Induction
Herbal Aloe Vera or Aloe Barbadensis is a well-known medicinal plant used in traditional medicine, including Ayurvedic, Homoeopathic, Siddha, and Unani(1) medicine in many cultures for the treatment of chronic ailments, including congestion, intestinal worms, indigestion, stomach ulcers, colitis, and hemorrhoids(2).
The chemical constituents of the plant process antimicrobial, anti-inflammatory, antioxidant, aphrodisiac, antihelminthic, antifungal, antiseptic activity. The herbal plant also used heavily in products with cosmetic values such as treatment of hair fall, and white hair(1).
Aloe Vera is species of succulent plant in the genus Aloe, belongings to the Family Xanthorrhoeaceae, native to Sudan.
The ten main areas of chemical constituents of Aloe vera are amino acids, anthraquinones, enzymes, minerals, vitamins, lignins, monosaccharide, polysaccharides, salicylic acid, saponins, and sterols(19). They all work together in a synergistic way to create healing and health-giving benefits, according to Gertrude Baldwin in the article of THE BENEFITS OF THE USE OF ALOE VERA IN HERBAL PREPARATIONS(20).
Today the herbal medicine has become very popular for commercial cultivation due to its health benefits. The Food and Drug Administration of the USA has approved the use of Aloe Vera for the treatment of cancer and AIDS(3).
Historically, the Egyptians use Aloe Vera to treat tuberculosis(1). The Ayurveda medicine uses Aloe Vera as a blood purifier, anti-inflammatory, diuretic, uterine tonic, spermatogenic, laxative and fever reliever(1). The traditional Chinese medicine uses the herbal plant as a laxative internally and traumatic externally(4).
Number studies in vitro and in vivo suggested, its pharmacological potency of the chemical constituents includes antimicrobial(11), antiviral(94), anti-inflammatory(12), antimutagenic(26), anticancer(21)(24) property.
In other words, herbal medicine Aloe Vera used in traditional medicine may form a fundamental source to provide information in pharmaceutical differentiation for the development of new drugs.
Health Benefits
Overall, data based on their traditional uses and scientific studies indicate that Aloe Vera is one of the most used herbal plants worldwide and may process various health benefits, including
1. Antioxidants
Antioxidants are stable molecules that inhibit oxidation(7). Antioxidants are either produced by the host or from the dietary sources(7).
Under normal conditions, antioxidants produced by the body are good enough to counter free radicals in a healthy individual(8)(9). However, people with a weakened immune system or medical condition, intake of dietary antioxidants may be necessary due to the depletion of the antioxidant enzymes(8)(9).
Free radicals are unstable molecules with a single electron in the outer ring(6). Due to the highly reactive nature, free radicals must either donate or intercept an electron from other molecules, leading a chain reaction that can not be stopped until all unpaired electrons(6)(7) in the outermost ring are either paired or inhibited by antioxidant (6)(7).
Oxidative stress is an imbalance of the ratio of free radical and antioxidant levels(7) in the body caused by either overexpression of free radicals or low level of antioxidant enzymes(7) produced by the host.
Epidemiological studies suggested, oxidative stress has been found to cause lipid and protein and cellular damage, leading to the onset of chronic diseases, including atherosclerosis, cancer, diabetics, rheumatoid arthritis, post-ischemic perfusion injury, myocardial infarction, cardiovascular diseases, chronic inflammation, and stroke(6)(7).
Under normal conditions, antioxidants produced by the body are good enough to counter free radicals in a healthy individual(8)(9). However, people with a weakened immune system or medical condition, intake of dietary antioxidants may be necessary due to the depletion of the antioxidant enzymes(8)(9).
Free radicals are unstable molecules with a single electron in the outer ring(6). Due to the highly reactive nature, free radicals must either donate or intercept an electron from other molecules, leading a chain reaction that can not be stopped until all unpaired electrons(6)(7) in the outermost ring are either paired or inhibited by antioxidant (6)(7).
Oxidative stress is an imbalance of the ratio of free radical and antioxidant levels(7) in the body caused by either overexpression of free radicals or low level of antioxidant enzymes(7) produced by the host.
Epidemiological studies suggested, oxidative stress has been found to cause lipid and protein and cellular damage, leading to the onset of chronic diseases, including atherosclerosis, cancer, diabetics, rheumatoid arthritis, post-ischemic perfusion injury, myocardial infarction, cardiovascular diseases, chronic inflammation, and stroke(6)(7).
Out of many risk factors associated with the onset of oxidative stress(7), widespread obesity may be one of the major factors that contribute to the severity of the disease due to oxidative stress(5)(10).
Dr. Keaney JF Jr said, "Smoking, diabetes, and body mass index were highly associated with systemic oxidative stress as determined by creatinine-indexed urinary 8-epi-PGF2alpha levels. The effect of body mass index was minimally affected by blood glucose, and diabetes and may suggest an important role of oxidative stress in the deleterious impact of obesity on cardiovascular disease"(5).
According to the Monash University Malaysia, Aloe vera bioactive compounds exerted inhibitory effects against numbers of bacterial strands, particular in Bacillus (20.7%)(11), Pseudomonas (20.7%) (11)and Enterobacter (13.8%)(11).
Dr. Akinsanya MA, the lead author in the joint study suggested, the efficacy of Aloe Vera is the result of the production of bioactive compounds with high DPPH, (an organic chemical compound with) scavenging properties (75-88%)(11).
In vitro, the testing of various phytochemicals such as total phenolic content found in the A. vera methanolic leaf extracts exhibited strong antioxidant activities(12) in free radical scavenging assay, metal chelating assay, and hydrogen peroxide scavenging assay(12).
Although Aloe Vera has a significant antioxidant property, the different agro-climatic conditions may affect the total phenolic content (TPC) and antioxidant potential of the plant(11)(12).
2. Burns
According to the statistics provided by the WHO, in 2015, approximately 180 000 deaths every year are burns related to under-developing countries(15). Burns have also been found to induce a higher risk of morbidity(15).
According to a review of the studies in MEDLINE, CINAHL, Cochrane Library, HealthSTAR, DARE, South-East Asia Database, Chinese Databases, and several Thai local Databases (1918-June 2004), Aloe vera processed a significant effect for burn wound healing with 8.79 days shorter, compared to the untreated group(16).
Dr. Maenthaisong R, the lead researcher said, " cumulative evidence tends to support that aloe vera might be an effective intervention used in burn wound healing for first to second-degree burns"(16).
In fact, the efficacy of topical Aloe vera gel in the treatment of thermal burns was attributed to its chemical constituents in an exhibition of different pharmacological actions(17).
The Chulalongkorn University Hospital study also supports the use of Aloe Vera for the treatment of thermo burn(18).
The study included a total of 48 male Wistar rats once-daily topical application of once-daily of lyophilized Aloe vera gel after 14 days, showed an arteriolar diameter increased up to normal condition in the healing area far better than other experimental groups(18).
Topical aloe vera may be used as a potential herbal medicine for the treatment of both anti-inflammation and wound healing applied on a second-degree burn wound, researchers said (18).
3. Cancer
On the growth of human cervical cancer cells, HeLa in the experiment treated by different doses of aloe-emodin for 1-5 days, the applications display significant effects in the inhibition of the growth of HeLa cells in a dose-dependent manner at concentrations ranging between 2.5 and 40 micromol/L. measured by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide assay(36).
Aloe-emodin induced HeLa cells death by disrupting the cell cycle division at the G2/M phase, according to the flow cytometric analysis(36).
The effects of aloe-emodin inhibited the human cervical cancer cells was attributed to the increase of the expression of proteins associated with cell death programming and decrease of the expression of proteins associated with cancer prefiltration and survival(36).
The Sree Chitra Tirunal Institute for Medical Sciences and Technology examine the anti-colon cancer effects on Aloe-emodin (AE), a natural anthraquinone colon cancer cell lines, suggested, AE inhibit cell proliferation by the cell cycle arrest at the G2/M phase and protein associated with cellular proliferation and division(44).
AE also induced cancer cell death by stimulating the function of proteins associated with pro-apoptosis(44).
According to the analyzed the molecular mechanisms involved in the anti-migratory and antiangiogenic activity of hydroxy anthraquinone, AE suppressed the phorbol-12-myristyl-13-acetate (PMA), a diester of phorbol that promotes tumor expression through migration and invasion(45).
AE also inhibited the mRNA expression of colon cancer cells and the matrixes involved malignant tumor growth, invasion, and metastasis and gene associated with the signaling in the formation and dissemination of a range of cancers. Vascular endothelial growth factor (VEGF) expression in forming a new blood vessel in the promotion of endothelial cell migration/invasion was also inhibited by the injection of AE(45).
AE also suppressed the protein complex that controls the transcription of DNA, cytokine production and cell survival(45).
Dr, Suboj P, the lead researcher wrote, "These data indicate that AE target multiple molecules responsible for cellular invasion, migration and angiogenesis" and "Inhibitory effect on angiogenic and metastatic regulatory processes make AE a sensible candidate as a specific blocker of tumor-associated events"(45).
Dietary Aloe vera improved plasma lipid profile, through enhancing antioxidant and hepatoprotective capacities, a study by a renowned institute suggested(64).
According to the joint study lead by the Nanjing Agricultural University, oral administration of less than or equal to 1.88, 1.86, and 2.79 %/kg in test animals showed to improve plasma lipid profile status, antioxidant, and hepatoprotective enzyme activities(64).
Dr. Gabriel NN, the lead author suggested, animal fed with Aloe Vera exhibited a significantly elevated high-density lipoprotein in 0.5 and 1 % Aloe/kg with no significant changes in low-density lipoprotein(64). After 8 weeks of treatment, the group fed dietary Aloe at 4 %/kg expressed a significantly reduced total cholesterol and triacylglycerol(64).
Also, in animal study of 5 treatment groups of rats (n = 7) fed with experimental diets: a normal control diet, a hypercholesterolemic diet hypercholesterolemic diet (HD), hypercholesterolemic diet (HD) + Lactobacillus rhamnosus GG (LGG), hypercholesterolemic diet (HD) + AV gel, and hypercholesterolemic diet (HD) + Lactobacillus rhamnosus GG (LGG) + AV gel, group fed with combination of LGG and AV gel exerted a therapeutic potential to decrease cholesterol levels and the risk of cardiovascular diseases(65).
Furthermore, the efficacy of Aloe vera in inhibited of high blood cholesterol is the result of the complex functions in restoring normal levels of high-density lipoprotein-cholesterol, low-density lipoprotein-and very low-density lipoprotein-cholesterol(65), through blocking altered fatty acid composition in the liver and kidney(65).
The most effective dose of oral administration of Aloe vera gel extract is at a dose of 300 mg/kg body weight per day to STZ-induced diabetic rats(66).
Dietary Aloe Vera has shown to inhibit lipid peroxidation and restore normal ratio levels of blood cholesterol in some animal studies(66).
In other words, diabetes is a result of abnormally and chronically high levels of sugar (glucose) in the blood. Insulin resistance is a hallmark of diabetes(74). The disease is either caused by cells in the pancreas that died off or receptor sites clogged up by fat and cholesterol(74).
Insulin receptors are areas on the outer part of a cell that allow the cell to bind with insulin in the blood(74). When the receptors are clogged up, the cell can not take glucose (sugar) from the blood and use it for energy(74).
Researchers do not know what causes insulin resistance in diabetic patients. However, they do know that long-term intake of a poor diet with high saturated and trans fat, red meat and processed food is one of many risk factors associated with clogged up the insulin receptors sites, leading to high blood glucose(75).
Other risk factors associated with the early onset of type II diabetes include overweight or obese, age 45 or older, family history, ethnicity, Alaska Native, high blood pressure and cholesterol and women with polycystic ovary syndrome(76).
Dr. David Hefner in the concern of the Western diet linked to type 2 diabetes, wrote, "The researchers surveyed 42,000 men over a 12-year period. The men's eating habits were divided into two groups: those who followed a Western diet and those who followed a "prudent" diet with fruit, vegetables, whole grain, fish and poultry. "Over the course of the study ... 1,321 new cases of Type 2 diabetes were diagnosed"(77).
These results clearly suggested that by changing to a healthy diet pattern with high fruits and vegetables and reducing the intake of saturated and trans fat, red meat and processed food, the risk of diabetes may be reduced.
Researchers at the University of Exeter launched a review by researching the database of MEDLINE, EMBASE, Biosis, and the Cochrane Library(78), only controlled clinical trials (on any indication) were included in the study(78).
After differentiating the 10 selected studies, researchers found that oral administration of aloe vera might be a useful adjunct for lowering blood glucose in diabetic patients(78) as well as for reducing blood lipid levels in patients with hyperlipidemia(78).
However, the topical application of aloe vera was not an effective preventative agent for radiation-induced injuries(78).
Furthermore, Dr. Okyar A and colleagues, in clarifying the controversy over the past 15 years on the hypoglycemic activity of Aloe species, launched an investigation with separate experiments on three main groups of rats, namely, non-diabetic (ND), type I (IDDM) and type II (NIDDM) diabetic rats(79)(80). At the end of the experiment, found that
* Application of Aloe vera A. vera leaf pulp and gel extracts were ineffective on lowering the blood sugar level of ND rats(80).
* A. vera leaf pulp extract showed hypoglycemic activity on IDDM and NIDDM rats, the effect is being enhanced for type II diabetes in comparison with glibenclamide(80).
* On the contrary, A. vera leaf gel extract showed hyperglycaemic activity on NIDDM rats(80).
These results suggested, pulps of Aloe vera leaves devoid of the gel could be useful in the treatment of non-insulin dependent diabetes mellitus.
Herpes simplex virus (HSV) belonging to the human Herpesviridae family is a class of viruses that cause viral infections in the majority of humans(94).
Diseases associated with the infection of herpes simplex viruses 1, including the skin, mouth, lips, eyes, and genitals. In severe cases, the viruses also cause encephalitis, meningitis, neonatal herpes(95). HSV-2 usually causes genital lesions(95).
Ethnicity, gender, increase in age, sex without a condom and people with HIV infection weakened the immune system and are some prevalent factors found in patients with HSV infection, particularly in people with certain sexual behavior(96).
Most importantly, pregnant women may put their newborns to serious complications, they have an outbreak of genital herpes at the time of childbirth(98).
Dr. Kalu E, the lead scientist at the Umuahia, Abia State in the concern of the sexual behavior in risk of HSV infection wrote, "Seroprevalence of HSV-2 antibody was 47.3%." and "Sexual behavioral factors that were significantly associated with HSV-2 seroprevalence included early exposure to sexual intercourse, number of sex partners, involvement in polygamous marriages, the involvement of husband in extra-marital affairs and hormonal contraceptive use"(97).
The cross-sectional study design was adopted and the study took place between November 2011 and June 2012 with the participation of 410 consenting ante-natal clinic patients in two major tertiary hospitals in Benin City(97).
The finding clearly suggested that certain sexual behaviors are associated with the risk of Herpes simplex virus 1 (HSV1) infection.
The study conducted by the Shiraz University of Medical Sciences examined the virus type 1 (HSV-1) activity with Aloe extraction pretreatment suggested the extraction with concentrations of Aloe vera (0.2, 0.5, 1, 2, and 5%) exhibited anti-HSV-1 activity assessed by plaque reduction assay(98).
Aloe vera showed no difference in concentration. However, the extract demonstrated a significantly inhibitory Vero cell infected with HSV-1 at one hour. However, there was no significant difference between the two serial concentrations(98).
Acemannan, an extracted polysaccharide from Aloe vera, has shown to exhibit antiviral activities against herpes simplex virus type 1 (HSV-1), in vivo through activation of immune responses(99).
A combination with azidothymidine(an antiretroviral medication) and acyclovir(an antiviral medication) administration acted synergistically to inhibit the replication of HIV-1 and herpes simplex virus type 1 (HSV-1), respectively(99)(100).
On U1 cells, the combination inhibited infected with HIV-1, was attributed to the function of blocking the potentiate of virus replication without inducing toxicity(101).
The Hamdard University in the investigation of the hypotensive effects of aloe-emodin on hypertension, , suggested, the chemical compound found in Aloe Vera expresses hypotensive effects by lower mean arterial blood pressure by 26 %, 52 %, and 79 % in the corresponding doses of 0.5, 1, and 3 mg/kg in an animal study(107).
Aloe-emodin, another major chemical compound in an animal model inhibited vascular smooth muscle stiffness, a condition in the development of hypertension, involved in cell support, structural and biochemical and the interior surface of blood vessels(108)(109).
In hypertension, increased large-artery stiffness is partly due to intrinsic mechanical properties of vascular smooth muscle cells(109).
More importantly, smooth muscle cells derived from hypertensive and control rats study, treatment of Aloe-emodin also significantly reduced hypertension by improving the elastic value of vascular smooth muscle cell, through its effects on vascular smooth muscle cell cytoskeletal proteins in the regulated function of cell division(108)(109).
Other researchers suggested that the antihypertensive properties of Aloe-emodin may be a result of inhibition of tonic tension and regulated apoptosis, pro- and anti-apoptotic activities on vascular smooth muscle cells (109).
Dr. Bhati N, the lead author said, "Herbal dentifrices containing A. Vera... can be safely recommended as an alternative to fluoridated dentifrices in terms of antimicrobial efficacy"(127).
In Streptococcus mutans strains, Aloe vera brushing showed a reduced the bacteria contamination of Streptococcus mutans strains, without differentiation from the other chemical agents used(128).
Aloe vera in the study against pathogenic such as Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus cereus, Salmonella Typhimurium, Proteus vulgaris, Klebsiella pneumoniae, Escherichia coli, Streptococcus pyogenes and Candida albicans displayed a significantly antimicrobial inhibition rate zones ranging from 6.0 ± 0.57 to 16.6 ± 0.57 mm(128) as the result of the expression of bioactive compounds with high 2,2-diphenyl-1-picrylhydrazyl (DPPH, stable free-radical molecules isolated from the herb), composed of scavenging properties(129).
In other words, oral administration of Aloe Vera reduces the risk of microbial infection and infectious diseases, but a large amount of intake should only be prescribed by related field specialists (128)(129).
According to the Mazandaran University of Medical Sciences, topical Aloe vera, a widely used for mild sunburn, frostbites, and scalding burns for its effect on mucositis(140).
Aloe gel showed the beneficial effects of wound healing, mucous membrane protection, and treatment of oral ulcers(140).
Application of Aloe gel also enhanced the anti-inflammatory, immunomodulation, antifungal, free radicals scavenging, increased collagen formation and inhibited collagenase, epidemiological studies suggested(140).
Oral Aloe vera mouthwash demonstrated significant prevention of radiation-induced mucositis by its wound healing and anti-inflammatory mechanism(141).
The herbal mouthwash also reduced oral candidiasis of patients undergoing head and neck radiotherapy due to its antifungal and immunomodulatory properties(141).
These efficacies indicated that Aloe vera mouthwash may be considered an alternative potential for the treatment of radiation-induced oral mucositis and candidiasis in patients with head and neck cancers(141).
The Haji Mirza Mohammad conducted a triple-blind, randomized controlled trial in the comparison of the Aloe vera mouthwash with a benzydamine mouthwash in the alleviation of radiation-induced mucositis in head and neck cancer of 26 eligible head and neck cancer patients who receive conventional radiation therapy at the radiation oncology department (142), Aloe vera plus benzydamine groups showed a means of reduction of 23.54±15.45 days)(142).
In a mouse tail model of psoriasis, the ethanolic extract of the gel displayed a significant differentiation in the epidermis, as seen from its degree of orthokeratosis (85.07 ± 3.36%) compared to the negative control (17.30 ± 4.09%)(152).
Its efficacy was found to be equivalent to the effect of the standard positive control, tazarotene (0.1%) gel, which showed a 90.03 ± 2.00% degree of orthokeratosis(152).
The ethanolic extract of Aloe vera leaf gel also produced a significant increase in relative epidermal thickness when compared with the control group, and no change in the standard tazarotene(152).
Dr. Dhanabal SP, the lead scientist said, "the extract showed an overall antipsoriatic activity of 81.95%, compared with 87.94 for tazarotene, in the mouse tail model for psoriasis"(152).
Another a randomized, comparative, double-blind, 8-week in a total of 80 patients compare the effects of topical aloe vera (AV) or 0.1% TA cream on various skin conditions, including psoriasis, suggested the mean Psoriasis Area Severity Index (PASI) score decreased from 11.6 to 3.9 (-7.7) in the AV group and from 10.9 to 4.3 (-6.6) in the TA group(153).
The mean Dermatology Life Quality Index (DLQI) score decreased from 8.6 to 2.5 (-6.1) in the AV group and from 8.1 to 2.3 (-5.8) in the TA group(153).
Dr. Choonhakarn C, the lead scientist wrote, "AV cream may be more effective than 0.1% TA cream in reducing the clinical symptoms of psoriasis; however, both treatments have similar efficacy in improving the quality of life of patients with mild to moderate psoriasis"(153).
Some researchers suggested that skin expression may be considered as a refect of the general health of an individual. An unhealthy skin due to skin nutritional deficiency has been a target by the dermatology and cosmetic industries(157)(158).
Dr. Silke K. Schagen in the study that links between nutrition and skin aging, said, "Vitamins, carotenoids, tocopherols, flavonoids and a variety of plant extracts have been reported to possess potent antioxidant properties and have been widely used in the skincare industry either as topically applied agents or oral supplements in an attempt to prolong youthful skin appearance"(158).
Researchers at the Seoul National University Boramae Hospital examined the effect of aloe gel on the clinical signs and biochemical changes of aging skin, in a total of 30 healthy female subjects over the age of 45 by giving 2 different doses (low-dose: 1,200 mg/d, high-dose: 3,600 mg/d) of aloe vera gel supplementation for 90 days with their baseline status as a control(159) suggested, Aloe gel intake, improved significantly the facial wrinkles (p<0.05) in both groups, and facial elasticity in the lower-dose group(159).
The injection of the gel increased the skin photoprotection and the type I procollagen mRNA levels in controlling the rate of procollagen synthesis(159).
The results were also accompanied by the matrix (MMP-1) mRNA levels associated with breaking down the interstitial collagens, types I, II, and III, particularly in the higher-dose group(159).
Type I procollagen was substantially increased throughout the dermis in Aloe treatment of the group.
Dr. Cho S, the lead scientist said, "Aloe gel significantly improves wrinkles and elasticity in photoaged human skin, with an increase in collagen production in the photoprotected skin and a decrease in the collagen-degrading MMP-1 gene expression"(159).
The Kyung Hee University Global Campus in the investigation of the effects of Aloe vera on ultraviolet (UV) irradiation-induced photo-damage of the skin, suggested, the application improves depletion of the dermal extracellular matrix and chronic alterations in skin structure(159).
BAE treatment also elevated type I procollagen which was reduced in photodamaged skin(159).
Most cases of skin disease are involved in allergens, irritants(163). However certain medical conditions such as irritable bowel disease, autoimmune diseases, and genetic preposition can also causer skin diseases(164).
Some researchers suggested that skin diseases are correlated directly or indirectly with a life-long unhealthy diet(165).
Dr. Rajani Katta and colleagues in the dermatological disease team at the Baylor College of Medicine said, " In this review, the authors focus on conditions for which the role of diet has traditionally been an underappreciated aspect of therapy"(165).
"In some cases, dietary interventions may influence the course of the skin disease, as in acne. In others, dietary change may serve as one aspect of prevention, such as in skin cancer and aging of the skin"(165).
" In others, lastly, systemic medications prescribed for dermatological diseases, such as steroids, are known to raise the risk of other diseases, and dietary change may reduce this risk"(166).
These results clearly suggested that by reducing intake of pro-inflammatory food such as fried and process foods and red meats and increasing anti-inflammatory foods such as tuna, salmon, garlic into your diet, the risk and treatment of skin diseases be reduced(167).
Researchers examined all dermatology-oriented in vitro and in vivo experiments and clinical trials on Aloe vera preparations of 40 selected studies, showed that oral administration of aloe vera in mice is effective on wound healing in inducing the decrease of the number and size of papillomas(167).
The herbal medicine was found to exert certain skin protective effects against psoriasis, seborrheic dermatitis, frostbite, burn, wound healing and inflammation(167).
The topical gel from Aloe vera can be considered a biological vehicle and an anti-microbial and antifungal agent against skin infection and inflammation. However, it was not effective in the prevention of radiation-induced injuries and sunburn or suntan protection(167).
In a double-blind, randomized, placebo-controlled trial of 44 hospital out-patients with ulcerative colitis randomly given oral aloe vera gel or placebo, 100 mL twice daily for 4 weeks(171), the oral administrated group showed an improvement and response in nine (30%), viewed by the Simple Clinical Colitis Activity Index and histological scores(171).
Dr. Langmead, the lead researcher said, "Oral aloe vera taken for 4 weeks produced a clinical response more often than placebo; it also reduced the histological disease activity and appeared to be safe"(171).
Furthermore, in the study of male Sprague Dawley rats fed experimental diets for 2 weeks before and during the induction of colitis, dietary aloe vera gel significantly ameliorated intestinal inflammatory responses in a dextran sulfate sodium (DSS) induced ulcerative colitis group(172).
In fact, the efficacy is also found to associate with the abundant bioactivity of the herbs(174).
Other researchers suggested that the anti ulcerative colitis activity of Aloe vera gel may be associated with healing properties of antioxidants, scavengers, chelators as well as strongly inhibited inflammation, electrical/mechanical impairment in the gut, and a great majority of oxidative stress(173).
By searching the relevant studies in MEDLINE, CINAHL, Cochrane Library, HealthSTAR, DARE, South-East Asia Databased associated with burn healing, researchers identified only 4 studies with a total of 371 patients(180).
According to the meta-analysis using the duration of wound healing as an outcome measure, the healing time of the Aloe vera group was 8.79 days shorter than those in the control group(180). Aloe vera can be an effective intervention used in burn wound healing for first to second-degree burns(180).
Another study suggested, the formulates that optimize a herbal gel of Aloe vera extract containing Carbopol 934 as a gelling agent, exert an 80.14% healing up to 14(th) day, compared to the untreated group I (control) animals that show 52.68%(181).
Treated group animals also showed a significantly lower inflammation comapred to none in the treatment group, evidenced by pus formation up to 5(th) day of study. These results supported the use of topical application of Carbopol 934 gel containing Aloe vera extract on the healing of skin wounds(181).
Conclusion
Based on the findings, herbal Aloe vera may be used for the treatment of the aforementioned health problems, pending to the large sample and multicenter human study.
Dr. Akinsanya MA, the lead author in the joint study suggested, the efficacy of Aloe Vera is the result of the production of bioactive compounds with high DPPH, (an organic chemical compound with) scavenging properties (75-88%)(11).
In vitro, the testing of various phytochemicals such as total phenolic content found in the A. vera methanolic leaf extracts exhibited strong antioxidant activities(12) in free radical scavenging assay, metal chelating assay, and hydrogen peroxide scavenging assay(12).
Although Aloe Vera has a significant antioxidant property, the different agro-climatic conditions may affect the total phenolic content (TPC) and antioxidant potential of the plant(11)(12).
2. Burns
A burn is a condition characterized by severe skin damage including scalding from hot, boiling liquids, chemical and electrical burns, fires, including flames from matches, candles, and lighters(13).
Believe it or not, excessive sun exposure and tanning are the common causes of skin burns and a leading cause of melanoma mortality from skin disease in the Western world(14).
Most cases of mild burns are resolved without serious health consequences and the use of medications(13). However, depending on the degree of injury, a severe case of burn may require immediate medical and emergency attention(13).
Burns can be classified into 3 types, depending on the severity of skin damage(13). The mild case of surface skin burns to the serious case of burns of third-degree that damage a large area of the inner layers of the skin. In some cases, the third-degree burns can also affect the bone tissue(13).
Believe it or not, excessive sun exposure and tanning are the common causes of skin burns and a leading cause of melanoma mortality from skin disease in the Western world(14).
Most cases of mild burns are resolved without serious health consequences and the use of medications(13). However, depending on the degree of injury, a severe case of burn may require immediate medical and emergency attention(13).
Burns can be classified into 3 types, depending on the severity of skin damage(13). The mild case of surface skin burns to the serious case of burns of third-degree that damage a large area of the inner layers of the skin. In some cases, the third-degree burns can also affect the bone tissue(13).
According to the statistics provided by the WHO, in 2015, approximately 180 000 deaths every year are burns related to under-developing countries(15). Burns have also been found to induce a higher risk of morbidity(15).
According to a review of the studies in MEDLINE, CINAHL, Cochrane Library, HealthSTAR, DARE, South-East Asia Database, Chinese Databases, and several Thai local Databases (1918-June 2004), Aloe vera processed a significant effect for burn wound healing with 8.79 days shorter, compared to the untreated group(16).
Dr. Maenthaisong R, the lead researcher said, " cumulative evidence tends to support that aloe vera might be an effective intervention used in burn wound healing for first to second-degree burns"(16).
In fact, the efficacy of topical Aloe vera gel in the treatment of thermal burns was attributed to its chemical constituents in an exhibition of different pharmacological actions(17).
The Chulalongkorn University Hospital study also supports the use of Aloe Vera for the treatment of thermo burn(18).
The study included a total of 48 male Wistar rats once-daily topical application of once-daily of lyophilized Aloe vera gel after 14 days, showed an arteriolar diameter increased up to normal condition in the healing area far better than other experimental groups(18).
Topical aloe vera may be used as a potential herbal medicine for the treatment of both anti-inflammation and wound healing applied on a second-degree burn wound, researchers said (18).
3. Cancer
Cancers are a class of medical diseases associated with cell growth irregularly and disorderly in some specific tissue and organ(21)(24)(26).
Most cases of cancer start at the cell on the surface of the inner lining of the organ's tissue. At the later stage, cancer cells can be found in the deeper layers(22)(24).
In the advanced stage, malignant cells can travel a distance away from the original site to infect other healthy tissue and organ(21)(23) through the circulation of fluids and blood(23)(24).
The causes of cancer are the results of the alternation of healthy cell DNA. Researchers do not why do the health cells DNA alternate?
Normally, healthy cells undergo a certain number of cell cycle divisions than die. In a cancerous cell, cell differentiation undergoes division indefinitely(24).
According to the statistic, approximately 38.4% of men and women will be diagnosed with cancer at some points during their lifetimes (25).
The genetic mutation of the cancer cell may be associated with certain risk factors. Epidemiological studies suggested that long-term exposure to carcinogens, the increased in age, gender, inherited genetic defects and skin type can increase the risk the cancer onset(24).
Most common and general symptoms of cancer are unintended weight loss, lump, fatigue, loss of appetite and persistent localized symptoms and localized pain in the later stage(24).
Out of numbers of the risk factor, the genetic preposition has been under intensive studied by many scientists(26).
Dr. Eric T, the lead author on the study of genetic implication on the cancer risk said, "Genetic testing for inherited cancer risk is now widely used to target individuals for screening and prevention" and "Overall, 17,340 PVs were identified in 17,000 (6.7%) of the tested individuals. The pathogenic variants (PV) positive rate was 9.8% among individuals with a personal cancer history, compared to 4.7% in unaffected individuals. PVs were most common in BRCA1/2 (42.2%), other breast cancer (BR) genes (32.9%), and the LS genes (13.2%)"(26).
These results clearly stated that people who carry certain mutated genes are at a substantially higher risk of cancer, compared to those who do not(26).
3.1. Breast Cancer
Breast cancer is a chronic condition characterized by cell growth controllably and disorderly in the breast tissue(27).
Most cases of breast cancer start at the cells on the surface of the inner lining tissue of the breast(27). At this stage, most patients may experience symptoms of lump on part of the breast, swelling, nipple pain and redness and scaliness(27).
Most cases of cancer start at the cell on the surface of the inner lining of the organ's tissue. At the later stage, cancer cells can be found in the deeper layers(22)(24).
In the advanced stage, malignant cells can travel a distance away from the original site to infect other healthy tissue and organ(21)(23) through the circulation of fluids and blood(23)(24).
The causes of cancer are the results of the alternation of healthy cell DNA. Researchers do not why do the health cells DNA alternate?
Normally, healthy cells undergo a certain number of cell cycle divisions than die. In a cancerous cell, cell differentiation undergoes division indefinitely(24).
According to the statistic, approximately 38.4% of men and women will be diagnosed with cancer at some points during their lifetimes (25).
The genetic mutation of the cancer cell may be associated with certain risk factors. Epidemiological studies suggested that long-term exposure to carcinogens, the increased in age, gender, inherited genetic defects and skin type can increase the risk the cancer onset(24).
Most common and general symptoms of cancer are unintended weight loss, lump, fatigue, loss of appetite and persistent localized symptoms and localized pain in the later stage(24).
Out of numbers of the risk factor, the genetic preposition has been under intensive studied by many scientists(26).
Dr. Eric T, the lead author on the study of genetic implication on the cancer risk said, "Genetic testing for inherited cancer risk is now widely used to target individuals for screening and prevention" and "Overall, 17,340 PVs were identified in 17,000 (6.7%) of the tested individuals. The pathogenic variants (PV) positive rate was 9.8% among individuals with a personal cancer history, compared to 4.7% in unaffected individuals. PVs were most common in BRCA1/2 (42.2%), other breast cancer (BR) genes (32.9%), and the LS genes (13.2%)"(26).
These results clearly stated that people who carry certain mutated genes are at a substantially higher risk of cancer, compared to those who do not(26).
3.1. Breast Cancer
Breast cancer is a chronic condition characterized by cell growth controllably and disorderly in the breast tissue(27).
Most cases of breast cancer start at the cells on the surface of the inner lining tissue of the breast(27). At this stage, most patients may experience symptoms of lump on part of the breast, swelling, nipple pain and redness and scaliness(27).
According to a statistic provided by the cancer society, women in Canada have a lifetime risk of breast cancer incidence rates of 11%. In other words, 11% of Canadian women will develop breast cancer by the time they reach 90 years of age(28),
The National Chung Hsing University analyzed the estrogenic activity as phytoestrogens on the estrogen receptor α (ER α ) activation and breast cancer cell growth suggested, application of both emodin and aloe-emodin, the major bioactive compound found in herbal Aloe Vera are capable to inhibit breast cancer cell proliferation(29) by reducing the ER α protein levels in suppressing ER α transcriptional (mRNA) activation(29).
High expression of ERα mRNA is found associated with patients with breast cancer(30).
Also, breast cancer treatment with aloe-emodin decreased the expression of the levels of ERα(29) associated with the protein that stimulate the division of breast cancer cells by increasing the cancer cell's degradation(29).
The efficacy of aloe-emodin inhibited breast cancer proliferation and induced apoptosis is attributed to breaking down the cytoplasm of ER α protein(29) in the breast cancer cells through distinct mechanisms(29).
3.2. Cervical Cancer
Cervical cancer is a medical condition caused by cells grown abnormally in the cervix uteri or cervical area due to the alternation of cells DNA(31).
Most cases of cervical cancer begin in the cells on the surface of the inner lining tissue in the cervix uteri or cervical area before penetrating into deeper layers to form a tumor by proliferation(31).
According to the statistics provided by the American Cancer Society, in 2019, approximately 13,170 new cases of invasive cervical cancer will be diagnosed and cervical cancer will cause the death of 4,250 American women(32).
Today, due to the introduction of the pep test, the cervical cancer death rate has dropped significantly as cancer can be diagnosed at a very early stage. Most cases of cervical cancer are diagnosed in women at the ages of 35 and 44(33).
The 5-year survival overall rate for all women with cervical cancer is 66%. However, the 5-year survival rate in women with invasive cervical cancer diagnosed at the early stage is 92%(33).
Pre-cervical cancer is the early stage of abnormal cell changes in the cervical tissue, if left untreated, the incidence can develop into true invasive cervical cancer(34).
Gardasil, a vaccine, has been used to prevent pre-cervical cancer from the infection of two types of HPV approved by the U.S. Food and Drug Administration in 2006. It is for women benefits to take this vaccine if you are sexually active with several partners(35).
The National Chung Hsing University analyzed the estrogenic activity as phytoestrogens on the estrogen receptor α (ER α ) activation and breast cancer cell growth suggested, application of both emodin and aloe-emodin, the major bioactive compound found in herbal Aloe Vera are capable to inhibit breast cancer cell proliferation(29) by reducing the ER α protein levels in suppressing ER α transcriptional (mRNA) activation(29).
High expression of ERα mRNA is found associated with patients with breast cancer(30).
Also, breast cancer treatment with aloe-emodin decreased the expression of the levels of ERα(29) associated with the protein that stimulate the division of breast cancer cells by increasing the cancer cell's degradation(29).
The efficacy of aloe-emodin inhibited breast cancer proliferation and induced apoptosis is attributed to breaking down the cytoplasm of ER α protein(29) in the breast cancer cells through distinct mechanisms(29).
3.2. Cervical Cancer
Cervical cancer is a medical condition caused by cells grown abnormally in the cervix uteri or cervical area due to the alternation of cells DNA(31).
Most cases of cervical cancer begin in the cells on the surface of the inner lining tissue in the cervix uteri or cervical area before penetrating into deeper layers to form a tumor by proliferation(31).
According to the statistics provided by the American Cancer Society, in 2019, approximately 13,170 new cases of invasive cervical cancer will be diagnosed and cervical cancer will cause the death of 4,250 American women(32).
Today, due to the introduction of the pep test, the cervical cancer death rate has dropped significantly as cancer can be diagnosed at a very early stage. Most cases of cervical cancer are diagnosed in women at the ages of 35 and 44(33).
The 5-year survival overall rate for all women with cervical cancer is 66%. However, the 5-year survival rate in women with invasive cervical cancer diagnosed at the early stage is 92%(33).
Pre-cervical cancer is the early stage of abnormal cell changes in the cervical tissue, if left untreated, the incidence can develop into true invasive cervical cancer(34).
Gardasil, a vaccine, has been used to prevent pre-cervical cancer from the infection of two types of HPV approved by the U.S. Food and Drug Administration in 2006. It is for women benefits to take this vaccine if you are sexually active with several partners(35).
On the growth of human cervical cancer cells, HeLa in the experiment treated by different doses of aloe-emodin for 1-5 days, the applications display significant effects in the inhibition of the growth of HeLa cells in a dose-dependent manner at concentrations ranging between 2.5 and 40 micromol/L. measured by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide assay(36).
Aloe-emodin induced HeLa cells death by disrupting the cell cycle division at the G2/M phase, according to the flow cytometric analysis(36).
The effects of aloe-emodin inhibited the human cervical cancer cells was attributed to the increase of the expression of proteins associated with cell death programming and decrease of the expression of proteins associated with cancer prefiltration and survival(36).
3.3. Colon Cancer
The colon formed part of the digestive tract including the large intestine with a function to reabsorb fluids and secrete waste products from the body(37).
Colon cancer is a medical and chronic condition characterized by irregular growth of cells in the colon, due to the alternation of cell DNA(37).
The colon formed part of the digestive tract including the large intestine with a function to reabsorb fluids and secrete waste products from the body(37).
Colon cancer is a medical and chronic condition characterized by irregular growth of cells in the colon, due to the alternation of cell DNA(37).
According to the statistic provided by the American Cancer Society, in 2019, approximately, 101,420 new cases of colon cancer will be diagnosed. Colon cancer will also cause the death of 51,020 deaths. during 2019(38).
The lifetime risk associated with the onset of colorectal cancer is 1 in 22 (4.49%) for men and 1 in 24 (4.15%) for women(38).
The lifetime risk associated with the onset of colorectal cancer is 1 in 22 (4.49%) for men and 1 in 24 (4.15%) for women(38).
Colon cancer is one most slow-growing cancer compared to other cancers(39). In some patients, colon cancer may exist in the colon more than 20 years before it is discovered(39). Therefore, only 39% of colon cancer is diagnosed in the early stage(39), leading to more incidences of death(39).
The median age diagnosed with colon cancer is 68 in men and 72 in women compared to the age of 63 of rectal cancer in both men and women(40). Most cases of colon cancer are adenocarcinomas, originated in epithelium tissues, that line the colon(40).
Dr. Robb Bird, the editor at the worldwide health wrote, "Poor diet is associated with about 80 percent of colorectal cancer cases"(41).
And "These cancers are a result of a combination of several causes including genetic, epigenetic and environmental causes, such as diet. Hopefully, with more research, the exact pathways by which diet leads to cancer can be discovered"(41).
These results strongly suggested that people who follow the Western diet are at substantial risk of the disease. In other words, the risk of colon cancer is significantly reduced for people who follow the diet with high fruits and vegetables and low red meat and processed foods(42)(43).
Dr. Robb Bird, the editor at the worldwide health wrote, "Poor diet is associated with about 80 percent of colorectal cancer cases"(41).
And "These cancers are a result of a combination of several causes including genetic, epigenetic and environmental causes, such as diet. Hopefully, with more research, the exact pathways by which diet leads to cancer can be discovered"(41).
These results strongly suggested that people who follow the Western diet are at substantial risk of the disease. In other words, the risk of colon cancer is significantly reduced for people who follow the diet with high fruits and vegetables and low red meat and processed foods(42)(43).
The Sree Chitra Tirunal Institute for Medical Sciences and Technology examine the anti-colon cancer effects on Aloe-emodin (AE), a natural anthraquinone colon cancer cell lines, suggested, AE inhibit cell proliferation by the cell cycle arrest at the G2/M phase and protein associated with cellular proliferation and division(44).
AE also induced cancer cell death by stimulating the function of proteins associated with pro-apoptosis(44).
According to the analyzed the molecular mechanisms involved in the anti-migratory and antiangiogenic activity of hydroxy anthraquinone, AE suppressed the phorbol-12-myristyl-13-acetate (PMA), a diester of phorbol that promotes tumor expression through migration and invasion(45).
AE also inhibited the mRNA expression of colon cancer cells and the matrixes involved malignant tumor growth, invasion, and metastasis and gene associated with the signaling in the formation and dissemination of a range of cancers. Vascular endothelial growth factor (VEGF) expression in forming a new blood vessel in the promotion of endothelial cell migration/invasion was also inhibited by the injection of AE(45).
AE also suppressed the protein complex that controls the transcription of DNA, cytokine production and cell survival(45).
Dr, Suboj P, the lead researcher wrote, "These data indicate that AE target multiple molecules responsible for cellular invasion, migration and angiogenesis" and "Inhibitory effect on angiogenic and metastatic regulatory processes make AE a sensible candidate as a specific blocker of tumor-associated events"(45).
3.4. Primary glioblastoma
Glioblastoma (GBM) is one of the most aggressive cancers that begins within the brain(46).
According to statistics, most patients diagnosed with cancer die within 12 to 15 months(47). Less than 5% of patients are survived longer than five years(48).
If you are male you are at a higher risk of glioblastoma, compared to the female's counterpart(49).
Most cases of GBM are diagnosed at an older age with a median age of 64. Some researchers suggested that aging with the change of body function may be one of the major risk factors that cause the incidence(49).
Glioblastoma (GBM) is one of the most aggressive cancers that begins within the brain(46).
According to statistics, most patients diagnosed with cancer die within 12 to 15 months(47). Less than 5% of patients are survived longer than five years(48).
If you are male you are at a higher risk of glioblastoma, compared to the female's counterpart(49).
Most cases of GBM are diagnosed at an older age with a median age of 64. Some researchers suggested that aging with the change of body function may be one of the major risk factors that cause the incidence(49).
Genetic preposition accompanied by aging is the 2 most common risk factors of the diseases. Dr. Athanassios P. Kyritsis, in the concern of the rapid progression of glioblastoma, wrote, "Scientific evidence during the last few years has revealed several constitutive genetic abnormalities that may influence glioma formation".(50)
And, "These germline abnormalities are manifested as either gene polymorphisms or hemizygous mutations of key regulatory genes that are involved either in DNA repair or in apoptosis".(50)
On human U87 malignant glioma cells, injection of Aloe-emodin exerted a significant apoptotic activity and induced proliferation in a time- and dose-dependent(51).
The percentage of viable U87 cells was also deceased substantial via the induction of apoptosis(51).
The formation of apoptotic bodies was observed by the confocal microscope by Annexin V-FITC/PI staining(51).
Aloe-emodin inhibits the human U87 malignant glioma cells, was attributed to the arrested the cell cycle in the S phase and promoted the loss of mitochondrial membrane potential (51).
On U-373MG glioma cell, researchers at the University of South Florida, Tampa suggested, SVG inhibits the protein kinase C (PKC) associated with cell proliferation, survival, invasion, migration, apoptosis, angiogenesis during glioma growth and development(52).
Aloe-emodin delayed the number of cells entering and exiting the DNA synthesis (S) phase in both SVG and U-373MG cells, a strong indication that Aloe-emodin may inhibit S phase progression(52).
In cell viability assay, U-373MG glioma cell was highly sensitive to the application of Aloe-emodin(52). Injection of Aloe-emodin-induced decreased proliferation, sustained at 48-96 hours(52).
Additionally, Aloe-emodin inhibited cancer growth was also associated with the activation of a protein in programming cell death(52).
Most cases of prostate cancer start in the cells on the surface of the inner lining tissue. However, at
the advanced stage, cancerous prostate cells can travel a distance away to infect other healthy tissue and organs, causing the secondary metastasis(53). Most often, prostate cancer spreads to the bones or lymph nodes(53).
According to the statistic, 1 man in 9 will be diagnosed with prostate cancer during his lifetime. 6 cases in 10 are diagnosed in men aged 65 or older and the average age at the time of diagnosis is about 66(54).
The 5-year survival rate for most men with stage 0 and 1 prostate cancer is nearly 100%. Ninety-eight percent (98%) are alive after 10 years(55).
These results strongly indicated that men who are at a higher risk of prostate cancer due to family history and genetic proposition should have a prostate exam taken every year(56).
Besides aging, other most common risk factors of prostate cancer are family history, ethnicity, genetic preposition, exposure to agent orange and eating habits(56).
Dr. Wambui G. Gathirua-Mwangi, the lead author in the cancer team in the joint study led by the Indiana University, wrote, "Epidemiologic studies have overall showed that the habitual consumption of a diet high in saturated fat, well-done meats, and calcium is associated with an increased risk of advanced prostate cancer"(57).
And, "measure the nutrients and their biochemical indicators, the risk of advanced prostate cancer, which is fatal and thus clinically significant, may be reduced by dietary modification or chemoprevention"(57).
The finding strongly indicated a healthy diet high in fruits and vegetables and whole-grain and low in
saturated and trans fat, red meat and processed foods have a decreased risk of prostate cancer.
Researchers at the Korea Research Institute of Bioscience and Biotechnology evaluated phytochemical Aloe-emodin, a bioactive compound isolated from the Aloe vera against prostate cancer suggested Aloe-emodin inhibited both proliferation and anchorage-independent growth of PC3 cells(58).
Aloe-emodin not only demonstrated a significant effect against the activation of a protein (mTORC2) in stimulating the cancer cell proliferation and migration but also inhibited the gene associated with tumor promoter, namely Protein kinase C alpha (PKCα)(58).
Expression of protein kinase C alpha (PKCα) has a strong implication in cancer metastasis and poor prognosis.
In other words, Aloe-emodin displays significant anti-prostate cancer properties by binding to proteins associated cancer cell proliferation, migration(58)
In vivo, Aloe-emodin also exhibited tumor suppression effects in an athymic nude mouse model(58).
Dr. Liu K after taking into account co and confounders said, "aloe-emodin suppresses prostate cancer progression by targeting mTORC2"(58).
And, "These germline abnormalities are manifested as either gene polymorphisms or hemizygous mutations of key regulatory genes that are involved either in DNA repair or in apoptosis".(50)
On human U87 malignant glioma cells, injection of Aloe-emodin exerted a significant apoptotic activity and induced proliferation in a time- and dose-dependent(51).
The percentage of viable U87 cells was also deceased substantial via the induction of apoptosis(51).
The formation of apoptotic bodies was observed by the confocal microscope by Annexin V-FITC/PI staining(51).
Aloe-emodin inhibits the human U87 malignant glioma cells, was attributed to the arrested the cell cycle in the S phase and promoted the loss of mitochondrial membrane potential (51).
On U-373MG glioma cell, researchers at the University of South Florida, Tampa suggested, SVG inhibits the protein kinase C (PKC) associated with cell proliferation, survival, invasion, migration, apoptosis, angiogenesis during glioma growth and development(52).
Aloe-emodin delayed the number of cells entering and exiting the DNA synthesis (S) phase in both SVG and U-373MG cells, a strong indication that Aloe-emodin may inhibit S phase progression(52).
In cell viability assay, U-373MG glioma cell was highly sensitive to the application of Aloe-emodin(52). Injection of Aloe-emodin-induced decreased proliferation, sustained at 48-96 hours(52).
Additionally, Aloe-emodin inhibited cancer growth was also associated with the activation of a protein in programming cell death(52).
3.5. Prostate cancer
Prostate cancer is a slow-growing cancer characterized by irregular cell growth in the prostate tissue(53).
Most cases of prostate cancer start in the cells on the surface of the inner lining tissue. However, at
the advanced stage, cancerous prostate cells can travel a distance away to infect other healthy tissue and organs, causing the secondary metastasis(53). Most often, prostate cancer spreads to the bones or lymph nodes(53).
According to the statistic, 1 man in 9 will be diagnosed with prostate cancer during his lifetime. 6 cases in 10 are diagnosed in men aged 65 or older and the average age at the time of diagnosis is about 66(54).
The 5-year survival rate for most men with stage 0 and 1 prostate cancer is nearly 100%. Ninety-eight percent (98%) are alive after 10 years(55).
These results strongly indicated that men who are at a higher risk of prostate cancer due to family history and genetic proposition should have a prostate exam taken every year(56).
Besides aging, other most common risk factors of prostate cancer are family history, ethnicity, genetic preposition, exposure to agent orange and eating habits(56).
Dr. Wambui G. Gathirua-Mwangi, the lead author in the cancer team in the joint study led by the Indiana University, wrote, "Epidemiologic studies have overall showed that the habitual consumption of a diet high in saturated fat, well-done meats, and calcium is associated with an increased risk of advanced prostate cancer"(57).
And, "measure the nutrients and their biochemical indicators, the risk of advanced prostate cancer, which is fatal and thus clinically significant, may be reduced by dietary modification or chemoprevention"(57).
The finding strongly indicated a healthy diet high in fruits and vegetables and whole-grain and low in
saturated and trans fat, red meat and processed foods have a decreased risk of prostate cancer.
Researchers at the Korea Research Institute of Bioscience and Biotechnology evaluated phytochemical Aloe-emodin, a bioactive compound isolated from the Aloe vera against prostate cancer suggested Aloe-emodin inhibited both proliferation and anchorage-independent growth of PC3 cells(58).
Aloe-emodin not only demonstrated a significant effect against the activation of a protein (mTORC2) in stimulating the cancer cell proliferation and migration but also inhibited the gene associated with tumor promoter, namely Protein kinase C alpha (PKCα)(58).
Expression of protein kinase C alpha (PKCα) has a strong implication in cancer metastasis and poor prognosis.
In other words, Aloe-emodin displays significant anti-prostate cancer properties by binding to proteins associated cancer cell proliferation, migration(58)
In vivo, Aloe-emodin also exhibited tumor suppression effects in an athymic nude mouse model(58).
Dr. Liu K after taking into account co and confounders said, "aloe-emodin suppresses prostate cancer progression by targeting mTORC2"(58).
4. High Blood Cholesterol
Cholesterol, a waxy substance produced by the liver plays a critical role in making hormones, vitamin D, building a strong cell membrane and digestive fluids(59). However, overexpression of cholesterol has been found to induce high blood pressure and heart diseases(59).
Not all cholesterols are bad, high-density lipoprotein, the type of cholesterol which returns cholesterol back to the liver is constantly keeping the bad cholesterol (low-density lipoprotein) in check(59).
The healthy ratio of total cholesterol is less than 4 (LDL)/1 (HDL).
Hypercholesterolemia is a medical condition of abnormally high cholesterol levels in the blood compared to hyperlipidemia which is considered a syndrome of abnormally elevated levels of any or all lipids or lipoproteins in the blood(61).
People with high blood cholesterol do not experience any symptoms. However, the condition has been found to increase the risk of heart diseases and stroke. particularly, atherosclerosis(61).
Where atherosclerosis is a disease involved the accumulation of plaque on the arterial wall, leading to an arterial blockage in facilitating cardiovascular diseases, depending on the location of the blockage.
Although there are many risk factors associated with the onset of high blood cholesterol, some researchers an unhealthy diet is one of the major risk factors that cause hypercholesterolemia in North America(61)(62).
Dr. Joan Carles Escola`-Gil, the lead scientist in the evaluation of the Western diet risk of hypercholesterolemia in mice wrote, ". Unlike a low-fat, low-cholesterol diet, the A high–saturated fatty acid– and cholesterol-containing (HFHC) diet increased liver ABCG5/G8 expression. The effect of the HFHC diet on fecal macrophage-derived [3 H]cholesterol excretion was totally blunted in ABCG5/G8-deficient mice(63)".
The results strongly suggested that if you follow the diet rich in high–saturated fatty acid–and cholesterol, your risk of hypercholesterolemia is increased many folds, compared to healthy adults with a traditional diet.
According to medical analysis, hypercholesterolemia is a form of hyperlipidemia, high blood lipids, and hyperlipoproteinemia(62).
Cholesterol, a waxy substance produced by the liver plays a critical role in making hormones, vitamin D, building a strong cell membrane and digestive fluids(59). However, overexpression of cholesterol has been found to induce high blood pressure and heart diseases(59).
Not all cholesterols are bad, high-density lipoprotein, the type of cholesterol which returns cholesterol back to the liver is constantly keeping the bad cholesterol (low-density lipoprotein) in check(59).
The healthy ratio of total cholesterol is less than 4 (LDL)/1 (HDL).
Hypercholesterolemia is a medical condition of abnormally high cholesterol levels in the blood compared to hyperlipidemia which is considered a syndrome of abnormally elevated levels of any or all lipids or lipoproteins in the blood(61).
People with high blood cholesterol do not experience any symptoms. However, the condition has been found to increase the risk of heart diseases and stroke. particularly, atherosclerosis(61).
Where atherosclerosis is a disease involved the accumulation of plaque on the arterial wall, leading to an arterial blockage in facilitating cardiovascular diseases, depending on the location of the blockage.
Although there are many risk factors associated with the onset of high blood cholesterol, some researchers an unhealthy diet is one of the major risk factors that cause hypercholesterolemia in North America(61)(62).
Dr. Joan Carles Escola`-Gil, the lead scientist in the evaluation of the Western diet risk of hypercholesterolemia in mice wrote, ". Unlike a low-fat, low-cholesterol diet, the A high–saturated fatty acid– and cholesterol-containing (HFHC) diet increased liver ABCG5/G8 expression. The effect of the HFHC diet on fecal macrophage-derived [3 H]cholesterol excretion was totally blunted in ABCG5/G8-deficient mice(63)".
The results strongly suggested that if you follow the diet rich in high–saturated fatty acid–and cholesterol, your risk of hypercholesterolemia is increased many folds, compared to healthy adults with a traditional diet.
According to medical analysis, hypercholesterolemia is a form of hyperlipidemia, high blood lipids, and hyperlipoproteinemia(62).
According to the joint study lead by the Nanjing Agricultural University, oral administration of less than or equal to 1.88, 1.86, and 2.79 %/kg in test animals showed to improve plasma lipid profile status, antioxidant, and hepatoprotective enzyme activities(64).
Dr. Gabriel NN, the lead author suggested, animal fed with Aloe Vera exhibited a significantly elevated high-density lipoprotein in 0.5 and 1 % Aloe/kg with no significant changes in low-density lipoprotein(64). After 8 weeks of treatment, the group fed dietary Aloe at 4 %/kg expressed a significantly reduced total cholesterol and triacylglycerol(64).
Also, in animal study of 5 treatment groups of rats (n = 7) fed with experimental diets: a normal control diet, a hypercholesterolemic diet hypercholesterolemic diet (HD), hypercholesterolemic diet (HD) + Lactobacillus rhamnosus GG (LGG), hypercholesterolemic diet (HD) + AV gel, and hypercholesterolemic diet (HD) + Lactobacillus rhamnosus GG (LGG) + AV gel, group fed with combination of LGG and AV gel exerted a therapeutic potential to decrease cholesterol levels and the risk of cardiovascular diseases(65).
Furthermore, the efficacy of Aloe vera in inhibited of high blood cholesterol is the result of the complex functions in restoring normal levels of high-density lipoprotein-cholesterol, low-density lipoprotein-and very low-density lipoprotein-cholesterol(65), through blocking altered fatty acid composition in the liver and kidney(65).
The most effective dose of oral administration of Aloe vera gel extract is at a dose of 300 mg/kg body weight per day to STZ-induced diabetic rats(66).
Dietary Aloe Vera has shown to inhibit lipid peroxidation and restore normal ratio levels of blood cholesterol in some animal studies(66).
5. Constipation
Constipation is a condition of hard and dry stool that is infrequent or hard to pass(67). Acute constipation caused by staying in a sitting position for long periods that kinks up the colon and restrain stool from passing through can be reversed in a few days with or without the use of
a laxative or over the counter medicine(67)
Chronic constipation is a condition characterized by difficult, infrequent, or perceived incomplete evacuation of bowel movements with less than 3 bowel movements a week(67).
In most cases, chronic constipation with no structural and medical problems is normally caused by long-term an unhealthy diet with low fiber(67).
Certain medications calcium channel blockers, narcotics are also found to induce constipation(67).
According to the recommendation of the health professionals, total fiber intake per day is 25-35 grams, depending on your sex, age, and weight for people with or without the condition of constipation(68).
Some people taking total fiber intake per day is 25-35 grams may experience symptoms of excess colon gas and flatus. In this instance, soluble fiber should be cut down on first before insoluble fiber(68).
More precisely, a high fiber diet must be accompanied by increased fluid intake and moderate exercise for maintaining good colon health against constipation in patients with no structural and medical problems (68).
According to the statistics, in the US, approximately 4 million or 2 percent of Americans have frequent constipation(69). Constipation also is the most common digestive complaint in the US, outnumbering all other chronic digestive conditions(69).
Some researchers suggested that there is a correlation between aging in the risk of constipation.
Dr. Brenda G. Schuster wrote, "Constipation is a common complaint and challenge for older adults. The prevalence of constipation increases with age and differs among settings. In individuals 65 years of age or older in the community, the prevalence is 26% for women and 16% for men"(70).
And "This rate increases to 34% for women and 26% for men in those 84 years of age and older.1For long-term care residents, the prevalence is as high as 80%"(70).
In other words, adults who are 65 years of age are at a higher risk of constipation(70).
Constipation is a condition of hard and dry stool that is infrequent or hard to pass(67). Acute constipation caused by staying in a sitting position for long periods that kinks up the colon and restrain stool from passing through can be reversed in a few days with or without the use of
a laxative or over the counter medicine(67)
Chronic constipation is a condition characterized by difficult, infrequent, or perceived incomplete evacuation of bowel movements with less than 3 bowel movements a week(67).
In most cases, chronic constipation with no structural and medical problems is normally caused by long-term an unhealthy diet with low fiber(67).
Certain medications calcium channel blockers, narcotics are also found to induce constipation(67).
According to the recommendation of the health professionals, total fiber intake per day is 25-35 grams, depending on your sex, age, and weight for people with or without the condition of constipation(68).
Some people taking total fiber intake per day is 25-35 grams may experience symptoms of excess colon gas and flatus. In this instance, soluble fiber should be cut down on first before insoluble fiber(68).
More precisely, a high fiber diet must be accompanied by increased fluid intake and moderate exercise for maintaining good colon health against constipation in patients with no structural and medical problems (68).
According to the statistics, in the US, approximately 4 million or 2 percent of Americans have frequent constipation(69). Constipation also is the most common digestive complaint in the US, outnumbering all other chronic digestive conditions(69).
Some researchers suggested that there is a correlation between aging in the risk of constipation.
Dr. Brenda G. Schuster wrote, "Constipation is a common complaint and challenge for older adults. The prevalence of constipation increases with age and differs among settings. In individuals 65 years of age or older in the community, the prevalence is 26% for women and 16% for men"(70).
And "This rate increases to 34% for women and 26% for men in those 84 years of age and older.1For long-term care residents, the prevalence is as high as 80%"(70).
In other words, adults who are 65 years of age are at a higher risk of constipation(70).
According to the University of Fort Hare, in a constipation condition induced by oral administration of loperamide (3 mg/kg body weight) in comparison to control rats received normal saline or Aloe vera extracts, intake of aqueous leaf extract of Aloe ferox Mill. with 50, 100 and 200 mg/kg body weight/day or 7 days improved the laxative property with the best efficacy in 200 mg/kg body weight(71).
Dr. Wintola OA, the lead researcher said, "The effect of the extract compares favorably well with senokot, a standard laxative drug. These findings have, therefore, lent scientific credence to the folkloric use of the herb as a laxative agent"(71).
In addition to the above, also in loperamide-induced constipated rats, intake of aqueous extract of Aloe ferox Mill. showed no toxicity to the kidney and liver even with of highest doses of 200 mg/kg body weight for 7 days(71). The study also insisted that the extract is very effective compared favorably with senokot, a recommended drug for the treatment of constipation(71).
Even though living with constipation is an irritable and uncomfortable experience but the use of herbal medicine in the treatment of constipation should be taken with care. People should start with small doses and increase the amount gradually(72).
Dr. Wintola OA, the lead researcher said, "The effect of the extract compares favorably well with senokot, a standard laxative drug. These findings have, therefore, lent scientific credence to the folkloric use of the herb as a laxative agent"(71).
In addition to the above, also in loperamide-induced constipated rats, intake of aqueous extract of Aloe ferox Mill. showed no toxicity to the kidney and liver even with of highest doses of 200 mg/kg body weight for 7 days(71). The study also insisted that the extract is very effective compared favorably with senokot, a recommended drug for the treatment of constipation(71).
Even though living with constipation is an irritable and uncomfortable experience but the use of herbal medicine in the treatment of constipation should be taken with care. People should start with small doses and increase the amount gradually(72).
6. Diabetes type 2
Diabetes is a medical and chronic condition characterized by insufficient insulin entering the bloodstream to regulate the glucose(74).In other words, diabetes is a result of abnormally and chronically high levels of sugar (glucose) in the blood. Insulin resistance is a hallmark of diabetes(74). The disease is either caused by cells in the pancreas that died off or receptor sites clogged up by fat and cholesterol(74).
Insulin receptors are areas on the outer part of a cell that allow the cell to bind with insulin in the blood(74). When the receptors are clogged up, the cell can not take glucose (sugar) from the blood and use it for energy(74).
Researchers do not know what causes insulin resistance in diabetic patients. However, they do know that long-term intake of a poor diet with high saturated and trans fat, red meat and processed food is one of many risk factors associated with clogged up the insulin receptors sites, leading to high blood glucose(75).
Other risk factors associated with the early onset of type II diabetes include overweight or obese, age 45 or older, family history, ethnicity, Alaska Native, high blood pressure and cholesterol and women with polycystic ovary syndrome(76).
Dr. David Hefner in the concern of the Western diet linked to type 2 diabetes, wrote, "The researchers surveyed 42,000 men over a 12-year period. The men's eating habits were divided into two groups: those who followed a Western diet and those who followed a "prudent" diet with fruit, vegetables, whole grain, fish and poultry. "Over the course of the study ... 1,321 new cases of Type 2 diabetes were diagnosed"(77).
These results clearly suggested that by changing to a healthy diet pattern with high fruits and vegetables and reducing the intake of saturated and trans fat, red meat and processed food, the risk of diabetes may be reduced.
Researchers at the University of Exeter launched a review by researching the database of MEDLINE, EMBASE, Biosis, and the Cochrane Library(78), only controlled clinical trials (on any indication) were included in the study(78).
After differentiating the 10 selected studies, researchers found that oral administration of aloe vera might be a useful adjunct for lowering blood glucose in diabetic patients(78) as well as for reducing blood lipid levels in patients with hyperlipidemia(78).
However, the topical application of aloe vera was not an effective preventative agent for radiation-induced injuries(78).
Furthermore, Dr. Okyar A and colleagues, in clarifying the controversy over the past 15 years on the hypoglycemic activity of Aloe species, launched an investigation with separate experiments on three main groups of rats, namely, non-diabetic (ND), type I (IDDM) and type II (NIDDM) diabetic rats(79)(80). At the end of the experiment, found that
* Application of Aloe vera A. vera leaf pulp and gel extracts were ineffective on lowering the blood sugar level of ND rats(80).
* A. vera leaf pulp extract showed hypoglycemic activity on IDDM and NIDDM rats, the effect is being enhanced for type II diabetes in comparison with glibenclamide(80).
* On the contrary, A. vera leaf gel extract showed hyperglycaemic activity on NIDDM rats(80).
These results suggested, pulps of Aloe vera leaves devoid of the gel could be useful in the treatment of non-insulin dependent diabetes mellitus.
7. Gastric/Stomach ulcer
Gastric ulcers or stomach ulcers are conditions characterized by painful sores in the stomach lining(81). Unlike the gastric ulcers, peptic ulcers are sores found in the stomach and small intestines(81).
The exact causes of gastric ulcers are not clearly identified(81). However, according to the epidemiological studies, a bacterial infection caused by the H. pylori infection has been found in the range of 30 to 50% of people with gastric ulcers(81).
Gastric ulcers caused by H. pylori infection are more likely to develop in patients over the age of 40 in the US(82).
Other risk factors associated with gastric ulcers are long-term use of certain medications, such as NSAID which has been found to cause more than 50% of peptic ulcers and stress(83).
Certain medical conditions such as Zollinger-Ellison syndrome and long-term use of some medication such as alendronate (Fosamax) and risedronate (Actonel) are also the prevalent risk factors that elevate the disease onset(85).
Treatment of gastric ulcers is depended totally on the underlying causes, including antacids for the reduced acid in the stomach, and antibiotics for the elimination of Helicobacter pylori(82).
Unfortunately, people with gastric ulcers infected by the Helicobacter pylori treated with antibiotics have a higher risk of recurrence. In severe cases, surgery may be necessary(84).
Untreated or uncovered stomach ulcers may induce some complications, including stomach bleeding penetration, and cancer(82).
Most cases of untreated gingivitis can also induce complications of bad breath, persistent gum bleeding, and receding gums(90).
Treatments of gingivitis are to control the infection and totally depending on the stages of the disease(89)(90). However, regardless of the type of treatment, patients are all required to keep up good daily care at home(90).
Researchers at the University of Fortaleza examined the effect of Aloe vera in a randomized, parallel and double-blind clinical trial include a total of 30 participants randomly allocated to the test group (n=15) dentifrice containing Aloe vera - or the control group (n=15) - fluoridated dentifrice.
Participants were asked to brush their teeth with the control or test dentifrice, three times a day, during a 30-day period(92).
According to the Plaque index (PI) and gingival bleeding index (GBI) assessed at days 0 and 30, there is a significant reduction on plaque and gingivitis in both groups, but no statistically significant difference was observed among them(92).
The result suggested that the dentifrice containing Aloe vera exerted similar effects as that of fluoridated dentifrice against plaque and gingivitis.
Another study containing a total of 45 patients who were diagnosed with plaque-induced gingivitis included in the study were divided into three groups with fifteen patients in each group to evaluate the effects of Aloe vera(93), including group 1 was asked to rinse with 10 ml of aloe vera mouthwash twice daily for three months and group 2 were treated with scaling only and group 3 patients were asked to rinse with aloe vera mouthwash and scaling was done(93).
According to the data obtained at the baseline, the end of the first month, and the end of the third month, all three groups showed a significant reduction in gingival inflammation. Aloe vera mouthwash showed the greatest effect compared to other groups(93).
The results were attributed to the Aloe vera anti-inflammatory activity(93).
Dr. Ajmera N, the lead scientist said, "it (Aloe vera) can be used as an adjunct to mechanical therapy for treating plaque-induced gingivitis"(93).
Gastric ulcers or stomach ulcers are conditions characterized by painful sores in the stomach lining(81). Unlike the gastric ulcers, peptic ulcers are sores found in the stomach and small intestines(81).
The exact causes of gastric ulcers are not clearly identified(81). However, according to the epidemiological studies, a bacterial infection caused by the H. pylori infection has been found in the range of 30 to 50% of people with gastric ulcers(81).
Gastric ulcers caused by H. pylori infection are more likely to develop in patients over the age of 40 in the US(82).
Other risk factors associated with gastric ulcers are long-term use of certain medications, such as NSAID which has been found to cause more than 50% of peptic ulcers and stress(83).
Certain medical conditions such as Zollinger-Ellison syndrome and long-term use of some medication such as alendronate (Fosamax) and risedronate (Actonel) are also the prevalent risk factors that elevate the disease onset(85).
Treatment of gastric ulcers is depended totally on the underlying causes, including antacids for the reduced acid in the stomach, and antibiotics for the elimination of Helicobacter pylori(82).
Unfortunately, people with gastric ulcers infected by the Helicobacter pylori treated with antibiotics have a higher risk of recurrence. In severe cases, surgery may be necessary(84).
Untreated or uncovered stomach ulcers may induce some complications, including stomach bleeding penetration, and cancer(82).
Some patients with a severe gastric ulcer may also experience symptoms of vomiting blood, feeling faint or losing consciousness. However, 75% of patients with gastric ulcers do not feel any symptoms(82).
In the study to examine the effects of Aloe vera and sucralfate on gastric microcirculatory changes, cytokine levels, and gastric ulcer healing in 48 Male Spraque-Dawley rat that were divided into four groups, including, group1 served as a control group, group 2 as gastric ulcer group without treatment, groups 3 and 4 as gastric ulcer treatment groups with sucralfate and Aloe vera(86), researchers found
* On day 1 after induction of gastric ulcer and before treatment, the leukocyte adherence in postcapillary venule was significantly increased in the ulcer groups, an indication of the immune response to the gastric damage when compared to the control group(86).
The level of TNF-alpha (pro-inflammatory protein) was elevated and the level of IL-10(anti-inflammatory protein) was reduced(86).
* In the ulcer groups treated with sucralfate and Aloe vera, leukocyte adherence was reduced in postcapillary venule. The level of IL-10 was elevated, without affecting the level of TNF-. alpha, an indication of the leading process with the presence of anti-inflammatory cytokine(86).
* On day 8, the leukocyte adherence in postcapillary venule and the level of TNF-alpha were still increased and the level of IL-10 was reduced in the ulcer group without treatment(86).
Dr. Eamlamnam K, the lead scientist at the final days of the study, wrote, "histopathological examination of the stomach on days 1 and 8 after induction of gastric ulcer showed that gastric tissue was damaged with inflammation. In the ulcer groups treated with sucralfate and Aloe vera on days 1 and 8, gastric inflammation was reduced, epithelial cell proliferation was enhanced and gastric glands became elongated"(86).
The results further confirm the efficacy of Aloe vera in promoting gastric ulcer healing, through the expressions of leukocyte adherence and TNF-alpha level, elevate IL-10 level.
Additionally, in the examination of the anti-inflammatory effects of Aloe vera on leukocyte-endothelium in the gastric microcirculation of Helicobacter pylori (H. pylori)-infected of 36 male Sprague-Dawley rats that were divided into 3 groups, including control, H. pylori-infected, and A. vera-treated group (200 mg/kg b.w., twice daily)(87). researchers found that
* H. pylori-infected group shows a significant increase of the leukocyte adhesion cells and the TNF-alpha level compared with the control group on day 8(87).
* After treatment with A. vera H. pylori-infected group exerts a reduced leukocyte adhesion and TNF-alpha significantly(87).
Dr. Prabjone R, the lead author at the final conclusion said, "enhancement in leukocyte-endothelium interaction could be improved by the treatment of A. vera, associated with the reduction in TNF-alpha level"(87).
Interestingly, in the acute gastric mucosal lesions induced by 0.6 M HCl and acid output Aloe vera endowed with gastric acid anti-secretory activity protected the gastric mucosa at low concentrations against injurious agents(88). Its bioactive component, the polymer fraction reduced 50% of the mRNA expressions of inducible nitric oxide synthase (iNOS) and neuronal nitric oxide synthase (nNOS) in the initiation of the pathogenesis of inflammation(88).
In the study to examine the effects of Aloe vera and sucralfate on gastric microcirculatory changes, cytokine levels, and gastric ulcer healing in 48 Male Spraque-Dawley rat that were divided into four groups, including, group1 served as a control group, group 2 as gastric ulcer group without treatment, groups 3 and 4 as gastric ulcer treatment groups with sucralfate and Aloe vera(86), researchers found
* On day 1 after induction of gastric ulcer and before treatment, the leukocyte adherence in postcapillary venule was significantly increased in the ulcer groups, an indication of the immune response to the gastric damage when compared to the control group(86).
The level of TNF-alpha (pro-inflammatory protein) was elevated and the level of IL-10(anti-inflammatory protein) was reduced(86).
* In the ulcer groups treated with sucralfate and Aloe vera, leukocyte adherence was reduced in postcapillary venule. The level of IL-10 was elevated, without affecting the level of TNF-. alpha, an indication of the leading process with the presence of anti-inflammatory cytokine(86).
* On day 8, the leukocyte adherence in postcapillary venule and the level of TNF-alpha were still increased and the level of IL-10 was reduced in the ulcer group without treatment(86).
Dr. Eamlamnam K, the lead scientist at the final days of the study, wrote, "histopathological examination of the stomach on days 1 and 8 after induction of gastric ulcer showed that gastric tissue was damaged with inflammation. In the ulcer groups treated with sucralfate and Aloe vera on days 1 and 8, gastric inflammation was reduced, epithelial cell proliferation was enhanced and gastric glands became elongated"(86).
The results further confirm the efficacy of Aloe vera in promoting gastric ulcer healing, through the expressions of leukocyte adherence and TNF-alpha level, elevate IL-10 level.
Additionally, in the examination of the anti-inflammatory effects of Aloe vera on leukocyte-endothelium in the gastric microcirculation of Helicobacter pylori (H. pylori)-infected of 36 male Sprague-Dawley rats that were divided into 3 groups, including control, H. pylori-infected, and A. vera-treated group (200 mg/kg b.w., twice daily)(87). researchers found that
* H. pylori-infected group shows a significant increase of the leukocyte adhesion cells and the TNF-alpha level compared with the control group on day 8(87).
* After treatment with A. vera H. pylori-infected group exerts a reduced leukocyte adhesion and TNF-alpha significantly(87).
Dr. Prabjone R, the lead author at the final conclusion said, "enhancement in leukocyte-endothelium interaction could be improved by the treatment of A. vera, associated with the reduction in TNF-alpha level"(87).
Interestingly, in the acute gastric mucosal lesions induced by 0.6 M HCl and acid output Aloe vera endowed with gastric acid anti-secretory activity protected the gastric mucosa at low concentrations against injurious agents(88). Its bioactive component, the polymer fraction reduced 50% of the mRNA expressions of inducible nitric oxide synthase (iNOS) and neuronal nitric oxide synthase (nNOS) in the initiation of the pathogenesis of inflammation(88).
8. Gingivitis
Gingivitis is a common and mild form of periodontal disease caused by inflammation of the gingiva, leading to symptoms of irritation, redness, and swelling of the gum that lines the base of the teeth(90).
Most common cause of gingivitis is poor hygiene(90). Epidemiologically, risk factors induced the onset of gingivitis are smoking or chewing tobacco. diabetes and long-term use of certain medication including oral contraceptives, steroids, anticonvulsants, calcium channel blockers(90).
Untreated gingivitis can lead to a serious infection of periodontitis, the major causes of tooth loss in adults, according to the Colgate Professional 89)(90).Gingivitis is a common and mild form of periodontal disease caused by inflammation of the gingiva, leading to symptoms of irritation, redness, and swelling of the gum that lines the base of the teeth(90).
Gingivitis dental plaques formed around the base of the teeth are sticky biofilm of bacteria associated with the interaction of the food intake and bacteria in the mouth(89). Over time, if untreated, the condition can lead to periodontitis and advanced periodontitis(89).
At this early stage, the bone and connective tissue that hold the teeth in place are not yet affected. The problems can be reversed by more frequent and proper brushing and flossing(90).
Some people under the treatment of chemotherapy may also experience symptoms of gingivitis(91).
The Colgate Professional in the examined the symptoms advised that if you have experienced some of the symptoms that do not heal themselves in a short time, such as puffy or swollen, or tender, bleeding during brushing or flossing, teeth that look longer due to receded gum, gums that have separated or pulled away, from your teeth, creating a pocket, changes in the way your teeth fit together when you bite, pus coming from between your teeth and gums, and constant bad breath or a bad taste in your mouth, you may have gingivitis(89).
Most cases of untreated gingivitis can also induce complications of bad breath, persistent gum bleeding, and receding gums(90).
Treatments of gingivitis are to control the infection and totally depending on the stages of the disease(89)(90). However, regardless of the type of treatment, patients are all required to keep up good daily care at home(90).
Researchers at the University of Fortaleza examined the effect of Aloe vera in a randomized, parallel and double-blind clinical trial include a total of 30 participants randomly allocated to the test group (n=15) dentifrice containing Aloe vera - or the control group (n=15) - fluoridated dentifrice.
Participants were asked to brush their teeth with the control or test dentifrice, three times a day, during a 30-day period(92).
According to the Plaque index (PI) and gingival bleeding index (GBI) assessed at days 0 and 30, there is a significant reduction on plaque and gingivitis in both groups, but no statistically significant difference was observed among them(92).
The result suggested that the dentifrice containing Aloe vera exerted similar effects as that of fluoridated dentifrice against plaque and gingivitis.
Another study containing a total of 45 patients who were diagnosed with plaque-induced gingivitis included in the study were divided into three groups with fifteen patients in each group to evaluate the effects of Aloe vera(93), including group 1 was asked to rinse with 10 ml of aloe vera mouthwash twice daily for three months and group 2 were treated with scaling only and group 3 patients were asked to rinse with aloe vera mouthwash and scaling was done(93).
According to the data obtained at the baseline, the end of the first month, and the end of the third month, all three groups showed a significant reduction in gingival inflammation. Aloe vera mouthwash showed the greatest effect compared to other groups(93).
The results were attributed to the Aloe vera anti-inflammatory activity(93).
Dr. Ajmera N, the lead scientist said, "it (Aloe vera) can be used as an adjunct to mechanical therapy for treating plaque-induced gingivitis"(93).
9. Human herpesvirus infection
Herpes simplex infection is a contagious disease caused mostly by human herpesvirus 1 and 2, the 2 members of the herpes virus family(94).
Herpes simplex virus (HSV) belonging to the human Herpesviridae family is a class of viruses that cause viral infections in the majority of humans(94).
Diseases associated with the infection of herpes simplex viruses 1, including the skin, mouth, lips, eyes, and genitals. In severe cases, the viruses also cause encephalitis, meningitis, neonatal herpes(95). HSV-2 usually causes genital lesions(95).
Ethnicity, gender, increase in age, sex without a condom and people with HIV infection weakened the immune system and are some prevalent factors found in patients with HSV infection, particularly in people with certain sexual behavior(96).
Most importantly, pregnant women may put their newborns to serious complications, they have an outbreak of genital herpes at the time of childbirth(98).
Dr. Kalu E, the lead scientist at the Umuahia, Abia State in the concern of the sexual behavior in risk of HSV infection wrote, "Seroprevalence of HSV-2 antibody was 47.3%." and "Sexual behavioral factors that were significantly associated with HSV-2 seroprevalence included early exposure to sexual intercourse, number of sex partners, involvement in polygamous marriages, the involvement of husband in extra-marital affairs and hormonal contraceptive use"(97).
The cross-sectional study design was adopted and the study took place between November 2011 and June 2012 with the participation of 410 consenting ante-natal clinic patients in two major tertiary hospitals in Benin City(97).
The finding clearly suggested that certain sexual behaviors are associated with the risk of Herpes simplex virus 1 (HSV1) infection.
The study conducted by the Shiraz University of Medical Sciences examined the virus type 1 (HSV-1) activity with Aloe extraction pretreatment suggested the extraction with concentrations of Aloe vera (0.2, 0.5, 1, 2, and 5%) exhibited anti-HSV-1 activity assessed by plaque reduction assay(98).
Aloe vera showed no difference in concentration. However, the extract demonstrated a significantly inhibitory Vero cell infected with HSV-1 at one hour. However, there was no significant difference between the two serial concentrations(98).
Acemannan, an extracted polysaccharide from Aloe vera, has shown to exhibit antiviral activities against herpes simplex virus type 1 (HSV-1), in vivo through activation of immune responses(99).
A combination with azidothymidine(an antiretroviral medication) and acyclovir(an antiviral medication) administration acted synergistically to inhibit the replication of HIV-1 and herpes simplex virus type 1 (HSV-1), respectively(99)(100).
On U1 cells, the combination inhibited infected with HIV-1, was attributed to the function of blocking the potentiate of virus replication without inducing toxicity(101).
10. Hypertension
And, "Meanwhile, a Western diet increased the odds of developing gestational hypertension by 18% (5491/39,362 women developed hypertension) and pre-eclampsia by 40% (1168/54,778 women developed pre-eclampsia)"(106).
High blood pressure, a member of the cluster of metabolic syndrome associated with the risk of heart disease, stroke, and diabetes is a medical condition characterized by elevated blood pressure in the arteries(102).
Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood(103).
More precisely, in high blood pressure patients, the heart has to work harder to circulate blood to the body's needs. Long-term elevated blood pressure raises the pressure of the heart, has been found to damage to the heart tissue, leading to the risk of cardiovascular disease(103).
According to the statistics provided by the CDC, approximately 54% of adults in the US are living with high blood pressure and half of them have an uncontrol condition(104).
In the US, high blood pressure is a major cause of heart disease and stroke and a leading cause of death(104).
More precisely, in high blood pressure patients, the heart has to work harder to circulate blood to the body's needs. Long-term elevated blood pressure raises the pressure of the heart, has been found to damage to the heart tissue, leading to the risk of cardiovascular disease(103).
According to the statistics provided by the CDC, approximately 54% of adults in the US are living with high blood pressure and half of them have an uncontrol condition(104).
In the US, high blood pressure is a major cause of heart disease and stroke and a leading cause of death(104).
Most patients with high blood pressure are asymptomatic(103). However, over time, elevated high blood pressure can induce symptoms of severe headache, fatigue or confusion, vision problems. chest pain difficulty breathing accompanied by abnormal heartbeat(103)
Most prevalent factors associated with high blood pressure found in patients are tobacco or excessive alcohol drinking, chronic medical conditions such as kidney disease, diabetes and sleep apnea(105).
Some researchers in the investigation of the correlation of diet in the risk hypertension in pregnancy wrote, " a diet rich in vegetables and fish decreased the odds of developing gestational hypertension by 14% (5491/39,362 women developed hypertension) and pre-eclampsia by 21% (1168/54,778 women developed pre-eclampsia) "(106).
Most prevalent factors associated with high blood pressure found in patients are tobacco or excessive alcohol drinking, chronic medical conditions such as kidney disease, diabetes and sleep apnea(105).
Some researchers in the investigation of the correlation of diet in the risk hypertension in pregnancy wrote, " a diet rich in vegetables and fish decreased the odds of developing gestational hypertension by 14% (5491/39,362 women developed hypertension) and pre-eclampsia by 21% (1168/54,778 women developed pre-eclampsia) "(106).
And, "Meanwhile, a Western diet increased the odds of developing gestational hypertension by 18% (5491/39,362 women developed hypertension) and pre-eclampsia by 40% (1168/54,778 women developed pre-eclampsia)"(106).
In other words, by following a healthy diet and moderate exercise, high blood pressure is preventable. Lower dietary quality was associated with an increased prevalence of untreated hypertension.
The Hamdard University in the investigation of the hypotensive effects of aloe-emodin on hypertension, , suggested, the chemical compound found in Aloe Vera expresses hypotensive effects by lower mean arterial blood pressure by 26 %, 52 %, and 79 % in the corresponding doses of 0.5, 1, and 3 mg/kg in an animal study(107).
Aloe-emodin, another major chemical compound in an animal model inhibited vascular smooth muscle stiffness, a condition in the development of hypertension, involved in cell support, structural and biochemical and the interior surface of blood vessels(108)(109).
In hypertension, increased large-artery stiffness is partly due to intrinsic mechanical properties of vascular smooth muscle cells(109).
More importantly, smooth muscle cells derived from hypertensive and control rats study, treatment of Aloe-emodin also significantly reduced hypertension by improving the elastic value of vascular smooth muscle cell, through its effects on vascular smooth muscle cell cytoskeletal proteins in the regulated function of cell division(108)(109).
Other researchers suggested that the antihypertensive properties of Aloe-emodin may be a result of inhibition of tonic tension and regulated apoptosis, pro- and anti-apoptotic activities on vascular smooth muscle cells (109).
11. Immunomodulatory effect
The immunomodulatory effect is an action in which the immune function is modulated to the needs of the body. In other words, immunomodulation is a process that not only improves immune defense function but also ensures the immune system functions properly(110).
The immune system included the thymus and bone marrow, as well as secondary lymphatic tissues including spleen, tonsils, lymph vessels, lymph nodes, adenoids, skin, and liver, is the body's defense against infectious organisms and foreign invaders(111).
In the acute phase of infection, the immune macrophages, the first line of defense stimulates the production of blood palette to cover the wound or injury and pro-inflammatory cytokines to the site of infection to kill off pathogens before they can enter the body to multiply(112).
Most cases of infection are stopped at the acute phase, depending on the size and penetration of the wound(112).
However, if the immune system for whatever reason such as in people with a weakened immune system can not destroy the foreign invaders in the set period (3-8 weeks), it will adapt to the new change, leading to chronic low-grade inflammation(113).
Low-grade inflammation over time has been found to destroy cells and tissues in the affected area or organ, leading to chronic inflammatory disease, including diabetes, arthritis, and cardiovascular disease(113).
Out of many low-grade inflammatory risk factors, some researchers suggested that an unhealthy diet may be one of the major culprits involved in the facilitation of the onset of the diseases(114).
Dr. Casas R, Sacanella E, the lead scientist wrote, "Dietary patterns high in refined starches, sugar, and saturated and trans-fatty acids, poor in natural antioxidants and fiber from fruits, vegetables, and whole grains, and poor in omega-3 fatty acids may cause an activation of the innate immune system, most likely by excessive production of proinflammatory cytokines associated with a reduced production of anti-inflammatory cytokines"(114).
According to the joint study led by the Sahlgrenska Academy at the University of Gothenburg, oral administrated (AVH200®), an aloe vera extract modified the protein involved activation, proliferation and cytokine secretion of healthy human blood T cells, in a dose-dependent manner(116).
Aloe-emodin(AE), a major constituent found in Aloe Vera exerted a positive effect in significantly enhanced dabrafenib (a BARF inhibitor) antiproliferative activity of mutant cell lines through immunomodulatory activity(117)
The study also confirmed that AE possesses remarkable antineoplastic properties of the drug(dabrafenib) used in the treatment of metastatic colon cancer, against melanoma cells(117).
In candida Albicans, A. vera extract and its fractions on infected macrophages demonstrated an antifungal effect through activated and modulated the immune response(118).
The extract also significantly increased the cell viability of macrophages, in comparison with the control group(118).
Additionally, a polysaccharide isolated from Aloe Vera explicitly also enhanced immune function in producing specific antibody and inducing delayed hypersensitivity in mice model(119).
Collectively, chemical constituents found in Aloe vera have shown to exhibit immunomodulatory effects in regulated immune function against foreign invasion, allergic reactions, and irregular cell growth, but further studies are necessary to confirm this validation(115-119).
The immune system included the thymus and bone marrow, as well as secondary lymphatic tissues including spleen, tonsils, lymph vessels, lymph nodes, adenoids, skin, and liver, is the body's defense against infectious organisms and foreign invaders(111).
In the acute phase of infection, the immune macrophages, the first line of defense stimulates the production of blood palette to cover the wound or injury and pro-inflammatory cytokines to the site of infection to kill off pathogens before they can enter the body to multiply(112).
Most cases of infection are stopped at the acute phase, depending on the size and penetration of the wound(112).
However, if the immune system for whatever reason such as in people with a weakened immune system can not destroy the foreign invaders in the set period (3-8 weeks), it will adapt to the new change, leading to chronic low-grade inflammation(113).
Low-grade inflammation over time has been found to destroy cells and tissues in the affected area or organ, leading to chronic inflammatory disease, including diabetes, arthritis, and cardiovascular disease(113).
Out of many low-grade inflammatory risk factors, some researchers suggested that an unhealthy diet may be one of the major culprits involved in the facilitation of the onset of the diseases(114).
Dr. Casas R, Sacanella E, the lead scientist wrote, "Dietary patterns high in refined starches, sugar, and saturated and trans-fatty acids, poor in natural antioxidants and fiber from fruits, vegetables, and whole grains, and poor in omega-3 fatty acids may cause an activation of the innate immune system, most likely by excessive production of proinflammatory cytokines associated with a reduced production of anti-inflammatory cytokines"(114).
In other words, if you follow the diet pattern of a high-fat diet, you are at a higher risk of low-grade inflammatory disease, compared to those who follow the diet pattern of the Mediterranean diet(115).
According to the joint study led by the Sahlgrenska Academy at the University of Gothenburg, oral administrated (AVH200®), an aloe vera extract modified the protein involved activation, proliferation and cytokine secretion of healthy human blood T cells, in a dose-dependent manner(116).
Aloe-emodin(AE), a major constituent found in Aloe Vera exerted a positive effect in significantly enhanced dabrafenib (a BARF inhibitor) antiproliferative activity of mutant cell lines through immunomodulatory activity(117)
The study also confirmed that AE possesses remarkable antineoplastic properties of the drug(dabrafenib) used in the treatment of metastatic colon cancer, against melanoma cells(117).
In candida Albicans, A. vera extract and its fractions on infected macrophages demonstrated an antifungal effect through activated and modulated the immune response(118).
The extract also significantly increased the cell viability of macrophages, in comparison with the control group(118).
Additionally, a polysaccharide isolated from Aloe Vera explicitly also enhanced immune function in producing specific antibody and inducing delayed hypersensitivity in mice model(119).
Collectively, chemical constituents found in Aloe vera have shown to exhibit immunomodulatory effects in regulated immune function against foreign invasion, allergic reactions, and irregular cell growth, but further studies are necessary to confirm this validation(115-119).
12. Irritable bowel syndrome
Irritable bowel syndrome is a condition characterized by abdominal pain or discomfort, bloating, and alteration of bowel habits at least three times a month for the last 3 months without the preexistence of other diseases(120).
According to the statistic, IBS affects approximately 11% of the population globally and only 30% of these patients consult physicians for their IBS symptoms(121). People with IBS without seeing their doctors were found to experience a significantly reduced quality of life and psychological symptoms(121).
Compared to the male counterpart, women are at high risk of the condition. Believe or not there is 25% less IBS diagnosed in the population of over 50 years of age(121).
People with family history and genetic factors are at a higher risk of the condition. Most patients diagnosed with IBS are infected by other functional diseases compared to the general population(120).
Besides family history, gender, and genetic factors, other most common risk factors of IBS include smoking, frequent alcohol consumption, younger age, according to epidemiological studies(120).
Some researchers suggested that a sedentary lifestyle, a type of lifestyle involving little or no physical activity is also a major component in the Western world associated with IBS(122).
Dr. said, "Potential solutions include augmenting weight-bearing time, moderating dietary fiber consumption, stimulating distal colon evacuation through chemical means and developing pharmaceuticals to block the reflexive distal colon distention associated with fiber consumption"(122).
And, " Amplified intestinal distention commenced when all classes of Renaissance Europeans became the first group in human history to wear shoes, which led to a sedentary lifestyle that moderates gravitational aid to colon motility and evacuation"(122).
According to the statistic, IBS affects approximately 11% of the population globally and only 30% of these patients consult physicians for their IBS symptoms(121). People with IBS without seeing their doctors were found to experience a significantly reduced quality of life and psychological symptoms(121).
Compared to the male counterpart, women are at high risk of the condition. Believe or not there is 25% less IBS diagnosed in the population of over 50 years of age(121).
People with family history and genetic factors are at a higher risk of the condition. Most patients diagnosed with IBS are infected by other functional diseases compared to the general population(120).
Besides family history, gender, and genetic factors, other most common risk factors of IBS include smoking, frequent alcohol consumption, younger age, according to epidemiological studies(120).
By examing the attenuation of gravitational aid to distal intestinal motility, that damage chronic intestinal distention, researchers at the McGill Centre suggested, the prevalence of IBS irritable bowel syndrome have worsened in recent years owing to excessive dietary fiber intake(122).
And, " Amplified intestinal distention commenced when all classes of Renaissance Europeans became the first group in human history to wear shoes, which led to a sedentary lifestyle that moderates gravitational aid to colon motility and evacuation"(122).
Therefore, by engaging in daily moderate exercise and following a healthy diet, IBS may be preventable. Please consult with your dietitian for better diet management that is suitable for you.
In IBS-induced rats by a 5-day that were divided into the groups of control (water), Matricaria recutita (German chamomile, GC) (300 mg/kg), loperamide (10 mg/kg), mixed Aloe vera (AV) and GC (50: 50 at doses of 150, 300 or 450 mg/kg assigned as Mix-150, Mix-300 and Mix-450, respectively)(123), researchers found that application of mixed AV and GC showed a significant reduction of pro-inflammatory cytokines and oxidative stress markers in the IBS-induced rats(123).
Lipid peroxidation (LPO) in colonic cells was also decreased substantially in the mixture treatment group, compared to the control group(123).
GC inhibited only small bowel transit while the AV/GC mixture delayed gastric emptying at the doses of 150 and 300 mg/kg, compared to that of the AV/GC mixture which reduces colonic transit and small bowel transit at the dose of 150 mg/kg(123).
Dr. Asadi-Shahmirzadi A and colleagues at the final day of the experiment said, "The severity of stress-induced IBS was diminished by the AV/GC mixture at all doses used but not dose-dependently, via inhibiting colonic MPO activity and improving oxidative stress status"(123).
In 58 patients in the refractory secondary care randomized received AV or matching placebo for a month with symptoms assessed at baseline, 1 and 3 months, Aloe vera treatment group showed a significant effect in diarrhea at 1 month(124)
Collectively, Aloe vera used alone or combined with chamomile for the prevention and combined with the primary medicine for the treatment of irritable bowel syndrome (IBS), pending to the results of large sample size and multicenter human study.
Lipid peroxidation (LPO) in colonic cells was also decreased substantially in the mixture treatment group, compared to the control group(123).
GC inhibited only small bowel transit while the AV/GC mixture delayed gastric emptying at the doses of 150 and 300 mg/kg, compared to that of the AV/GC mixture which reduces colonic transit and small bowel transit at the dose of 150 mg/kg(123).
Dr. Asadi-Shahmirzadi A and colleagues at the final day of the experiment said, "The severity of stress-induced IBS was diminished by the AV/GC mixture at all doses used but not dose-dependently, via inhibiting colonic MPO activity and improving oxidative stress status"(123).
In 58 patients in the refractory secondary care randomized received AV or matching placebo for a month with symptoms assessed at baseline, 1 and 3 months, Aloe vera treatment group showed a significant effect in diarrhea at 1 month(124)
Collectively, Aloe vera used alone or combined with chamomile for the prevention and combined with the primary medicine for the treatment of irritable bowel syndrome (IBS), pending to the results of large sample size and multicenter human study.
13. Microbial Activity
In other words, antimicrobial activity is the process of killing or inhibiting the disease-causing microbes, including the use of antibiotics for the treatment of infectious diseases caused by bacterias and fungi(125).
In a total of Sixty students in the age group, 6-12 years selected from an orphanage center, divided into four groups study, oral administration of Aloe Vera group showed a decrease of the bacterial count by 80.94 %(127).
Antimicrobial activity is the process of either kill or inhibits microorganisms before they can cause damage to the body tissues(125).
Most common diseases associated with microbial infection are
* Diseases caused by bacteria that are totally dependent on the types of bacterias, such as pneumonia, caused by Streptococcus and Pseudomonas, and foodborne illnesses, such as Shigella, Campylobacter, and Salmonella(126).
* Diseases caused by the virus including smallpox. the common cold and different types of flu. measles, mumps, rubella, chickenpox, and shingles. hepatitis. herpes and cold sores. polio. rabies, Ebola and Hanta fever(126).
* Diseases caused by parasites including malaria, trichomoniasis, giardiasis, cryptosporidiosis, and toxoplasmosis(126).
* Diseases caused by fungi aspergillosis that usually occurs in patients with lung diseases or weakened immune systems and Candidiasis is caused by the yeast Candida(126).
Dr. Bhati N, the lead author said, "Herbal dentifrices containing A. Vera... can be safely recommended as an alternative to fluoridated dentifrices in terms of antimicrobial efficacy"(127).
In Streptococcus mutans strains, Aloe vera brushing showed a reduced the bacteria contamination of Streptococcus mutans strains, without differentiation from the other chemical agents used(128).
Aloe vera in the study against pathogenic such as Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus cereus, Salmonella Typhimurium, Proteus vulgaris, Klebsiella pneumoniae, Escherichia coli, Streptococcus pyogenes and Candida albicans displayed a significantly antimicrobial inhibition rate zones ranging from 6.0 ± 0.57 to 16.6 ± 0.57 mm(128) as the result of the expression of bioactive compounds with high 2,2-diphenyl-1-picrylhydrazyl (DPPH, stable free-radical molecules isolated from the herb), composed of scavenging properties(129).
In other words, oral administration of Aloe Vera reduces the risk of microbial infection and infectious diseases, but a large amount of intake should only be prescribed by related field specialists (128)(129).
14. Neurological disorders
Neurological disorders are class of diseases associated with the brain, the spinal cord including the nerves that connect them(130).
Most common diseases of neurological disorders are dementia, including ALS. PD, Alzheimer's disease, birth defects of the brain and spinal cord, brain injury and tumor(130).
Back pain associated with the related nerve damage is one of the common complaints in the US that send many patients to their doctor. Believe it or not, 80% of the US population will experience back pain at some time in their lives(131).
There is no single cause of neuro-dysfunction. Lifestyle, infections, genetics, and nutrition-related disease, environment, and physical injuries are some major prevalent factors that induce the onset of neurological abnormalities(132).
Neurological disorders have been found to facilitate psychological symptoms such as anxiety and depression and physical symptoms, depending totally on the neurons affected, including partial or complete paralysis muscle weakness seen on post-stroke patients, difficulty reading and writing and poor cognitive abilities such as patients with dementia(132).
According to the American Addiction Center, if you experience some of the below symptoms persistently, including headaches, blurry vision, persistent fatigue, changes in behavior, numbness in the legs or arms, changes in coordination or balance weakness, slurred speech and tremors, you should seek help from the professionals immediately, these may be the first signs of neurological disorders(133).
Neurological disorders are class of diseases associated with the brain, the spinal cord including the nerves that connect them(130).
Most common diseases of neurological disorders are dementia, including ALS. PD, Alzheimer's disease, birth defects of the brain and spinal cord, brain injury and tumor(130).
Back pain associated with the related nerve damage is one of the common complaints in the US that send many patients to their doctor. Believe it or not, 80% of the US population will experience back pain at some time in their lives(131).
There is no single cause of neuro-dysfunction. Lifestyle, infections, genetics, and nutrition-related disease, environment, and physical injuries are some major prevalent factors that induce the onset of neurological abnormalities(132).
Neurological disorders have been found to facilitate psychological symptoms such as anxiety and depression and physical symptoms, depending totally on the neurons affected, including partial or complete paralysis muscle weakness seen on post-stroke patients, difficulty reading and writing and poor cognitive abilities such as patients with dementia(132).
According to the American Addiction Center, if you experience some of the below symptoms persistently, including headaches, blurry vision, persistent fatigue, changes in behavior, numbness in the legs or arms, changes in coordination or balance weakness, slurred speech and tremors, you should seek help from the professionals immediately, these may be the first signs of neurological disorders(133).
According to the joint study lead by the Cadi Ayyad University, Neurosciences, Pharmacology and Environment Unit, Aloe Vera expressed altered dopaminergic innervations associated with neurological disorders, Parkinson's disease following Cu intoxication(134).
Dr. Abbaoui A, the lead researcher said, " (Aloe arborescens gel )AEAAG administration to Cu intoxicated rats showed a noticeable beneficial effect; this potential was featured by a complete recovery of the (tyrosine hydroxylase)TH expression (in the regulation of dopamine Synthesis)
and locomotor behavior deficiencies in the intoxicated rats"(134).
Aloe-emodin, an active compound found in Aloe Vera leaf, also exhibited neuroprotective effects by attenuated scopolamine(a medication used to treat motion sickness and postoperative nausea and vomiting)-induced cognitive deficits via inhibiting acetylcholinesterase (AChE) activity involved breaking down of neurotransmitter and modulating oxidative stress(135).
The study also insisted the antioxidant activities inhibited significantly extracellular intracellular reactive oxygen species (ROS) production to prevent cytotoxicity in patients with Alzheimer's disease(AD)(135).
The neuroprotective expression of Aloe Vera polysaccharide is found to downregulate(caspase-3 expression) the process of apoptotic cell death in the brain during injury(136).
Dr. Abbaoui A, the lead researcher said, " (Aloe arborescens gel )AEAAG administration to Cu intoxicated rats showed a noticeable beneficial effect; this potential was featured by a complete recovery of the (tyrosine hydroxylase)TH expression (in the regulation of dopamine Synthesis)
and locomotor behavior deficiencies in the intoxicated rats"(134).
Aloe-emodin, an active compound found in Aloe Vera leaf, also exhibited neuroprotective effects by attenuated scopolamine(a medication used to treat motion sickness and postoperative nausea and vomiting)-induced cognitive deficits via inhibiting acetylcholinesterase (AChE) activity involved breaking down of neurotransmitter and modulating oxidative stress(135).
The study also insisted the antioxidant activities inhibited significantly extracellular intracellular reactive oxygen species (ROS) production to prevent cytotoxicity in patients with Alzheimer's disease(AD)(135).
The neuroprotective expression of Aloe Vera polysaccharide is found to downregulate(caspase-3 expression) the process of apoptotic cell death in the brain during injury(136).
15. Oral mucositis
Oral mucositis is considered a side effect in patients who undergo cancer treatment, particularly chemotherapy and radiation(137).
In cancer, oral mucositis is caused by the reduced function of the immune system to protect the infection of open sores in the mucosa(137).
Dr. Francesco Chiappelli wrote, "Mucositis is observed in a variety of immunosuppressed patients, but is most often consequential to cancer therapy. It appears as early as the third day of the intervention and is usually established by Day 7 of treatment"(139).
Oral mucositis is considered a side effect in patients who undergo cancer treatment, particularly chemotherapy and radiation(137).
However, poor oral or dental health, smoking or chewing tobacco and drinking alcohol, female gender, dehydration and patients with previous cancer treatment or kidney disease are some of the most common risk factors that cause the onset of oral mucositis(137).
Most common symptoms of oral mucositis are red, shiny, or swollen mouth and gums, sores in the mouth or on the gums or tongue, pain in the mouth or throat, mild burning, or pain when eating food(137).
Some patients may also experience symptoms of difficulty swallowing or talking, soft, whitish patches or pus in the mouth or on the tongue, particularly the increase of mucus or thicker saliva in the mouth(137).
Some researchers suggested the onset of oral mucositis in most cases are associated with people with a weakened immune system, including the use of chemotherapy(138)(139).
And, "The precise immune components involved in the etiology of mucositis are unclear, but evidence-based research (EBR) data has shown that applications of granulocyte–macrophage-colony stimulating factor prevent the onset of the exacerbation of oropharyngeal mucositis(139)".
According to the Mazandaran University of Medical Sciences, topical Aloe vera, a widely used for mild sunburn, frostbites, and scalding burns for its effect on mucositis(140).
Aloe gel showed the beneficial effects of wound healing, mucous membrane protection, and treatment of oral ulcers(140).
Application of Aloe gel also enhanced the anti-inflammatory, immunomodulation, antifungal, free radicals scavenging, increased collagen formation and inhibited collagenase, epidemiological studies suggested(140).
Oral Aloe vera mouthwash demonstrated significant prevention of radiation-induced mucositis by its wound healing and anti-inflammatory mechanism(141).
The herbal mouthwash also reduced oral candidiasis of patients undergoing head and neck radiotherapy due to its antifungal and immunomodulatory properties(141).
These efficacies indicated that Aloe vera mouthwash may be considered an alternative potential for the treatment of radiation-induced oral mucositis and candidiasis in patients with head and neck cancers(141).
The Haji Mirza Mohammad conducted a triple-blind, randomized controlled trial in the comparison of the Aloe vera mouthwash with a benzydamine mouthwash in the alleviation of radiation-induced mucositis in head and neck cancer of 26 eligible head and neck cancer patients who receive conventional radiation therapy at the radiation oncology department (142), Aloe vera plus benzydamine groups showed a means of reduction of 23.54±15.45 days)(142).
16. Polycystic ovarian syndrome (PCOs)
A polycystic ovarian syndrome is a medical condition characterized by undeveloped follicles clumping on the ovaries that interfere with the function of the normal ovaries, leading to enlarged ovaries(143), a hormonal disorder that affects between 6 to 10% of women(143).
The causes of PCOS are not identified. However, some researchers suggested that genetic preposition may play a critical role in facilitating the hormone levels and insulin resistance(144).
A polycystic ovarian syndrome is a medical condition characterized by undeveloped follicles clumping on the ovaries that interfere with the function of the normal ovaries, leading to enlarged ovaries(143), a hormonal disorder that affects between 6 to 10% of women(143).
According to the statistics, in the US, about 6 to 10% of women suffered from PCOS(143).
The causes of PCOS are not identified. However, some researchers suggested that genetic preposition may play a critical role in facilitating the hormone levels and insulin resistance(144).
Some researchers in the comparison of 80% PCOS prevalent rate in overweight and obesity in women in the US and much lower prevalent rate outside the US(145) suggested that the prevalence and severity of obesity are lower in women with PCOS outside the U.S. probably associated with some environmental factors, such as lifestyle, contribute to development of obesity in PCOS that do not exist in other counties(145).
Women with PCOS due to hormonal imbalance are associated with a higher risk of infertility(143)(145).
As of today, treatment of PCOS are medications used mostly to balance the hormones and relieve some of the symptoms, such as acne and weight gain(146).
Most common symptoms are menstrually related such as irregular periods, no period and painful period, insulin resistance, obesity, acne, and male pattern hair growth(146).
Compared to other risk factors, genetic preposition has been under intensified studies by many scientists.
Dr. N Prapas, the lead author in the study "Genetics of Polycystic Ovary Syndrome" said, "Polycystic ovary syndrome has been proven to be a familial condition....the role of genetic factors in PCOS is strongly supported(144)" and
" Some genes (such as Gly972Arg, CAPN10) have shown altered expression suggesting that the genetic abnormality in PCOS affects signal transduction pathways controlling steroidogenesis, steroid hormones action, gonadotrophin action and regulation, insulin action and secretion, energy homeostasis, chronic inflammation, and others"(144).
Researchers examined the effects of Aloe vera in Charles Foster female rats induced-PCOS by oral administration of non-steroidal aromatase inhibitor letrozole (0.5 mg/kg body weight, 21 days)(147)showed that all rats before injection of the Aloe vera expressed a significant increase of hyperglycemia and 90% rats, elevated plasma triglycerides, elevated LDL cholesterol levels, and lowered plasma HDL cholesterol levels, an indication of a dyslipidemic profile(147).
PCOS positive rats with an aberrant lipid profile were selected to the treatment with AVG formulation (1 ml (10 mg)/day, 30 days) administered orally(147).
Infection of AVG in PCOS rats exhibited a significant reduction in plasma triglyceride and LDL cholesterol levels, with an increase in HDL cholesterol(147).
In Aloe vera gel application, the formula treatment also completely restored the abnormal estrous cyclicity, glucose intolerance, and lipid metabolizing enzyme activities, comapred to 90% increased hyperglycemia, elevated plasma triglycerides, elevated LDL cholesterol levels, and lowered plasma HDL cholesterol levels in untreated. PCOS positive rats(148).
In other words, AVG which contains a high amount of phyto components processes an anti-hyperlipidemic effect not only on PCOS but also the associated metabolic complication of dyslipidemia(148).
Dr. N Prapas, the lead author in the study "Genetics of Polycystic Ovary Syndrome" said, "Polycystic ovary syndrome has been proven to be a familial condition....the role of genetic factors in PCOS is strongly supported(144)" and
" Some genes (such as Gly972Arg, CAPN10) have shown altered expression suggesting that the genetic abnormality in PCOS affects signal transduction pathways controlling steroidogenesis, steroid hormones action, gonadotrophin action and regulation, insulin action and secretion, energy homeostasis, chronic inflammation, and others"(144).
Researchers examined the effects of Aloe vera in Charles Foster female rats induced-PCOS by oral administration of non-steroidal aromatase inhibitor letrozole (0.5 mg/kg body weight, 21 days)(147)showed that all rats before injection of the Aloe vera expressed a significant increase of hyperglycemia and 90% rats, elevated plasma triglycerides, elevated LDL cholesterol levels, and lowered plasma HDL cholesterol levels, an indication of a dyslipidemic profile(147).
PCOS positive rats with an aberrant lipid profile were selected to the treatment with AVG formulation (1 ml (10 mg)/day, 30 days) administered orally(147).
Infection of AVG in PCOS rats exhibited a significant reduction in plasma triglyceride and LDL cholesterol levels, with an increase in HDL cholesterol(147).
In Aloe vera gel application, the formula treatment also completely restored the abnormal estrous cyclicity, glucose intolerance, and lipid metabolizing enzyme activities, comapred to 90% increased hyperglycemia, elevated plasma triglycerides, elevated LDL cholesterol levels, and lowered plasma HDL cholesterol levels in untreated. PCOS positive rats(148).
In other words, AVG which contains a high amount of phyto components processes an anti-hyperlipidemic effect not only on PCOS but also the associated metabolic complication of dyslipidemia(148).
17. Psoriasis
Psoriasis is an autoimmune disease caused by speeding up the life cycle of skin cells that lead to patches of the abnormal skin(149).
Psoriasis may be localized which causes red, dry, itchy, and scaly skin patches in the affected area(149). In cases of severity, psoriasis can cover the body completely(149).
Psoriasis is an autoimmune disease caused by speeding up the life cycle of skin cells that lead to patches of the abnormal skin(149).
Some patients also experience symptoms of thickened, pitted or ridged nails and swollen and stiff joints(149).
The causes of psoriasis are not identified. However, researchers believed that genetic proposition exacerbated by certain factors such as weather, injury, illness, or stress is the most causable factors that induce the onset of the condition(150).
Other risk factors associated with psoriasis may include skin injury that did not heal properly, people who are obese and side effects of long term use of certain medicines such as oral steroids(150).
Some researchers suggested smoking, having a strong impact on the immune system may also be one of the major causes of psoriasis in smokers(151).
Dr. Luigi Naldi wrote, "A number of inflammatory immune-related conditions have been associated with smoking, including psoriasis. Smoking affects the onset of psoriasis"(151).
And, " Several pathophysiological mechanisms may explain the association of psoriasis with smoking, including oxidative stress, interaction with signaling pathways active in psoriasis, and vascular influences"(151).
In a mouse tail model of psoriasis, the ethanolic extract of the gel displayed a significant differentiation in the epidermis, as seen from its degree of orthokeratosis (85.07 ± 3.36%) compared to the negative control (17.30 ± 4.09%)(152).
Its efficacy was found to be equivalent to the effect of the standard positive control, tazarotene (0.1%) gel, which showed a 90.03 ± 2.00% degree of orthokeratosis(152).
The ethanolic extract of Aloe vera leaf gel also produced a significant increase in relative epidermal thickness when compared with the control group, and no change in the standard tazarotene(152).
Dr. Dhanabal SP, the lead scientist said, "the extract showed an overall antipsoriatic activity of 81.95%, compared with 87.94 for tazarotene, in the mouse tail model for psoriasis"(152).
Another a randomized, comparative, double-blind, 8-week in a total of 80 patients compare the effects of topical aloe vera (AV) or 0.1% TA cream on various skin conditions, including psoriasis, suggested the mean Psoriasis Area Severity Index (PASI) score decreased from 11.6 to 3.9 (-7.7) in the AV group and from 10.9 to 4.3 (-6.6) in the TA group(153).
The mean Dermatology Life Quality Index (DLQI) score decreased from 8.6 to 2.5 (-6.1) in the AV group and from 8.1 to 2.3 (-5.8) in the TA group(153).
Dr. Choonhakarn C, the lead scientist wrote, "AV cream may be more effective than 0.1% TA cream in reducing the clinical symptoms of psoriasis; however, both treatments have similar efficacy in improving the quality of life of patients with mild to moderate psoriasis"(153).
18. Skin aging
Facial aging is a biological process caused by the structural rearrangements, uneven fat distribution on the face(154), leading to wrinkles and pockets plumped up the forehead, temples, cheeks, and areas around the eyes and mouth(154).
Facial aging is a biological process caused by the structural rearrangements, uneven fat distribution on the face(154), leading to wrinkles and pockets plumped up the forehead, temples, cheeks, and areas around the eyes and mouth(154).
Aging caused by the gravity, fats that lose volume, clumps up, and shifts downward accompanied(154) by the natural degeneration of the skin can also contribute to facial aging(154).
Also, the facial muscles continually tug on, leading to the formation of facial wrinkles (154).
Besides aging, wrinkles may be caused by long-term exposure to the sun and smoking(155).
However, in North America, the wrong perception of sun exposure is one of the extrinsic factors that add a burden to natural facial aging(155)(156).
Dr. Frederic Flament, wrote, "During a lifetime, skin will change in appearance and structure not only because of chronological and intrinsic processes but also due to several external factors such as gravity, sun and ultraviolet exposure, and high levels of pollution; or lifestyle factors that have important and obvious effects on skin aging, such as diet, tobacco, illness, or stress(156)".
And, "Clinical signs of aging are essentially influenced by extrinsic factors, especially sun exposure. Indeed UV exposure seems to be responsible for 80% of visible facial aging signs(156)".
Some researchers suggested that skin expression may be considered as a refect of the general health of an individual. An unhealthy skin due to skin nutritional deficiency has been a target by the dermatology and cosmetic industries(157)(158).
Dr. Silke K. Schagen in the study that links between nutrition and skin aging, said, "Vitamins, carotenoids, tocopherols, flavonoids and a variety of plant extracts have been reported to possess potent antioxidant properties and have been widely used in the skincare industry either as topically applied agents or oral supplements in an attempt to prolong youthful skin appearance"(158).
Researchers at the Seoul National University Boramae Hospital examined the effect of aloe gel on the clinical signs and biochemical changes of aging skin, in a total of 30 healthy female subjects over the age of 45 by giving 2 different doses (low-dose: 1,200 mg/d, high-dose: 3,600 mg/d) of aloe vera gel supplementation for 90 days with their baseline status as a control(159) suggested, Aloe gel intake, improved significantly the facial wrinkles (p<0.05) in both groups, and facial elasticity in the lower-dose group(159).
The injection of the gel increased the skin photoprotection and the type I procollagen mRNA levels in controlling the rate of procollagen synthesis(159).
The results were also accompanied by the matrix (MMP-1) mRNA levels associated with breaking down the interstitial collagens, types I, II, and III, particularly in the higher-dose group(159).
Type I procollagen was substantially increased throughout the dermis in Aloe treatment of the group.
Dr. Cho S, the lead scientist said, "Aloe gel significantly improves wrinkles and elasticity in photoaged human skin, with an increase in collagen production in the photoprotected skin and a decrease in the collagen-degrading MMP-1 gene expression"(159).
The Kyung Hee University Global Campus in the investigation of the effects of Aloe vera on ultraviolet (UV) irradiation-induced photo-damage of the skin, suggested, the application improves depletion of the dermal extracellular matrix and chronic alterations in skin structure(159).
BAE treatment also elevated type I procollagen which was reduced in photodamaged skin(159).
19. Skin diseases
Skin, a large external organ in the human body is the outer layer, with a total area of about 20 square feet which protect the internal organs, bones, and tissues against damage(160).
Skin, a large external organ in the human body is the outer layer, with a total area of about 20 square feet which protect the internal organs, bones, and tissues against damage(160).
The skin processes 3 main layers(160)
* Epidermis is the outer most layer of the skin, which provides a barrier against infection from environmental pathogens(160). The outer layers also regulate the amount of water released from the body through transepidermal water loss(160).
* Dermis is the second layer of skin, containing blood capillaries, nerve endings, sweat glands, hair follicles, and other structures(160).
* The bottom layer is the subcutaneous fat which has been found to process the protective effect against the dangers of visceral fat(160).
Some researchers suggested that by providing enough nutrition to the skin cells, we can maintain healthy skin. In other words, macronutrients including carbohydrates, proteins, and lipids and micronutrients such as vitamins and essential minerals all work together to maintain healthy skin. (162).
Skin health refers to the use of material or agents, including topical and oral herbal remedies with the function to protect the skin cell against the environment harmful substance, including the sun UV light and microbial infection(161).
More precisely, we can maintain healthy skin by eating a healthy diet accompanied by moderate exercise and avoid exposure of skin to harmful substances(162).
Most cases of skin disease are involved in allergens, irritants(163). However certain medical conditions such as irritable bowel disease, autoimmune diseases, and genetic preposition can also causer skin diseases(164).
Some researchers suggested that skin diseases are correlated directly or indirectly with a life-long unhealthy diet(165).
Dr. Rajani Katta and colleagues in the dermatological disease team at the Baylor College of Medicine said, " In this review, the authors focus on conditions for which the role of diet has traditionally been an underappreciated aspect of therapy"(165).
"In some cases, dietary interventions may influence the course of the skin disease, as in acne. In others, dietary change may serve as one aspect of prevention, such as in skin cancer and aging of the skin"(165).
" In others, lastly, systemic medications prescribed for dermatological diseases, such as steroids, are known to raise the risk of other diseases, and dietary change may reduce this risk"(166).
These results clearly suggested that by reducing intake of pro-inflammatory food such as fried and process foods and red meats and increasing anti-inflammatory foods such as tuna, salmon, garlic into your diet, the risk and treatment of skin diseases be reduced(167).
Researchers examined all dermatology-oriented in vitro and in vivo experiments and clinical trials on Aloe vera preparations of 40 selected studies, showed that oral administration of aloe vera in mice is effective on wound healing in inducing the decrease of the number and size of papillomas(167).
The herbal medicine was found to exert certain skin protective effects against psoriasis, seborrheic dermatitis, frostbite, burn, wound healing and inflammation(167).
The topical gel from Aloe vera can be considered a biological vehicle and an anti-microbial and antifungal agent against skin infection and inflammation. However, it was not effective in the prevention of radiation-induced injuries and sunburn or suntan protection(167).
20. Ulcerative colitis
Ulcerative colitis is a type of inflammatory bowel disease induced chronic inflammation and ulcers (sores) in the digestive tract(168).
According to the statistic, in the US, approximately, 1.6 million Americans are living with inflammatory bowel disease, including 907,000 people with ulcerative colitis(169).
Ulcerative colitis is a type of inflammatory bowel disease induced chronic inflammation and ulcers (sores) in the digestive tract(168).
The disease affects the colon and the rectum, leading to bloody diarrhea accompanied by symptoms of belly pain, not feeling hungry, fatigue, weight loss, dehydration(168).
Some patients may also experience symptoms of joint pain or soreness and sudden urges to empty the colon right away(168).
The UC is caused by the immune system mistakenly attacks the cell of the colon, leading to low-grade inflammation(168).
More precisely, the risk of people diagnosed with ulcerative colitis per 100,000 person-years is between 2 and 14(169).
Dr. Mitsuro Chiba, the lead scientist wrote, " Diets rich in animal protein (risk factor) and deficient in dietary fiber (preventive factor) are characteristic of westernized diets in affluent societies. Recent research shows that westernized diets are associated with reduced gut microbial diversity (dysbiosis), which may result in increased susceptibility to IBD and other common chronic diseases"(170).
And, "Plant-based diets rich in dietary fiber are associated with increased microbial diversity. Recent reports on IBD therapy that replaced westernized diets with plant-based diets achieved far better outcomes than those previously reported in the literature. We believe that westernized diet-associated gut dysbiosis is the most ubiquitous environmental factor in IBD"(170).
Conventionally, the treatment of UC is focused on reduced symptoms and prevented the fare up. In some cases, surgery may be necessary if medication fails(168).
The are many prevalent factors associated with UC, including aging, ethnicity, and family. However, some researchers suggested that the promotion of a high-fat diet over the past few decades may have a strong implication in inducing the rise of ulcerative colitis(168)(170).
And, "Plant-based diets rich in dietary fiber are associated with increased microbial diversity. Recent reports on IBD therapy that replaced westernized diets with plant-based diets achieved far better outcomes than those previously reported in the literature. We believe that westernized diet-associated gut dysbiosis is the most ubiquitous environmental factor in IBD"(170).
The results strongly link the risk of IBD in people who follow the Western diet(170).
In a double-blind, randomized, placebo-controlled trial of 44 hospital out-patients with ulcerative colitis randomly given oral aloe vera gel or placebo, 100 mL twice daily for 4 weeks(171), the oral administrated group showed an improvement and response in nine (30%), viewed by the Simple Clinical Colitis Activity Index and histological scores(171).
Dr. Langmead, the lead researcher said, "Oral aloe vera taken for 4 weeks produced a clinical response more often than placebo; it also reduced the histological disease activity and appeared to be safe"(171).
Furthermore, in the study of male Sprague Dawley rats fed experimental diets for 2 weeks before and during the induction of colitis, dietary aloe vera gel significantly ameliorated intestinal inflammatory responses in a dextran sulfate sodium (DSS) induced ulcerative colitis group(172).
In fact, the efficacy is also found to associate with the abundant bioactivity of the herbs(174).
Other researchers suggested that the anti ulcerative colitis activity of Aloe vera gel may be associated with healing properties of antioxidants, scavengers, chelators as well as strongly inhibited inflammation, electrical/mechanical impairment in the gut, and a great majority of oxidative stress(173).
21. Wound healing
Wound healing is a natural process of repair of skin damage and injury associated with the immune system response to protect our body against the harmful pathogenic invasion(175).
The process of skin healing in humans is gone through several stages. First, the immune system after sensing the skin wound activates the immune first-line defense stimulating the constriction of the blood vessel to reduce blood flow, activate platelets, and many different clotting factors to cover the wound area(179) and production of pro-inflammatory cytokines to kill off the stimuli and pathogens which try to enter the body through the wound(176).
Some anti-inflammatory cytokines under normal conditions also switch to pro-inflammatory cytokines depending on the severity of the injury(176).
In some cases, overproduction of pro-inflammatory cytokines can cause damage or death of the nearby cells, leading to the formation of irreversible scars, such as hepatitis infection(176).
Even worse, if the immune system can not kill off all pathogens in the acute phase of infection, it will compromise to the new change, leading to chronic low-grade inflammation(176).
Bacterial pathogens often cause infection in specific areas of the body by multiplying in the site, including the gut(177).
According to the epidemiological studies, some bacterias are opportunistic pathogens, people with a weakened immune system are particularly prone to their invasion(177)(178)(179).
Dr. Dennis W. Metzger, the lead scientist wrote, " While it has been commonly thought that viral-induced epithelial cell damage allows bacterial invasiveness, recent studies by several groups have now implicated dysfunctional innate immune defenses, following influenza as the primary culprit for enhanced susceptibility to secondary bacterial infections"(178).
The results strongly indicated the increased risk of bacterial infection in people with a weakened immune system(178).
Wound healing is a natural process of repair of skin damage and injury associated with the immune system response to protect our body against the harmful pathogenic invasion(175).
The process of skin healing in humans is gone through several stages. First, the immune system after sensing the skin wound activates the immune first-line defense stimulating the constriction of the blood vessel to reduce blood flow, activate platelets, and many different clotting factors to cover the wound area(179) and production of pro-inflammatory cytokines to kill off the stimuli and pathogens which try to enter the body through the wound(176).
Some anti-inflammatory cytokines under normal conditions also switch to pro-inflammatory cytokines depending on the severity of the injury(176).
In some cases, overproduction of pro-inflammatory cytokines can cause damage or death of the nearby cells, leading to the formation of irreversible scars, such as hepatitis infection(176).
Even worse, if the immune system can not kill off all pathogens in the acute phase of infection, it will compromise to the new change, leading to chronic low-grade inflammation(176).
Bacterial pathogens often cause infection in specific areas of the body by multiplying in the site, including the gut(177).
According to the epidemiological studies, some bacterias are opportunistic pathogens, people with a weakened immune system are particularly prone to their invasion(177)(178)(179).
Dr. Dennis W. Metzger, the lead scientist wrote, " While it has been commonly thought that viral-induced epithelial cell damage allows bacterial invasiveness, recent studies by several groups have now implicated dysfunctional innate immune defenses, following influenza as the primary culprit for enhanced susceptibility to secondary bacterial infections"(178).
The results strongly indicated the increased risk of bacterial infection in people with a weakened immune system(178).
By searching the relevant studies in MEDLINE, CINAHL, Cochrane Library, HealthSTAR, DARE, South-East Asia Databased associated with burn healing, researchers identified only 4 studies with a total of 371 patients(180).
According to the meta-analysis using the duration of wound healing as an outcome measure, the healing time of the Aloe vera group was 8.79 days shorter than those in the control group(180). Aloe vera can be an effective intervention used in burn wound healing for first to second-degree burns(180).
Another study suggested, the formulates that optimize a herbal gel of Aloe vera extract containing Carbopol 934 as a gelling agent, exert an 80.14% healing up to 14(th) day, compared to the untreated group I (control) animals that show 52.68%(181).
Treated group animals also showed a significantly lower inflammation comapred to none in the treatment group, evidenced by pus formation up to 5(th) day of study. These results supported the use of topical application of Carbopol 934 gel containing Aloe vera extract on the healing of skin wounds(181).
Conclusion
Based on the findings, herbal Aloe vera may be used for the treatment of the aforementioned health problems, pending to the large sample and multicenter human study.
References
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(3) Nine health benefits and medical uses of Aloe vera By Christian Nordqvist. (Medical News Today)
(4) Aloe Vera Gel (Lu Hui) by Chinese Herbs Healing
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(73) Toxicological evaluation of aqueous extract of Aloe ferox Mill. in loperamide-induced constipated rats by Wintola OA1, Sunmonu TO, Afolayan AJ. (PubMed)
(74) Type 2, the American Diabetes Association
(75) Junk food and diabetes: Tips for eating out By Jayne Leonard. (Medical News Today)
(76) Metabolic syndrome, dyslipidemia, hypertension and type 2 diabetes in youth: from diagnosis to treatment by Alfredo Halpern,1 Marcio C Mancini, Maria Eliane C Magalhães, Mauro Fisberg,R sana Radominski, Marcelo C Bertolami, Adriana Bertolami, Maria Edna de Melo, Maria Teresa Zanella, Marcia S Queiroz,and Marcia Nery. (PMC)
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(79) Hypoglycemic and hypolipidemic effects of processed Aloe vera gel in a mouse model of non-insulin-dependent diabetes mellitus. by Kim K, Kim H, Kwon J, Lee S, Kong H, Im SA, Lee YH, Lee YR, Oh ST, Jo TH, Park YI, Lee CK, Kim K.(PubMed)
(80) Effect of Aloe vera leaves on blood glucose level in type I and type II diabetic rat models.
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(81) Stomach ulcer by NHS
(82) Helicobacter Pylori Infections by Medline Plus
(83) [Risk factors for the adverse course of gastric and duodenal peptic ulcer].[Article in Russian] by Komar OM, Kizlova NM, Trylevych OD, Kravchenko VV. (PubMed)
(84) Peptic Ulcer Disease and Helicobacter pylori infection by Mechu Narayanan. (PMC)
(85) What’s the Difference Between Gastric and Duodenal Ulcers? by Health Line
(43) Western diet increases colorectal cancer risk in Japanese women: Cohort study by 25-Jul-2017 By Gary Scattergood. (NUTRA)
(44) Aloe-emodin induces G2/M cell cycle arrest and apoptosis via activation of caspase-6 in human colon cancer cells by Suboj P, Babykutty S, Srinivas P, Gopala S.(PubMed)
(45) Aloe-emodin inhibits colon cancer cell migration/angiogenesis by downregulating MMP-2/9, RhoB, and VEGF via reduced DNA binding activity of NF-κB by Suboj P, Babykutty S, Valiyaparambil Gopi DR, Nair RS, Srinivas P, Gopala S.(PubMed)
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(47) A very rare case report of long-term survival: A patient operated on in 1994 of glioblastoma multiforme and currently in perfect health by Riccardo Caruso, Alessandro Pesce, and Venceslao Wierzbicki. (PMC)
(48) Scientists discover chemical which can kill glioblastoma cells by University of Leeds
(49) A population-based description of glioblastoma multiforme in Los Angeles County, 1974-1999 by Chakrabarti I1, Cockburn M, Cozen W, Wang YP, Preston-Martin S. (PMC)
(50) Inherited predisposition to glioma by Athanassios P. Kyritsis, Melissa L. Bondy, Jasti S. Rao, and Chrissa Sioka. (PMC)
(51) Enhanced induction of cell cycle arrest and apoptosis via the mitochondrial membrane potential disruption in human U87 malignant glioma cells by aloe-emodin by Ismail S, Haris K, Abdul Ghani AR, Abdullah JM, Johan MF, Mohamed Yusoff AA. (PubMed)
(52) Aloe-emodin modulates PKC isozymes, inhibits proliferation, and induces apoptosis in U-373MG glioma cells by Acevedo-Duncan M, Russell C, Patel S, Patel R.(PubMed)
(53) What is prostate cancer? by the Canadian Cancer Society
(54) Key Statistics for Prostate Cancer. Prostate Cancer Facts by the American Cancer Society
(55) Survival Rates for Prostate Cancer the American Cancer Society
(56) Risk factors for prostate cancer by the Canadian Cancer Society
(57) Dietary factors and risk for advanced prostate cancer by Gathirua-Mwangi WG1, Zhang J. (PubMed)
(58) Aloe-emodin suppresses prostate cancer by targeting the mTOR complex 2 by Liu K, Park C, Li S, Lee KW, Liu H, He L, Song NK, Ahn JS, Bode AM, Dong Z, Kim BY, Dong Z.(PubMed)
(59) Lipids by Khan Academy
(60) LDL-cholesterol versus non-HDL-to-HDL-cholesterol ratio and risk for coronary heart disease in type 2 diabetes by Eliasson B1, Gudbjörnsdottir S1, Zethelius B2, Eeg-Olofsson K1, Cederholm J3; National Diabetes Register (NDR). (PubMed)
(61) Hypercholesterolemia by Genetics Home Reference (NIH)
(62) Epidemiology and Management of Hyperlipidemia by Samantha Karr. (AJMC)
(63) The cholesterol content of Western diets plays a major role in the paradoxical increase in high-density lipoprotein cholesterol and upregulates the macrophage reverse cholesterol transport pathway by Escolà-Gil JC1, Llaverias G, Julve J, Jauhiainen M, Méndez-González J, Blanco-Vaca F. (PubMed)
(64) Dietary Aloe vera improves plasma lipid profile, antioxidant, and hepatoprotective enzyme activities in GIFT-tilapia (Oreochromis niloticus) after Streptococcus iniae challenge by Gabriel NN1,2, Qiang J3,4, Ma XY3, He J3,4, Xu P5,6, Liu K3,4. (PubMed)
(65) Probiotic Lactobacillus rhamnosus GG and Aloe vera gel improve lipid profiles in hypercholesterolemic rats by Kumar M1, Rakesh S, Nagpal R, Hemalatha R, Ramakrishna A, Sudarshan V, Ramagoni R, Shujauddin M, Verma V, Kumar A, Tiwari A, Singh B, Kumar R.(PubMed)
(66) Beneficial effects of aloe vera leaf gel extract on lipid profile status in rats with streptozotocin diabetes by Rajasekaran S1, Ravi K, Sivagnanam K, Subramanian S.(PubMed)
(67) Chapter 77. Acute and Chronic Constipation by Vito Rocco, and Paul Krivickas. (Acess Medicine)
(68) Constipation by Frank W. Jackson MD (Prebiotin-Prebiotics)
(69) Epidemiology of constipation in the United States by Sonnenberg A1, Koch TR. (PubMed)
(70) Constipation in older adults by Brenda G. Schuster. (PMC)
(71) The effect of Aloe ferox Mill. in the treatment of loperamide-induced constipation in Wistar rats by Wintola OA1, Sunmonu TO, Afolayan AJ. (PubMed)
(72) A qualitative study of quality of life and the experience of complementary and alternative medicine in Korean women with constipation by Lee EJ1, Warden S.(PubMed)
(73) Toxicological evaluation of aqueous extract of Aloe ferox Mill. in loperamide-induced constipated rats by Wintola OA1, Sunmonu TO, Afolayan AJ. (PubMed)
(74) Type 2, the American Diabetes Association
(75) Junk food and diabetes: Tips for eating out By Jayne Leonard. (Medical News Today)
(76) Metabolic syndrome, dyslipidemia, hypertension and type 2 diabetes in youth: from diagnosis to treatment by Alfredo Halpern,1 Marcio C Mancini, Maria Eliane C Magalhães, Mauro Fisberg,R sana Radominski, Marcelo C Bertolami, Adriana Bertolami, Maria Edna de Melo, Maria Teresa Zanella, Marcia S Queiroz,and Marcia Nery. (PMC)
(77) Western Diet Linked to Type 2 Diabetes by David Hefner. (J Natl Med Assoc. 2002 May; 94(5): 287)
(78) Aloe vera: a systematic review of its clinical effectiveness. by Vogler BK, Ernst E.(PubMed)
(79) Hypoglycemic and hypolipidemic effects of processed Aloe vera gel in a mouse model of non-insulin-dependent diabetes mellitus. by Kim K, Kim H, Kwon J, Lee S, Kong H, Im SA, Lee YH, Lee YR, Oh ST, Jo TH, Park YI, Lee CK, Kim K.(PubMed)
(80) Effect of Aloe vera leaves on blood glucose level in type I and type II diabetic rat models.
Okyar A, Can A, Akev N, Baktir G, Sütlüpinar N.(PubMed)
(81) Stomach ulcer by NHS
(82) Helicobacter Pylori Infections by Medline Plus
(83) [Risk factors for the adverse course of gastric and duodenal peptic ulcer].[Article in Russian] by Komar OM, Kizlova NM, Trylevych OD, Kravchenko VV. (PubMed)
(84) Peptic Ulcer Disease and Helicobacter pylori infection by Mechu Narayanan. (PMC)
(85) What’s the Difference Between Gastric and Duodenal Ulcers? by Health Line
(86) Effects of Aloe vera and sucralfate on gastric microcirculatory changes, cytokine levels and gastric ulcer healing in rats, by Eamlamnam K, Patumraj S, Visedopas N, Thong-Ngam D.(PubMed)
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(88) Polymer fraction of Aloe vera exhibits a protective activity on ethanol-induced gastric lesions.
Park CH, Nam DY, Son HU, Lee SR, Lee HJ, Heo JC, Cha TY, Baek JH, Lee SH. (PubMed)
(89) Are You At Risk For Periodontal (Gum) Disease? by Colgate Professional
(90) What Are The Stages Of Gum Disease? by Colgate Professional
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(94) Medical Microbiology. Chapter 68, Herpesviruses by Richard J. Whitley. (NCBI)
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(88) Polymer fraction of Aloe vera exhibits a protective activity on ethanol-induced gastric lesions.
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(91) Side effects of chemotherapy by the Canadian Cancer Society
(92) A randomized, double-blind clinical study to assess the antiplaque and antigingivitis efficacy of Aloe vera mouth rinse by Chandrahas B, Jayakumar A, Naveen A, Butchibabu K, Reddy PK, Muralikrishna T.(PubMed)
(93) Aloe vera: It's the effect on gingivitis by Ajmera N, Chatterjee A, Goyal V.(PubMed)
(94) Medical Microbiology. Chapter 68, Herpesviruses by Richard J. Whitley. (NCBI)
(95) Herpes Simplex Virus (HSV) Infections by Merch Manual
(96) Prevalence and risk factors associated with herpes simplex virus-2 infection in a contemporary cohort of HIV-infected persons in the United States by Patel P1, Bush T, Mayer KH, Desai S, Henry K, Overton ET, Conley L, Hammer J, Brooks JT; SUN Study Investigators. (PubMed)
(97) Sexual behavioral correlates with HSV-2 seroprevalence among pregnant women in Nigeria by Kalu EI1, Ojide CK, Fowotade A, Nwadike VU.(PubMed)
(98) How do sexually transmitted diseases and sexually transmitted infections (STDs/STIs) affect pregnancy? by NIH
(99) Assessment of Anti-HSV-1 Activity of Aloe Vera Gel Extract: an In Vitro Study by Rezazadeh F1, Moshaverinia M1, Motamedifar M2, Alyaseri M3. (PubMed)
(100) Acemannan, an extracted polysaccharide from Aloe vera: A literature review by Sierra-García GD, Castro-Ríos R, González-Horta A, Lara-Arias J, Chávez-Montes A.(PubMed)
(101) In vitro evaluation of the synergistic antiviral effects of acemannan in combination with azidothymidine and acyclovir by Kahlon JB1, Kemp MC, Yawei N, Carpenter RH, Shannon WM, McAnalley BH. (PubMed)
(102) The Metabolic Syndrome by Marc-Andre Cornier, Dana Dabelea, Teri L. Hernandez, Rachel C. Lindstrom, Amy J. Steig, Nicole R. Stob, Rachael E. Van Pelt, Hong Wang, and Robert H. Eckel. (PMC)
(103) High Blood Pressure/Hypertension by Johns Hopkins Medicine
(104) High Blood Pressure CDC
(105) The link between diabetes and hypertension By Lana Barhum, Reviewed by Maria Prelipcean, MD. (Medical News Today)
(106) A diet rich in vegetables and fish linked to lower risk of high blood pressure during pregnancy by Royal College of Obstetricians & Gynaecologists
(107) Hypotensive effect of chemical constituents from Aloe barbadensis by Saleem R1, Faizi S, Siddiqui BS, Ahmed M, Hussain SA, Qazi A, Dar A, Ahmad SI, Qazi MH, Akhtar S, Hasnain SN.(PubMed)
(108) Increased vascular smooth muscle cell stiffness: a novel mechanism for aortic stiffness in hypertension by Sehgel NL1, Zhu Y, Sun Z, Trzeciakowski JP, Hong Z, Hunter WC, Vatner DE, Meininger GA, Vatner SF. (PubMed)
(109) Emodin inhibits tonic tension through suppressing PKCδ-mediated inhibition of myosin phosphatase in rat isolated thoracic aorta by Lim KM1, Kwon JH, Kim K, Noh JY, Kang S, Park JM, Lee MY, Bae ON, Chung JH. (PubMed)
(110) Nutritional Modulation of Immune Function: Analysis of Evidence, Mechanisms, and Clinical Relevance by Dayong Wu1, Erin D. Lewis, Munyong Pae, and Simin Nikbin Meydani. (Frontiers In Immunology)
(111) Overview of Immunity by Cells and Organs of the Immune System by Boundless Microbiology
(112) Acute phase response in infectious disease by Gauldie J, Lamontagne L, Stadnyk A. (PubMed)
(113) Chronic Inflammation by Roma Pahwa; Ishwarlal Jialal. (NCBI)
(114) The immune protective effect of the Mediterranean diet against chronic low-grade inflammatory diseases by Casas R, Sacanella E, Estruch R. (PubMed)
(115) Effects of Aloe barbadensis Mill. extract (AVH200®) on human blood T cell activity in vitro by Ahluwalia B1, Magnusson MK2, Isaksson S3, Larsson F4, Öhman L5. (PubMed)
(116) Effects of Aloe barbadensis Mill. extract (AVH200®) on human blood T cell activity in vitro by Ahluwalia B1, Magnusson MK2, Isaksson S3, Larsson F4, Öhman L5. (PubMed)
(117) Aloe-emodin exerts a potent anticancer and immunomodulatory activity on BRAF-mutated human melanoma cells by Tabolacci C1, Cordella M2, Turcano L3, Rossi S2, Lentini A3, Mariotti S4, Nisini R4, Sette G5, Eramo A2, Piredda L3, De Maria R5, Facchiano F6, Beninati S3. (PubMed)
(118) Immunomodulatory effects of Aloe vera and its fractions on the response of macrophages against Candida albicans by Farahnejad Z1, Ghazanfari T, Yaraee R(PubMed)
(119) An anti-complementary polysaccharide with immunological adjuvant activity from the leaf parenchyma gel of Aloe vera by t' Hart LA, van den Berg AJ, Kuis L, van Dijk H, Labadie RP. (PubMed)
(120) Irritable Bowel Syndrome (IBS) by GI Society
(121) The epidemiology of irritable bowel syndrome by Caroline Canavan, Joe West, and Timothy Card. (PMC)
(122) A common cause of irritable bowel syndrome and diverticulitis: chronic distal colon distention from sedentary behavior and excessive dietary fiber by Robbins SE. (PubMed)
(123) The benefit of Aloe vera and Matricaria recutita mixture in rat irritable bowel syndrome: Combination of antioxidant and spasmolytic effects by Asadi-Shahmirzadi A, Mozaffari S, Sanei Y, Baeeri M, Hajiaghaee R, Monsef-Esfahani HR, Abdollahi M.(PubMed)
(124) Randomized double-blind placebo-controlled trial of aloe vera for irritable bowel syndrome.
Davis K, Philpott S, Kumar D, Mendall M.(PubMed)
(125) Antimicrobial by Wikipedia
(126) Everything you need to know about infections by By Christian Nordqvist. Reviewed by Michael Charles, MD. (Medical News Today)
(127) Evaluation of antimicrobial efficacy of Aloe vera and Meswak containing dentifrices with fluoridated dentifrice: An in vivo study by Bhati N1, Jaidka S1, Somani R1(PubMed)
(128) The antimicrobial capacity of Aloe vera and propolis dentifrice against Streptococcus mutans strains in toothbrushes: an in vitro study by Bertolini PF1, Biondi Filho O, Pomilio A, Pinheiro SL, Carvalho MS.(PubMed)
(129) Diversity, antimicrobial and antioxidant activities of culturable bacterial endophyte communities in Aloe vera by Akinsanya MA1, Goh JK2, Lim SP2, Ting AS3.(PubMed)
(130) Neurological Disorders by UCSF
(131) Low Back Pain Fact Sheet by NIH
(132) NEUROLOGICAL DISORDERS of public health challenges by WHO
(133) Effects of Drugs and Alcohol on the Brain: Causes of Brain Damage by American Addiction Center
(134) Neuroprotective potential of Aloe arborescens against copper-induced neurobehavioral features of Parkinson's disease in the rat by Abbaoui A1, Hiba OE2, Gamrani H3.(PubMed)
(135) Protective effects of aloe-emodin on scopolamine-induced memory impairment in mice and H₂O₂-induced cytotoxicity in PC12 cells by Tao L, Xie J, Wang Y, Wang S, Wu S, Wang Q, Ding H.(PubMed)
(136) Effect of aloe polysaccharide on caspase-3 expression following cerebral ischemia and reperfusion injury in rats by Lu ZQ1, Deng YJ, Lu XJ.(PubMed)
(137) Mucositis by the Oral Cancer Foundation
(138) Prevention And Treatment Of Oral Mucositis In Cancer Patients (Best Practice)
(139) The Molecular Immunology of Mucositis: Implications for Evidence-Based Research in Alternative and Complementary Palliative Treatments by Francesco Chiappelli. (PMC)
(140)) Potential prevention: Aloe vera mouthwash may reduce radiation-induced oral mucositis in head and neck cancer patients. by Ahmadi A.(PubMed)
(141)) Comparative Efficacy of Aloe vera and Benzydamine Mouthwashes on Radiation-induced Oral Mucositis: A Triple-blind, Randomised, Controlled Clinical Trial by Sahebjamee M, Mansourian A, Hajimirzamohammad M, Zadeh MT, Bekhradi R, Kazemian A, Manifar S, Ashnagar S, Doroudgar K.(PubMed)
(142) Comparative Efficacy of Aloe vera and Benzydamine Mouthwashes on Radiation-induced Oral Mucositis: A Triple-blind, Randomised, Controlled Clinical Trial by Sahebjamee M, Mansourian A, Hajimirzamohammad M, Zadeh MT, Bekhradi R, Kazemian A, Manifar S, Ashnagar S, Doroudgar K. (PubMed)
(143) Polycystic Ovary Syndrome (PCOS)(Hyperandrogenic Chronic Anovulation; Stein-Leventhal Syndrome) By JoAnn V. Pinkerton. (Merck Manual)
(144) Polycystic ovary syndrome by Genetics Home References
(145) Obesity and Polycystic Ovary Syndrome by Susan Sam, MD. (PMC)
(146) Evaluation and Treatment of Polycystic Ovary Syndrome by Richard S Legro, M.D. (NCBI)
(147) Effect of Aloe barbadensis Mill. the formulation of Letrozole induced polycystic ovarian syndrome rat model (PubMed)
(148) Aloe barbadensis Mill. formulation restores lipid profile to normal in a letrozole-induced polycystic ovarian syndrome rat Model (PubMed)
(149) What to know about psoriasis By Adam Felman, Reviewed by Debra Sullivan, Ph.D. (Medical News Today)
(150) Psoriasis: Who gets it and causes by the American Academy Dermatology Association
(151) Psoriasis and smoking: links and risks by Luigi Naldi. (PMC)
(152) Evaluation of the antipsoriatic activity of Aloe vera leaf extract using a mouse tail model of psoriasis by Dhanabal SP, Priyanka Dwarampudi L, Muruganantham N, Vadivelan R.(PubMed)
(153) A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis by Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P.(PubMed)
(154) Why your face ages and what you can do by Harvard Medical School
(155) Effect of Smoking and Sun on the Aging Skin by Science Direct
(156) Effect of the sun on visible clinical signs of aging in Caucasian skin by Flament F1, Bazin R, Laquieze S, Rubert V, Simonpietri E, Piot B. (PubMed)
(157) Discovering the link between nutrition and skin aging by Silke K. Schagen, Vasiliki A. Zampeli, Evgenia Makrantonaki, and Christos C. Zouboulis. (PubMed)
(158) Dietary Aloe Vera Supplementation Improves Facial Wrinkles and Elasticity and It Increases the Type I Procollagen Gene Expression in Human Skin in vivo. by Cho S, Lee S, Lee MJ, Lee DH, Won CH, Kim SM, Chung JH. (PubMed)
(159) A Comparative Study of Baby Immature and Adult Shoots of Aloe Veraon UVB-Induced Skin Photoaging in vitro. by Hwang E, Kim SH, Lee S, Lee CH, Do SG, Kim J, Kim SY. (PubMed)
(160) Skin: The Human Body's Largest Organ By Kim Ann Zimmermann (Live Science)
(161) Plants used to treat skin diseases by Nahida Tabassum and Mariya Hamdani. (PMC)
(162) Nutrition: What is it and why is it important? By Christian Nordqvist, Reviewed by Natalie Butler, RD, LD. (Medical News Today)
(163) ALLERGIC SKIN CONDITIONS by the American Academy Allergy Asthma & Immunology (164) The Autoimmune Disease Edited by Noel R. Rose and Ian R. Mackay. (Science Direct)
(165) Diet and Dermatology. The Role of Dietary Intervention in Skin Disease by Rajani Katta, MD and Samir P. Desai, MD. (PMC)
(166) Aloe vera in dermatology: a brief review. by Feily A, Namazi MR (PubMed)
(167) 14 Foods That Fight Inflammation By AMANDA MACMILLAN, Health.com
(168) Ulcerative colitis by Mayo Clinic
(169) Chronic ulcerative colitis: incidence and prevalence in a community C M STONNINGTON, S F PHILLIPS, L J MELTON III, AND A R ZINSMEISTER
(170) Westernized Diet is the Most Ubiquitous Environmental Factor in Inflammatory Bowel Disease by Chiba M, Nakane K, Komatsu M. (PubMed)
(171) Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis by Langmead L1, Feakins RM, Goldthorpe S, Holt H, Tsironi E, De Silva A, Jewell DP, Rampton DS. (PubMed)
(172) Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis by Langmead L1, Feakins RM, Goldthorpe S, Holt H, Tsironi E, De Silva A, Jewell DP, Rampton DS. (PubMed)
(173) Dietary aloin, aloesin, or aloe-gel exerts anti-inflammatory activity in a rat colitis model by Park MY1, Kwon HJ, Sung MK. (PubMed)
(174) The protective and healing effects of a natural antioxidant formulation based on ubiquinol and Aloe vera against dextran sulfate-induced ulcerative colitis in rats by Korkina L1, Suprun M, Petrova A, Mikhal'chik E, Luci A, De Luca C.(PubMed)
(175) Wound Healing and Repair by Michael Mercandetti, MD, MBA, FACS; Chief Editor: Joseph A Molnar. (Netscape)
(176) Inflammatory responses and inflammation-associated diseases in organs by Linlin Chen,#1 Huidan Deng, Hengmin Cui, Jing Fang, Zhicai Zuo,Junliang Deng,Yinglun Li, Xun Wang, and Ling Zhao. (PMC)
(177) Medical Microbiology, Chapter 95Microbiology of the Gastrointestinal Tract by Sherwood L. Gorbach. (NCBI)
(178) Immune Dysfunction and Bacterial Co-Infections following Influenza by Dennis W. Metzger and Keer Sun. (PMC)
(179) Skin: Anatomy, Physiology and Wound Healing Heather L. Orsted RN BN ET MSc David H. Keast BSc MSc Dip Ed MD CCFP FCFP Louise Forest-Lalande RN MEd ET Janet L. Kuhnke RN BA BScN MSc ET Deirdre O’Sullivan-Drombolis BScPT MClSc (Wound Healing) