
A. vera extract is used for the dilution of semen for the
artificial fertilization of sheep.[28] Plant juice is used as a fresh
food preservative,[29] while plant canopy is used for water
conservation in small farms.[30] A. vera seeds are also tried
for obtaining biofuels.[31] Orally ingested non-decolorized
A. vera leaf extract along with goldenseal is used for lower
down cancer risks and reproductive toxicity.[32] Its topical
use is not associated with significant side effects,[33] but
sometimes ingested non-decolorized liquid[33] found to be
carcinogenic in animals.[34] Its yellow juice from few varieties
found carcinogenic to humans as well.[35] A. vera is used
as moisturizer to keep facial skin tissues soft and shining,
and it acts as anti-irritant to reduce chafing of the nose.
Cosmetic companies use thick plant sap to prepare makeup
products, tissues, moisturizers, soaps, sunscreens, incense,
shaving cream, or shampoos.[19] Fresh plant sap is used in
the preparation of many hygiene products which create
moisturizing emollient effect.[36] Aloin found in the exudate
of some Aloe species is used as laxative natural product.[33]
A. vera shows potential toxicity, with side effects occurring
at higher dose levels both when ingested and applied
topically.[22] Before adding A. vera sap to prepare fairness
creams, aloin is removed by processing. More specifically,
Aloe species that contains aloin in excess amounts is not
commonly used because it causes side effects.[16,37,38]
Nutraceutical Uses
A. vera juice is marketed to support the health of the
digestive system. Although Ayurveda supports its use for
many medicinal preparations, there is no scientific evidence
available.[39] In old texts, it is known as Ghrit Kumari and
is a significant part of a number of digestive preparations.
Now, it is scientifically reported that overuse of plant extract
is said to be harmful and its toxicity appears to be dose-
dependent for toxic effects.[40] A. vera is a good nutrition
supplementation for diabetic wound healing,[41] while
processed Aloe food products contain ingredients which
show cancer prevention.[42] A. vera ingredients suppress
common foodborne enteropathogens.[43] Aloe barbadensis
Miller affects survivability, proteolysis, and ACE inhibition
of potential probiotic cultures in fermented milk.[44] A. vera
polysaccharides are used in blend modification of soy protein/
lauric acid to make edible films.[45] A. vera L. gel from different
germ plasms does mushroom tyrosinase inhibition.[46] A. vera
polysaccharides were found active against chronic alcohol-
induced hepatotoxicity in mice,[47] while its gel extract
attenuates ethanol-induced hepatic lipid accumulation by
suppressing the expression of lipogenic genes in mice.[48]
A. vera L. shows hypoglycemic and hypolipidemic effect in
non-insulin-dependent diabetics.[49] Probiotic Lactobacillus
rhamnosus GG and A. vera gel improve lipid profiles
in hypercholesterolemic rats.[50] Chemical constituents
of A. barbadensis Miller show inhibitory effects on
phosphodiesterase-4D activity.[51] Oral ingestion of a high
amount of crude A. vera causes abdominal cramps and
diarrhea that decrease the absorption of drugs.[33] A. vera
juice affects growth and activities of Lactobacilli in vitro.[52]
Its gel showed bacteriostatic and/or bactericidal effects on
cultures of Listeria monocytogenes.[53] A. vera gel does
microbiological stabilization due to high hydrostatic pressure
Figure 1: (a and b) Vegetative parts of Aloe vera plant
ab
Upadhyay: Alea vera: A review
International Journal of Green Pharmacy • Jan-Mar 2018 (Suppl) • 12 (1)| S53
treatment.[54] Dried A. vera gel powder reduces body fat
mass in diet-induced obesity rats,[55] while its gel protects the
liver from oxidative stress-induced damage in experimental
rat model.[56] A. vera gel powder is used for colour stability
during storage of different packaging materials because of
its high shelf-life.[57] For long storage, apple slices are coated
with A. vera gel.[58] Purified decolorized (low anthraquinone)
whole leaf A. vera (L.) Burm juice is toxic to rats.[59] Aloe
ferox seed is a potential source of oil for cosmetic and
pharmaceutical use,[60] while Aloe emodin, rhein, and emodin
oral administration shows therapeutic effects in rats.[61]
A. vera gel and extract are used in herboprobiotic therapy
used for cardioprotection.[62] Dietary use of the low dosage
of A. vera extract showed antioxidant effects, induced
cytokine synthesis,[63] and displayed immune modulatory
effects.[64] Aloe polymannose multinutrient complex affects
cognitive and immune functioning in Alzheimer’s disease.[65]
A. vera anthraquinones were found effective in severe acute
pancreatitis.[66] Anthraquinones also showed antioxidant
effects[67] in normal and thrombotic focal cerebral ischemia-
induced rats.[68] Aloin showed α-glucosidase inhibitory
and antioxidant activity with and without camel β-casein
and its peptides[69] in different growth stages.[70] A. vera is
antidiabetic,[71] but its overuse showed carcinogenic effects in
F344/N rats.[72] Stabilized diluted A. vera gel is used to make
good supplement drink to beat dehydration.[73]
ANTI-INFLAMMATORY
Mucilaginous leaf gel of A. vera is used to treat
inflammatory-based disorders. Aloe emodin from rhubarb
(Rheum rhabarbarum) inhibits lipopolysaccharide-induced
inflammatory responses in RAW264.7 macrophages.[74] It
contains anti-inflammatory ingredients[75] which also show
antioxidant effects in rats.[76] A. vera adventitious root extracts
show enhancement of anti-inflammatory activity through
the alteration of primary and secondary metabolites through
salicylic acid elicitation.[77] Transemulgel prepared using
nimesulide with A. vera reduces inflammation.[78] A. vera
polysaccharides showed hepatoprotective potential against
chronic alcohol-induced hepatotoxicity in mice.[47] A.
vera downregulates LPS-induced inflammatory cytokine
production and expression of NLRP3 inflammasome in human
macrophages.[79] A. vera inhibits the cyclooxygenase pathway
and reduces prostaglandin E2 production from arachidonic
acid. C-glucosyl chromone was isolated from A. vera gel
extracts which showed anti-inflammatory activity.[40]
Immunomodulatory Effect
A. vera shows immunomodulatory properties and its fractions
on the response of macrophages against Candida albicans.[80]
A. vera gel shows immunostimulatory and immunomodulatory
properties.[81] A. barbadensis Mill. extract (AVH200®) shows
potential to reduce the activation, proliferation, and cytokine
secretion of healthy human blood T-cells. AVH200® shows
a suppressive effect on human blood T cells in vitro.[81] A.
vera components act as antioxidants or immunostimulants
and showed immunomodulatory effects on phorbol myristate
acetate-stimulated leukocytes in a dose-dependent manner
(P ≤ 0.05).[82] A. vera (A. barbadensis Miller)-supplemented
probiotic lassi prevents Shigella infiltration from epithelial
barrier into systemic blood flow in mice model.[83]
An aqueous extract of Aloe arborescens (A. arborescens
Mill.) contains lectins (glycoproteins) and mannans
(polysaccharides) which show immunomodulatory, anti-
inflammatory, antiviral, and antibacterial activities.[84] A. vera
polysaccharides showed antitumor, antioxidant, anticoagulant,
antidiabetic, and radioprotective activities. These also
showed antiviral, hypolipidemic, and immunomodulatory
activities.[85] Aloe emodin exerts a potent anticancer and
immunomodulatory activity on BRAF-mutated human
melanoma cells.[86] Aloe polysaccharide is used as adjuvants
as they possess immunity-enhancing functions. These
can be used in the formulation for the development of
poultry vaccines.[87] A. vera downregulates LPS-induced
inflammatory cytokine production and expression of NLRP3
inflammasomes in human macrophages.[79] A. vera is used to
treat ocular diseases conjunctivitis, dry eye, dacryocystitis,
or degenerative diseases. A. vera (A. barbadensis Miller
[Liliaceae]) possesses wound-healing properties. It also
shows immunomodulatory, anti-inflammatory, or antioxidant
activities. A. vera extract is used to restore the function of
human corneal cells.[88] A. vera ethanol and ethyl acetate
extracts are also used in eye drops to treat inflammations and
other ailments of external parts of the eye such as the cornea.
Aloctin I found in A. vera leaf pulp extract shows prophylactic
effect and assists in cancer prevention.[89] A. vera leaf pulp
extract decreases serum sialic acid and tumor necrosis factor
alpha levels which is an important tumor markers. Aloctin I
showed immunomodulatory and mitogenic effects of lectins
A. vera which could be proposed as a prophylactic. A. vera
leaf pulp lectin (Aloctin I) shows tumor preventive effects on
Ehrlich ascites tumors in mice. Aloe gel shows antidiabetic,
anticancer, and antibiotic activities if its ingredients are used
in dosable quantities/limits.[90] Plant contains polysaccharides
which consist of several monosaccharides of which mannose
is dominant. Polysaccharides inhibit the opsonization of
zymosan HPS and display adjuvant activity on specific
antibody production and the induction of delayed-type
hypersensitivity in mice.[91]
Wound Healing
A. vera affects on corneal wound closure and collagenase
activity.[92] Its nutrition supplementation is used for diabetic
wound healing.[41] Polymeric films loaded with Vitamin E
and A. vera are topically applied for the treatment of burn
Upadhyay: Alea vera: A review
International Journal of Green Pharmacy • Jan-Mar 2018 (Suppl) • 12 (1)| S54
wounds.[93,94] Polysaccharides of Aloe A. vera induce MMP-3
and TIMP-2 gene expression during the skin wound repair
of the rat.[95] A. vera gel is also used as decontamination
agent during wound healing.[96,97] A. vera influences water
absorption and enzymatic degradation of alginate hydrogel
films. in vitro.[98] Its nanoscaffold impregnated with human
Wharton’s jelly stem cells or its secretions improves
healing of wounds.[99] Crosslinking chitosan/A. vera-based
membranes have many biomedical applications.[100] A.
