Research - Aloe Vera
Aloe Vera Shows Promise in Lowering Blood Glucose and Reducing Other Symptoms of Prediabetes
Zhang Y, Liu W, Liu D, Zhao T, Tian H. Efficacy of aloe vera supplementation on prediabetes and early non-treated diabetic patients: a systematic review and meta-analysis of randomized controlled trials. Nutrients. June 23, 2016;8(7). pii: E388. doi: 10.3390/nu8070388.
Diabetes is characterized partly by elevated blood glucose and is a serious disease that may lead to potentially devastating health complications. Standard medications for diabetes often cause adverse side effects; thus, botanicals may be an effective and less expensive option for lowering blood glucose. Aloe vera (Aloe vera, Xanthorrhoeaceae) is used to treat many health concerns, but the research on its potential use for diabetes is conflicted. This systematic review and meta-analysis focused on randomized clinical trials (RCTs) investigating potential hypoglycemic activity of aloe vera.
The authors searched PubMed, Embase, and Cochrane Central Register of Controlled Trials, from each database's origin to January 28, 2016. The search terms used were extensive, including "hyperglycemia," "impaired glucose tolerance," "diabetes mellitus," and "aloe vera," among others. Publications in any language were considered. The American Diabetes Association and World Health Organization criteria for prediabetes and type 2 diabetes mellitus were used. Studies included were RCTs, with or without lifestyle interventions, used aloe vera alone, included patients that were not using hypoglycemic medication and did not have heart disease or other serious health problems, and had glucose and/or lipid status as primary outcomes. The studies were evaluated on quality, with the terms "adequate, inadequate, and unclear," to describe randomization, allocation concealment, blinding, and intention-to-treat (ITT) analysis.
The search yielded 282 publications and was narrowed down to five RCTs, published from 1996 to 2016, with 415 patients. It was found that of the five studies, two reported randomization methodology, and no RCTs had adequate blinding. Three RCTs had adequate patient withdrawal and dropout data, and ITT analysis occurred in one study. Patients were overweight or obese as reported in four RCTs, and study length was six to 12 weeks.
There was significant heterogeneity for fasting blood glucose in patients across the five RCTs (P<0.00001). Aloe vera performed better than placebo in reducing fasting blood glucose concentrations (P=0.02). No effect was noted on insulin concentrations, but heterogeneity was reported in the two RCTs with this outcome (P<0.00001). Glycated hemoglobin (HbA1c, a long-term glucose metric) was measured in two RCTs and was significantly decreased by aloe vera usage (P<0.00001) with no significant heterogeneity.
Of the RCTs, four investigated aloe vera in comparison to placebo for triglyceride and total cholesterol (TC) concentrations. It was found that aloe vera was more effective than placebo in decreasing triglyceride (P=0.0001) and TC concentrations (P<0.00001); however, heterogeneity in both metrics was observed (P<0.00001 for both). Also, aloe vera was found to better increase high-density lipoprotein (HDL) cholesterol (P=0.04) and decrease low-density lipoprotein (LDL) cholesterol (P<0.00001) as compared with placebo. Both outcomes had significant heterogeneity (P=0.0008 and P<0.00001, respectively).
In summary, the authors conclude that aloe vera treatment impacted fasting blood glucose concentrations, HbA1c, and triglyceride, TC, and LDL and HDL cholesterol concentrations, despite heterogeneity across RCTs. Discussed possible mechanisms include potentiation of glucose transport, attenuation of cholesterol gut absorption, and modulation of gene expression. Stated limitations include the finite RCT sample size, discrepancy of patient background, publication bias, variation in form and dose of aloe vera (studies included used capsules, powder, or juice), and lack of available data for certain outcomes. Additionally, some methodology was not reported. Larger and more rigorous trials to establish the efficacy and safety of aloe vera in this population are recommended.
--Amy C. Keller, PhD
Source : American Botanical Council - Herb Cllip
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Reduction of Fasting Blood Glucose and Hemoglobin A1c Using Oral Aloe Vera: A Meta-Analysis
Dick William R., Fletcher Emily A., and Shah Sachin A..
Purpose: Diabetes mellitus is a global epidemic and one of the leading causes of morbidity and mortality. Additional medications that are novel, affordable, and efficacious are needed to treat this rampant disease. This meta-analysis was performed to ascertain the effectiveness of oral aloe vera consumption on the reduction of fasting blood glucose (FBG) and hemoglobin A1c (HbA1c).
Methods: PubMed, CINAHL, Natural Medicines Comprehensive Database, and Natural Standard databases were searched. Studies of aloe vera's effect on FBG, HbA1c, homeostasis model assessment-estimated insulin resistance (HOMA-IR), fasting serum insulin, fructosamine, and oral glucose tolerance test (OGTT) in prediabetic and diabetic populations were examined. After data extraction, the parameters of FBG and HbA1c had appropriate data for meta-analyses. Extracted data were verified and then analyzed by StatsDirect Statistical Software. Reductions of FBG and HbA1c were reported as the weighted mean differences from baseline, calculated by a random-effects model with 95% confidence intervals. Subgroup analyses to determine clinical and statistical heterogeneity were also performed. Publication bias was assessed by using the Egger bias statistic.
Results: Nine studies were included in the FBG parameter (n = 283); 5 of these studies included HbA1c data (n = 89). Aloe vera decreased FBG by 46.6 mg/dL (p < 0.0001) and HbA1c by 1.05% (p = 0.004). Significant reductions of both endpoints were maintained in all subgroup analyses. Additionally, the data suggest that patients with an FBG ≥200 mg/dL may see a greater benefit. A mean FBG reduction of 109.9 mg/dL was observed in this population (p ≤ 0.0001). The Egger statistic showed publication bias with FBG but not with HbA1c (p = 0.010 and p = 0.602, respectively).
Conclusion: These results support the use of oral aloe vera for significantly reducing FBG (46.6 mg/dL) and HbA1c (1.05%). Further clinical studies that are more robust and better controlled are warranted to further explore these findings.
Source : Journal Alternative and Complementary Medicine
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Review of the Efficacy of Aloe Vera in Dentistry
Mangaiyarkarasi SP, Manigandan T, Elumalai M, Cholan PK, Kaur RP. Benefits of Aloe vera in dentistry. J Pharm Bioallied Sci. 2015;7(Suppl 1):S255-S259.
The succulent leaves of the aloe vera (Aloe vera syn. A. barbadensis, Xanthorrhoeaceae) plant have been used medicinally for hundreds of years. The yellow leaf sap or latex is rich in 12 different anthraquinones, which are strong laxatives. The clear gel, or mucilage, found inside the leaves, is a well-known treatment for burns and has wound-healing, anti-inflammatory, and analgesic properties. The gel is composed primarily of polysaccharides and contains 75 nutrients including vitamins A, C, E, B1, B2, B3 (niacin), B6, choline, folic acid, alpha-tocopherol, and beta-carotene, and 19 of the 20 required amino acids. Aloe vera also contains enzymes that aid in digestion and are anti-inflammatory (e.g., bradykinase). Other components that are anti-inflammatory are acemannan, fatty acids, hormones (auxins and gibberellins), salicylic acid (also an analgesic), and sterols. The sterol lupeol also has antiseptic and analgesic properties. The polysaccharide acemannan is an antiviral and has immunomodulating properties; it has been shown to reduce secondary infections and increase the activity of T-lymphocytes and macrophages. This review article provides very brief summaries of the experimental and clinical evidence supporting the use of aloe vera in dentistry.
Patients with oral submucous fibrosis (n = 20) receiving 5 mg of topical aloe vera gel three times per day for three months had reduced burning and enhanced mouth opening compared to patients treated with antioxidant capsules two times per day for three months. Oral aloe gel was also clinically more effective than placebo in the treatment of oral lichen planus and minor aphthous stomatitis. In the latter study, 2% gel decreased patient pain scores, reduced wound size, and increased the rate of healing.
Patients undergoing head and neck radiotherapy who used an oral aloe vera mouthwash had reduced oral candidiasis and radiation-induced mucositis.
Patients (n = 15) with plaque-induced gingivitis treated with 10 mL aloe vera mouthwash two times per day for three months plus scaling had reduced gingival inflammation compared to patients treated with the mouthwash alone (n = 15) or scaling alone (n = 15).
Adults (n = 15) with periodontitis and mechanical debridement (scaling plus root planing) treated with intra-pocket placement of aloe vera in one site of the mouth or no aloe vera in another site had improved periodontal condition in the aloe vera site.
Several studies demonstrate the antimicrobial activity of aloe vera. In an in vitro study, aloe vera toothpaste was more effective than two popular commercial toothpastes (The Colgate-Palmolive Company; New York, New York) in destroying seven microbes commonly found in the mouth despite the absence of additional fluoride in the aloe vera toothpaste. It is noted that aloe vera does not contain the abrasives found in commercial toothpastes and hence is less harsh on teeth and a good alternative for patients with sensitive teeth. Aloe vera also controlled bacteria-induced inflammation around dental implants. Aloe vera was an effective antimicrobial for disinfecting gutta percha cones (used for root canals). Also, aloe vera plus sterile water had superior antimicrobial activity against 18 strains of microorganisms isolated from infected root canals. A patch containing acemannan hydrogel derived from aloe vera was found to significantly reduce the incidence of alveolar osteitis following molar extraction compared to clindamycin (n = 607). Acemannan has also been formulated as a denture adhesive with minimal cytotoxicity.
Aloe vera is not recommended during pregnancy or lactation because theoretically it can stimulate the uterus of pregnant women, and it could cause gastrointestinal distress in nursing infants. Other side effects include transient redness, burning, or stinging after topical use and have been reported in a few cases. Oral aloe vera containing high levels of latex-derived anthraquinones can cause cramps, diarrhea, red urine, hepatitis, and dependency or worsening of constipation. Prolonged use of anthraquinone-rich latex as a purgative may increase the risk of colorectal cancer. The laxative effect may cause electrolyte imbalances (low potassium levels).
The authors conclude that for the purposes of dentistry, aloe vera has the advantage of being easily available, inexpensive, easy to apply orally, and has no adverse effects. The authors caution that it should not be used in people allergic to plants in the Liliaceae family, or by pregnant or lactating women. [Note: Formerly classified as a member of the Liliaceae family, aloe vera is now placed in the Xanthorrhoeaceae family.] The authors acknowledge that long-term studies with larger populations are needed.
—Heather S. Oliff, PhD
Source : American Botanical Council - Herbclip
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Efficacy and safety of Aloe vera syrup for the treatment of gastroesophageal reflux disease: a pilot randomized positive-controlled trialAbstract
ObjectiveTo investigate the use of Aloe vera (A. vera) for the treatment of gastroesophageal reflux disease (GERD) symptoms and compare its effects with those of omeprazole and ranitidine.
Methods In this pilot, randomized controlled trial, 79 subjects were allocated to A. vera syrup (standardized to 5.0 mg polysaccharide per mL of syrup) at a dose of 10 mL/d, omeprazole capsule (20 g/d) or ranitidine tablet (150 mg in a fasted state in the morning and 150 mg 30 min before sleep at night) for a period of 4 weeks. The frequencies of eight main symptoms of GERD (heartburn, food regurgitation, flatulence, belching, dysphagia, nausea, vomiting and acid regurgitation) were assessed at weeks 2 and 4 of the trial.
Results A. vera was safe and well tolerated and reduced the frequencies of all the assessed GERD symptoms, with no adverse events requiring withdrawal.
Conclusion A. vera may provide a safe and effective treatment for reducing the symptoms of GERD.
Source : Journal of Traditional Chinese Medicine
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Phytochemical and Therapeutic Profile of Aloe vera
Pulok K. Mukherjee, Neelesh K. Nema, Niladri Maity, Kakali Mukherjee, Ranjit K. Harwansh
Aloe vera (L.) Burm. f. (Family Liliaceae) is an evergreen perennial succulent plant widely used from antiquity. Aloe vera contains various carbohydrate polymers, notably glucomannans, along with a range of other organic and inorganic components. Phenolic compounds have been identified so far as chromone, anthraquinone or anthrone derivatives. Three distinct preparations of aloe plants are mostly used in medicinal practices that are quite different in their chemical composition and their therapeutic properties, aloe latex (aloe); aloe gel (Aloe vera); and, aloe whole leaf (aloe extract). Aloe latex is used for its laxative effect; aloe gel is used topically for skin ailments, such as wound healing, psoriasis, genital herpes and internally by oral administration in diabetic and hyperlipidaemic patients and to heal gastric ulcers; and, aloe extract is potentially useful for cancer and AIDS. Aloe vera possesses several pharmacological properties such as promoting and healing wound and burn, frost-bite healing, with addition to having antiinflammatory, antifungal, hypoglycemic and gastroprotective properties. This review explored the phytochemical and pharmacological knowledge as well as several promising aspects for research on aloe.
Source : Journal of Herbal Remedies
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Probiotic Lactobacillus rhamnosus GG and Aloe vera gel improve lipid profiles in hypercholesterolemic rats.
Kumar M, Rakesh S, Nagpal R, Hemalatha R, Ramakrishna A, Sudarshan V, Ramagoni R, Shujauddin M, Verma V, Kumar A, Tiwari A, Singh B, Kumar R.
Source : Department of Microbiology and Immunology, National Institute of Nutrition, Hyderabad, India.
OBJECTIVE: The effects of Lactobacillus rhamnosus GG (LGG) and Aloe vera (AV) gel on lipid profiles in rats with induced hypercholesterolemia were studied.
METHODS: Five treatment groups of rats (n = 7) were the fed experimental diets: a normal control diet, a hypercholesterolemic diet (HD), HD + LGG, HD + AV gel, and HD + LGG + AV gel.
RESULTS: Supplementation with LGG decreased serum total cholesterol by 32%; however, in combination with AV, the decrease was 43%. The decreases in triacylglycerol levels in the HD + LGG, HD + AV, and HD + LGG + AV groups were 41%, 23% and 45%, respectively. High-density lipoprotein increased by 12% in the HD + LGG + AV group, whereas very low-density and low-density lipoprotein values decreased by 45% and 30%, respectively. The atherogenic index in the HD + LGG + AV group decreased to 2.45 from 4.77 in the HD + LGG group. Furthermore, fecal Lactobacillus species counts increased significantly when LGG was fed in combination with the AV gel. The oral administration of LGG fermented milk alone or in combination with the AV gel increased cholesterol synthesis (3-hydroxy-3-methylglutaryl coenzyme A reductase expression) and absorption (low-density lipoprotein receptor expression), whereas cholesterol 7α-hydroxylase mRNA expression levels were lower in the HD + LGG and HD + LGG + AV groups compared with the control HD group.
CONCLUSION: The combination of LGG and AV gel may have a therapeutic potential to decrease cholesterol levels and the risk of cardiovascular diseases.
Source : Nutrition. 2012 Dec 31. pii: S0899-9007(12)00362-0. doi: 10.1016/j.nut.2012.09.006
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