vera gel is used in burn wound dressing in second-degree
burns and found much effective than 1% silver sulfadiazine
cream.[101] A. vera shows pharmacological attribute and works
well in wound cleansing for pressure ulcers.[102] It is used as
moisturizing creams to protect skin during radiotherapy for
breast cancer.[103]
Glucomannan, a mannose-rich polysaccharide, and gibberellin,
a growth hormone, interact with growth factor receptors on the
fibroblast, thereby stimulating its activity and proliferation,
which in turn significantly increases collagen synthesis
after topical and oral A. vera treatment.[104] Aloe gel not only
increased collagen content of the wound but also changed
collagen composition (more type III) and increased the degree
of collagen cross-linking. Due to this, it accelerated wound
contraction and increased the breaking strength of resulting
scar tissue.[105] An increased synthesis of hyaluronic acid and
dermatan sulfate in the granulation tissue of a healing wound
following oral or topical treatment has been reported.[106]
ANTIOXIDANT
Aqueous leaf extract of A. vera showed antioxidant
activity.[107,108] It also shows the preventive effect on
gentamicin-induced nephrotoxicity in male Wistar
rats.[109] It reduces the action of carcinogenic effect
induced in pulmonary tissue of mice by cigarette smoke
inhalation.[110] It also reduces oxidative stress caused due to
diabetics.[111] A. vera (A. barbadensis) gel showed in vitro and
in vivo antioxidant activities.[112,113] Aloe saponaria showed
antioxidant activity in UVB-induced paw sunburn in rats.[76]
A. vera gel protects the liver from oxidative stress-induced
damage in experimental rat model.[56] Both polysaccharides
and phenolic constituents A. vera showed antioxidant
and antimycoplasmic activities.[114] Barbaloin and folate
showed pharmacological potential.[115] A. arborescens Mill.
extract induces prooxidant–antioxidant equilibrium and
cytokine synthesis in rowers.[63] Combination of A. vera and
Matricaria recutita mixture reduce chances of rat irritable
bowel syndrome of antioxidant and spasmolytic effects.[116]
Skin
A. vera is used to prepare aromatic, natural, and bacteriostatic
skin caregel.[117,118] It is also found effective in wound
healing[97,119]
and is used in the management of skin disorders.[120]
Its natural ingredients are used to treat in atopic dermatitis and
other inflammatory skin disease.[121] Leaf skin and flowers of
A. vera (L.) and A. saponaria showed anti-inflammatory and
antioxidant effects in a model of UVB-induced paw sunburn
in rats.[122] Similarly, polymeric films loaded with Vitamin E
and A. vera are used for topical application in the treatment of
burn wounds.[56,94,98] Polysaccharides of A. vera induce MMP-3
and TIMP-2 gene expression during the skin wound repair of
rat.[95] A. vera extract is used to prepare decontaminant and
wound healing formulation to treat sulfur mustard-induced
skin injury.[96] Microparticles of A. vera/Vitamin E/chitosan
are used in nuclear imaging and an in vivo test analysis for
burn treatment.[98]
Burn
A. vera crude gel is a well-reported remedy of burns in Ayurveda.
Polymeric films loaded with Vitamin E and A. vera are used for
topical application in the treatment of burn wounds.[98] A. vera
gel was found effective in wound dressing of second-degree
burns.[101,123-125] It prevents infections from burn injuries.[126,127]
It reduces inflammation effects due to thermal injury[128] and
induces wound healing activities.[129] A. vera is also used
for treating acute and chronic wounds.[25] It is topically used
in the treatment of Klebsiella pneumoniae B5055-induced
burn wound infection in mice using natural products.[130]
Effects of A. vera cream reduced post-hemorrhoidectomy
pain and wound healing blind.[131] It also inhibits the growth
of infectious microbes on injury sites[132] and shows better
healing of burn skin.[24] A. vera gel is a protective effect against
radiation damage to the skin.[133,134] It induces the production of
an antioxidant protein and metallothionein in the skin, which
scavenges hydroxyl radicals and prevents suppression of
superoxide dismutase and glutathione peroxidase. Thereby, it
reduces the production and release of skin keratinocyte-derived
immunosuppressive cytokines such as interleukin-10 (IL-10)
and hence prevents UV-induced suppression of delayed type
hypersensitivity.[135]
PSORIASIS
A. vera leaf extract using is used in the topical management
of psoriasis.[27,136] It contains bioactive natural ingredients
which show better skin care.[137] A. vera plant extract is highly
beneficial for skin and skin disorders.[138] It can be used in
alternative therapies for common dermatologic disorders.[139]
A. vera with 0.1% triamcinolone acetonide is topically applied
to treat plaque psoriasis.[140-143] Its mineralized cream showed
protective effects against UVB-induced stress in human
skin.[24,144] A. vera gel is a good topical herbal product which
is clinically effective and safe for dermatological use.[17] It
contains natural anthraquinone that shows laxative actions.[145]
A. vera processed components are used as supplementation
for diabetic wound healing systematic review of current
Upadhyay: Alea vera: A review
International Journal of Green Pharmacy • Jan-Mar 2018 (Suppl) • 12 (1)| S55
literature. Plant extracts for the topical management of
psoriasis: A systematic review and meta-analysis.[146]
Add one reference In vivo monitoring of oxidative burst
on aloe under salinity stress using hemoglobin and
single-walled carbon nanotubes modified carbon
fiber ultramicroelectrode.[154] A. vera leaf gel is anti-
hypercholesterolemic and[148] antioxidant capacity and
possesses many pharmacological attributes.[108,148]
ANTIDIABETES
A. vera shows nutritional and metabolic effects in animal
models.[149] It has great ethnomedicinal values as local healers
use its extract to treat diabetes mellitus.[150,151] It is good
among native remedies used against diabetes and related
complications.[152] Aloe is famous for its use in herbal self-
care remedies for type 2 diabetes and obese pre-diabetes
patients.[153,154] Its blended fibroin/aloe gel film was found
effective in wound healing in streptozotocin-induced diabetic
rats. It can also be used as nutritional supplement in diabetic
wound healing.[41] Metabolic effects of A. vera gel complex
in obese pre-diabetes and early non-treated diabetic patients:
Randomized controlled trial.[155] A. vera gel shows better
wound healing than topical nitroglycerin formulations in
diabetes-induced foot ulcer.[156] UP780, a chromone-enriched
aloe composition, improves insulin sensitivity.[157] It is a good
nutraceutical to control diabetes naturally.[158] A. barbadensis
Miller extracts showed the presence of antidiabetic effects in
streptozotocin-induced type 2 diabetic model rats.[159] A. vera
supplementation shows curative effects in subjects with pre-
diabetes/metabolic syndrome.[71] Dietary Aloe QDM complex
reduces obesity-induced insulin resistance and adipogenesis
in obese mice fed a high-fat diet.[160]
Juice
A. vera juice is topically used for cure for lichen planus
disease.[161] Oral lichen planus is a difficult condition to treat
because of its chronic nature It is also used in herbal therapy
in inflammatory bowel disease.[162] Aloe vera gel is used
to finish cross reactive effects of two drugs when applied
topically for skin treatment simultaneously..[163,52] A. vera
mixed with the extract of citrus lemon and essential oils are
used as nasal spray to treat allergic rhinopathy.[164] Regular
use of A. vera juice is effective in controlling diabetes[158]
and treatment of ulcerative colitis.[165] Thick juice contains
with 4% hydroquinone/10% L-ascorbic acid treatment to
keep skin fair and glowing.[166] A. vera juice shows dual
mechanistic inhibition of CYP3A4 and CYP2D6.[167]
Oral
A. vera gel shows in vivo inhibitory effect on mouse parental
splenic lymphocytes to induce cutaneous angiogenesis.
[168] A. vera is used to prepare scented mouthwash to keep
periodontal system healthy.[169] A. vera is used in various
root canal filling materials along with used in primary
teeth.[170] It is found highly effective in prevention and
clinical management of dental trauma in individuals during
their developmental age.[171] A. vera suppresses common
foodborne enteropathogens, but Lactobacillus brevis strains
survive in gastroduodenal environment and.[43] A. vera gel is
used as an adjuvant treatment of oral submucous fibrosis.[172]
A. vera - and myrrh-based oral mucoadhesive gels are used
in the management of minor recurrent aphthous stomatitis.
[173] Nimesulide-incorporated A. vera transemulgel is used
to relieve pain.[78] Effects of Japanese traditional herbal
medicines (Kampo) contain Aloe extract which shows
potential against growth and virulence of Porphyromonas
gingivalis and viability of oral epithelial cells.[174] Aloe
extract contains aloe emodin and emodin which can be
used to control the growth of C. albicans and Enterococcus
faecalis in root canals.[175]
Antimicrobial
Fresh A. vera gel is used against multidrug-resistant
bacteria in infected leg ulcers[176] and as skin moisturizer.[24]
A. vera gel shows antimicrobial properties[177] and is used as
antimicrobial agents in traditional medicinal soft soaps.[178]
Plant is used in preparation of eye drops containing both
Aloe and neomycin sulfate.[179] A. vera is also used in
various root canal filling materials to check primary
microbiological infection.[180] Retardation of wound healing
by silver sulfadiazine is reversed by A. vera and nystatin.
It is also used for wound dressings.[108,181] Aloin and aloe
emodin in A. vera show antiplsomodial potential.[182] and
A. pulcherrima leaves showed antiplasmodial activities[183]
while its latex antimalarial activity[184] is used by Luhya
Community of Kakamega East sub-County, Kenya;[185 ]
A new compound, 9-dihydroxyl-2’-O-(Z)-cinnamoyl-7-
methoxy-aloesin (1), and eight known compounds (2-9)
were isolated from Aloe vera tyrosinase inhibitory activity
in Pepper mild mottle virus.[186] The extracts show better
antimicrobial activity against bacterial strains as compared
to fungal strains.[187] Crude extract of A. arborescens Mill.
found active against enteropathogens Salmonella enterica
serovar Typhimurium, a pathogen causes diarrhea.[188] Leaf
latex of Aloe calidophila Reynolds shows antileishmanial
activity.[189] Aloin and its derivatives showed anti-
Trypanosoma congolense activity.[190] A. vera contains 6
antiseptic agents: Lupeol, salicylic acid, urea nitrogen,
cinnamic acid, phenols, and sulfur. They all have inhibitory
action on fungi, bacteria, and viruses.
Anticancer Activity
A. vera contains Aloe emodin that shows antineoplastic
activity.[191] Aloe emodin also inhibit invasion and metastasis
of high metastatic breast cancer MDA-MB-231 cells.[192]
Aloe emodin-loaded solid lipid nanoparticles showed strong
Upadhyay: Alea vera: A review
International Journal of Green Pharmacy • Jan-Mar 2018 (Suppl) • 12 (1)| S56
chemotherapeutics in vitro anticancer activity.[191,193] A. vera
gel showed protective effect on the permeability transition
pore in the inner membrane of rat liver mitochondria in
vitro.[194] A. vera products target cancer progression, reduce
inflammatory activity and restore other signal pathways.[42,195]
It also has wider clinical applications.[191] Tyrosinase inhibitory
components from A. vera showed antiviral activity.[196]
Non-colorized whole leaf extract of A. barbadensis Miller
(A. vera) was found active in F344/N rats and B6C3F1
mice[72]. It showed reduction of intestinal polyp formation
in mice fed a high-fat diet with A. vera gel extract.[197] A.
vera shows prevention of radiation-induced dermatitis. It
enhances induction of cell cycle arrest and apoptosis through
the mitochondrial membrane potential disruption in human
U87 malignant glioma cells by aloe emodin.[198] Emodin and
aloe modin suppress breast cancer cell proliferation through
ER α Inhibition.[199]
A. arborescens leaf extract shows antiproliferative
and prodifferentiative activity.[103] Aloe emodin stops
invasion and metastasis of high metastatic breast cancer
MDA-MB-231 cells.[192] A. vera polysaccharides showed
hepatoprotective potential against chronic alcohol-induced
hepatotoxicity in mice.[47] A. vera shows high antioxidant
potential in vitro and in vivo[200] and assists in cancer
prevention.[47] A. barbadensis Miller gel, leaf, and flowers
of A. vera (L.) are skin protective. A. vera mouthwash may
reduce radiation-induced oral mucositis in head-and-neck
cancer patients.[201] A. vera shows nutritional and metabolic
effects.[52] Its polysaccharides influence on proliferation
and hyaluronic acid and hydroxyproline secretion of human
fibroblasts in vitro.[202]
Aloe emodin-loaded solid lipid nanoparticles potential
antineoplastic affects formulation design and in vitro anti-cancer
study.[203] A non-colorized whole leaf extract of A. barbadensis
Miller (A. vera) shows anticarcinogenic effects in F344/N rats
and B6C3F1 mice. Oral administration of decolorized whole
leaf A. vera extract impose adverse effects in rat colon.[59] Aloin
inhibits angiogenesis and growth of human colorectal cancer
in vitro and in vivo.[204] Whole leaf extract of A. barbadensis
Miller (A. vera) shows anticarcinogenic activity in F344/N
rats.[205] A. vera mouthwash may reduce radiation-induced
oral mucositis in head-and-neck cancer patients.[201] A. vera
components can reduce the chances of chronic lymphocytic
leukemia, HCV infection and B-cell non-Hodgkin’s.[206] but
its before treatment its dosage and toxicological evaluation
is important for knowing its therapeutic potential.[207] A. vera
gel protects the acute skin side effects in patients treated
with radiotherapy for breast cancer.[103] A. vera also shows
melanogenesis and anti-tyrosinase activity of selected South
African plants.[208]
A. vera components cause stimulation of the immune
system and put direct effect is due to anthraquinones. The
anthraquinone aloin inactivates various enveloped viruses
such as herpes simplex, varicella zoster, and influenza.[209]
A. vera polysaccharide fraction has shown to inhibit the
binding of benzopyrene to primary rat hepatocytes. These
potentially prevent the formation of potentially cancer-
initiating benzopyrene-DNA adducts. Aloe gel assists in
cancer chemoprevention and inhibits tumor-promoting
effects of phorbol myristic acetate in animal experimental
models.[210,211] A. barbadensis Miller polysaccharides showed
chemopreventive effects.[212] A. vera products are safe, after
processing, and food applications. Higher dose of A. vera is
harmful for human health, but lower dose in supplementation
is highly beneficial and used as herbal medicine.[73,213,214]
Antiparasitic
Natural products from Aloe vera such as aloe-emodin show
antineoplastic effects.[215] It potentially inhibits angiogenesis
and growth human colorectal cancer both in vitro and in vivo
[216]. Contrary to this whole leaf extract of Aloe barbadensis
miller shows carcinogenic activity in rats.[217] Decolorized
low anthraquinone whole leaf Aloe vera showed less
antiplasmodial potential in comparison to crude extracts.[218]
Chemical Constituents found in leaf latex of Aloe pulcherrima
shows antiplasmodial activities activity.[219]
Constipation
Aaqueous leaf extract of A. ferox Mill improve intestinal
motility, increased fecal volume and normalized body weight
in the constipated rats.[223] It reduces the chances of colorectal
cancer.[224] A. vera gel is found active against H. pylori
strains.[225] Anthraquinones present in latex are a potent
laxative. It increases intestinal water content, stimulates
mucus secretion, and increases intestinal peristalsis.[226]
ULCERATIVE COLITIS
A. vera is used as complementary and alternative
medicine[227-229] in herbal therapy for the treatment of
inflammatory bowel disease.[171] A. vera gel is also used as
herbal medicine in the treatment of ulcerative colitis.[175,230]
A. vera gel also showed anti-inflammatory effects in human
colorectal mucosa in vitro.[131] Dietary aloin, aloesin, or
aloe-gel exert anti-inflammatory activity in a rat colitis
model.[131] Oral treatment of A. vera gel found active in
ulcerative colitis.[232] It also shows the protective and healing
effects of against dextran sulfate-induced ulcerative colitis in
rats.[191]
Commercial Use
A. vera natural products are important resources in traditional
medicine and have been long used for prevention and
treatment of many diseases. It has many natural bioorganic
components which are of multiple uses.[80] The genus Aloe
Upadhyay: Alea vera: A review
International Journal of Green Pharmacy • Jan-Mar 2018 (Suppl) • 12 (1)| S57
is also renowned for its medicinal and cosmetic properties.
There are several species of Aloe occur around the world with
long history of use. However, those which are cultivable are
surviving well, and wild ones are threatened with extinction
or facing mass replacement by modern farm practices. Plant
is highly commercially useful, and hence, its wild species are
exploited a lot. There must be sound conservation strategies to
protect this plant. Different ethnic groups in Africa recognize
their most-valued Aloe at the genus level as “the aloe” and
add explanatory names for the other species, such as the
“spotted aloe” and the one-legged aloe.[233] Plant is heavily
used as medicinal purposes by pastoral and agro-pastoral
communities living in African, Asian and European dry eco-
climatic regions.[234] In India, plant is traditionally used by
many ethnic groups for various household and medicinal
purposes. Plant is used for the treatment of various human
diseases, as well as assessed the species of interest for
bioprospecting potential.[235] A. vera (A. barbadensis Miller)
is used for a wide variety of ailments, mouth washers, and
tooth gel and the toothpastes.
A. vera paste found effective against C. albicans,
Streptococcus mutans, Lactobacillus acidophilus, E.
faecalis, Prevotella intermedia, and Peptostreptococcus
anaerobius.[235] The most frequently cited medicinal uses
were the treatment of infections and internal parasites,
digestive ailments, and injuries.[234] A. vera tooth gel protects
against Streptococcus mitis infection,[235] while its juice
found effective against P. gingivalis[174] and plaque-induced
gingivitis.[219] A. vera gel shows antimicrobial efficacy
against buccal cavity microbial infection, and it is also used
to prepare tooth popular commercial toothpastes[236,237] A.
vera blended collagen-chitosan composite scaffold for tissue
engineering applications.[237] Polysaccharides found in juice,
gel, and flower of A. vera are antiparasitic in nature.[108,238]
A. vera is used in natural passive ultrasonic irrigation in
comparison with 1% sodium hypochlorite for removal
of E. faecalis biofilm.[239] Its natural products were found
effective against gastrointestinal nematodes of sheep.[240]
Mucopolysaccharides from A. vera help in binding moisture
into the skin. Aloe stimulates fibroblast which produces the
collagen and elastin fibers making the skin more elastic and
less wrinkled.[40] It also has cohesive effects on the superficial
flaking epidermal cells by sticking them together, which
softens the skin.[241]
The amino acids also soften hardened skin cells, and zinc acts
as an astringent to tighten pores. Its moisturizing effects have
also been studied in the treatment of dry skin associated with
occupational exposure where A. vera gel gloves improved
the skin integrity, decreases appearance of fine wrinkle, and
decreases erythema.[242] It also has antiacne effect. A. vera is
used for the treatment and management of cancer.[241] Juice
is used for the treatment of abdominal cramps, diarrhea, red
urine, hepatitis, dependency, or worsening of constipation.
Plant also shows allergic reactions which are mostly due to
anthraquinones, such as aloin and barbaloin. Prolonged use
of plant juice is reported to increase the risk of colorectal
cancer. Various A. vera constituents and extracts were found
activive against number of diseases such as Seborrheic
dermatitis,[242] psoriasis vulgaris,[141,142] genital herpes,[243,244]
skin burns,[245] diabetes (type 2),[246] HIV infection,[247]
cancer prevention,[248,249] and ulcerative colitis[230] and used
in wound healing,[250] pressure ulcers,[251] mitigate potential
worsening and dermal wound[252,253] mucositis,[254] radiation
dermatitis;[255] acne vulgaris,[256] lichen planus,[257] frostbite,[258]
aphthous stomatitis,[259] and constipation[223].
PHYTOCHEMISTRY
A. vera has wide spectrum of the properties and uses. It
contains more than 75 constituents among which important
are vitamins, enzymes, minerals, sugars, lignin, saponins,
salicylic acids, and amino acids [Table 1].[260-262] Plant
contains Vitamins A (beta-carotene), C, and E, which are
antioxidants. It also contains Vitamin B12, folic acid, and
choline [Table 2]. Antioxidant neutralizes free radicals.
A. vera also contains 8 enzymes with different catalytic
activity, i.e., aliiase, alkaline phosphatase, amylase,
bradykinase, carboxypeptidase, catalase, cellulase, lipase,
and peroxidase. Bradykinase helps to reduce excessive
inflammation when applied to the skin topically, while others
help in the breakdown of sugars and fats. A. vera watery juice
contains ample amount of important minerals such as calcium,
chromium, copper, selenium, magnesium, manganese,
potassium, sodium, and zinc. They are essential for the
proper functioning of various enzyme systems in different
metabolic pathways and few are antioxidants. It also contains
sugars mainly monosaccharides, i.e., glucose and fructose
and polysaccharides, i.e., glucomannans/polymannose
[Figure 2]. These are derived from the mucilage layer of
the plant and are known as mucopolysaccharides. The most
prominent monosaccharide is mannose-6-phosphate, and
the most common polysaccharides are called glucomannans
[beta-(1,4)-acetylated mannan]. Acemannan, a prominent
glucomannan, has also been found. Recently, a glycoprotein
with antiallergic properties, called alprogen and novel anti-
inflammatory compound, C-glucosyl chromone, has been
isolated from A. vera gel.[263,264] Plant also contains 12
anthraquinones, which are phenolic compounds traditionally
known as laxatives. Aloin and emodin act as analgesics,
antibacterials, and antivirals [Table 1]. A. vera contains
important fatty acids mainly steroids such as cholesterol,
campesterol, β-sitosterol, and lupeol. All these have anti-
inflammatory action, and lupeol also possesses antiseptic
and analgesic properties. It also contains auxins and
gibberellin hormones that help in wound healing and have
anti-inflammatory action. Plant provides 20 of the 22 human
required amino acids and 7 of the 8 essential amino acids. It
also contains salicylic acid that possesses anti-inflammatory
and antibacterial properties. Lignin, an inert substance,
when included in topical preparations, enhances penetrative
effect of the other ingredients into the skin. Saponins are
Upadhyay: Alea vera: A review
International Journal of Green Pharmacy • Jan-Mar 2018 (Suppl) • 12 (1)| S58
Table 1: Therapeutic and biological efficacy of various major and minor bioorganic natural products isolated
from A. vera plant species
Aloespecies
plant parts
Major component/s Sub-constituents Biological activity Anti-cancer/
antitumor
Plant juice Anthraquinones/
anthrones
Phenolic compounds, aloe emodin,
aloetic acid, anthranol, aloin A and B,
isobarbaloin, emodin, ester of cinnamic
acid
Analgesics,
antibacterials and
antivirals
Antitumor, laxative/
cathartic compound,
antiproliferative
Plant juice Anthrones Aloin
Aloetine
Aloesin
α‑Glucosidase
inhibitory action
antioxidant activity
Purgative, anticancer,
antiviral, antibacterial
laxative
anti‑inflammatory
Plant juice Anthrones Lapel, anthracene, anthranol, aloetine
acid, emodin, and aloe emodin
Analgesic ‑
Plant juice Cinnamic acid, lupeol (natural salicylic
acid), phenol, saponins, urea nitrogen,
sulfur, resistannol
Antiseptic ‑
Plant juice Brady kinase, beta‑sitosterol,
campesterol, HDL‑cholesterol
Anti‑inflammatory Antitumor
Inner mass
and juice
Carbohydrates
Monosaccharides
Polysaccharides
Pure mannan, acetylated mannan,
acetylated glucomannan,
glucogalactomannan, galactan,
galactogalacturan, arabinogalactan,
galactoglucarabinomannan, pectic
substance, xylan, cellulose
Hepatoprotective,
antiallergic,
antimicrobial,
anti‑inflammatory
Antitumor
Chromones 8‑C‑β‑d‑glucopyranosyl‑2‑[(S)‑2‑
hydroxylpropy
l‑7‑hydroxy‑5‑methylchromone
(8‑C‑glucosyl‑(S)‑aloesol),
8‑C‑β‑d‑glucopyranosyl‑2‑
(1′,2′‑dihydroxylpropyl)‑
7‑methoxy‑5‑methylchromone
(8‑C‑glucosyl‑
7‑O‑methylaloediol) and 8‑C‑β‑d‑
[2′‑O‑(E)‑caffeoyl] glucopyranosyl‑
2‑[(S)‑2‑hydroxylpropyl‑7‑methoxy‑
5‑methylchromone
Inhibitory action
against tyrosine
oxidation
Antitumor
Mucopolysaccharides Glucomannans [beta‑(1,4)‑acetylated
mannan]
Antibacterial Hepatoprotective
potential
Watery juice Vitamins Vitamins A (beta‑carotene),
C and E, Vitamin B12, folic acid
Act as coenzymes Anticancer
Rind and
latex
Saponins Soapy substances Antioxidants,
antimicrobial,
antiseptic
Anticancer
Rind and
latex
Fatty acids mainly
steroids
Cholesterol, campesterol, β‑sitosterol
and lupeol
Inflammatory action
and lupeol also
possesses
Anticancer
Inner leaf
juice
Enzymes Aliiase, alkaline phosphatase, amylase,
bradykinase, carboxypeptidase,
catalase, cellulase, lipase, and
peroxidase. bradykinase
Reduce excessive
inflammation
Breakdown of sugars
and fats.
A. vera gel Alprogen Glycoprotein Antiallergic Antiallergic
A. vera gel C‑glucosyl chromone Chromone Anti‑inflammatory Anticancer
Sugars Glucose Nutritional Anticancer
(Contd...)
Upadhyay: Alea vera: A review
International Journal of Green Pharmacy • Jan-Mar 2018 (Suppl) • 12 (1)| S59
the soapy substances showed antiseptic properties. A. vera
polysaccharides showed hepatoprotective potential against
chronic alcohol-induced hepatotoxicity in mice.[234] Aloe
polymannose multinutrient complex shows positive effects on
cognitive and immune functioning in Alzheimer’s disease.[65]
Aloin shows α-glucosidase inhibitory action of aloin and its
antioxidant activity with and without camel β-casein and its
peptides.[69]
CONCLUSION
A. vera is a small farm field plant that has a wide spectrum of
the properties and uses. It contains multiple pharmacologically
active substances with diverse biological activity. As literature
reveals, plant is of immense therapeutic value as it is used to
cure constipation, skin burns, wounds, psoriasis, dermatitis,
potential worsening, pressure ulcers, mucositis, acne, lichen
planus, frostbite, and aphthous stomatitis. Plant contains
anticancer, antioxidant, anti-inflammatory, antiparasitic,
and antimicrobial activities. Its sap is used to treat glaucoma
to multiple sclerosis. In Ayurveda, so many therapeutic
preparations are based on A. vera. The plant is used widely in
the traditional herbal medicine of many countries. Plant is a
good choice of cosmetic and pharmaceutical industries as they
are using it for preparation of pain soothing, moisturizing,
face shining creams, makeup products, tissues, moisturizers,
soaps, sunscreens, incense, shaving cream, or shampoos.
Aloe juice and gel provide protection for humans from
sunburn. A. vera gel is used commercially as an ingredient in
yogurts and beverages in tropical countries. Anthraquinones
present in latex are a potent laxative. It increases intestinal
water content, stimulates mucus secretion, and increases
intestinal peristalsis. Plant also shows allergic reactions
which are mostly due to presence of anthraquinones, such as
aloin and barbaloin. Prolonged use or overuse of plant juice
increases the risk of colorectal cancer. Plant juice is used as
a fresh food preservative while plant canopy assists in water
conservation in small farms. Aloin found in the exudate is
a laxative natural product. A. vera shows potential toxicity,
with side effects occurring at higher dose levels both when
ingested and applied topically. Before adding A. vera sap
to prepare fairness creams, aloin is removed by processing.
A. vera juice is marketed to support the health of the
Aloespecies
plant parts
Major component/s Sub-constituents Biological activity Anti-cancer/
antitumor
Polymannose
multinutrient complex
Aloe polymannose Cognitive and
immune functioning
in Alzheimer’s
disease
Antimicrobial,
regeneration
Rind and
latex
Salicylic acids Acids Anti‑inflammatory,
antibacterial
Not reported
Rind and
latex
Lignin Complex organic polymers Renewable
aromatic resource
Membrane
penetrative property
Inner leaf
juice
Hormones Auxins and gibberellins Wound healing
and have
anti‑inflammatory
Not reported
Inner leaf
juice
Amino acids Acids Nutritional Anti‑inflammatory,
antitumor
A. vera
watery juicy
Minerals Calcium, chromium, copper,
selenium, magnesium, manganese,
potassium, sodium and zinc
Nutritional Anti‑inflammatory,
antitumor
Estereol Tranquilizing ‑
Aloetic acid Antibiotic ‑
Anthranol ‑
Ester of cinnamic acid Analgesic and
anesthetic
‑
Chrisophanic acid Skin fungus ‑
Resistnol Protection against
fungal and insect
attack including
termites
‑
Cinnamic acid Detergent
germicide and
fungicidal
‑
Table 1: (Continued)
Upadhyay: Alea vera: A review
International Journal of Green Pharmacy • Jan-Mar 2018 (Suppl) • 12 (1)| S60
Figure 2: Major biological active chemical constituents found in Aloe vera plant
Upadhyay: Alea vera: A review
International Journal of Green Pharmacy • Jan-Mar 2018 (Suppl) • 12 (1)| S61
Table 2: Important major and minor dietary bioorganic natural products found in A. vera plant species
Supplement % daily value Sub-constituents (%) Activity
Calcium 25 mg 2 Mineral nutrient
Magnesium 42 g 11 Mineral nutrient
Sodium 30 mg 1 Nerve ion
Potassium 276 mg 6 Nerve ion
Phosphorous 73 10 Component for bone
Iron <0.1 mg Trace Hemoglobin base
Copper <0.1 mg Trace Trace element
Zinc <0.4 mg 4 Coenzyme inducer
Manganese 0.225 mg <1 Coenzyme inducer
Total carbohydrates 11.95 g <1 Dietary/energy
Protein 2.89 3 Dietary/energy
Fat 0.34 0.34 Dietary/energy
Vitamins thiamine B1 0.05 4 Nutrient
Riboflavin B2 0.089 6 Nutrient
Niacin B3 0.111 1 Nutrient
Pantothenic acid B5 0.240 mg 5 Nutrient
Vitamin B6 0.081 mg 6 Nutrient
Organic A. vera Juice 58 mL Partial use Freshness
Organic polysaccharide‑rich aloesorb 60 mg 0.03 Anticancer/burn
Folate B9 89 ug 22 Growth
Vitamin C 7.4 mg 12 Nutrient
digestive system. A. vera is a good nutrition supplementation
for diabetic wound healing. Its gel showed bacteriostatic
and/or bactericidal effects on culture. A. vera is capable of
modulating cellular phenotypes and functions. Stabilized
diluted A. vera gel is used to make good supplement drink
to beat dehydration. Because Aloe species found in various
climates and possess various biologically active compounds
which are of very high therapeutic value. Among them, some
are cultivable and domestic, but more than 57 species of it are
grown in wild which are of immense ethno pharmacological
importance, they are facing stress of extinction. Hence, they
need immediate concern of conservation and preservation of
their germ plasm to carry forward genetically important plant
diversity which is chemotypically too important to save the
future of ethnic groups.
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Source of Support: Nil. Conflict of Interest: None declared.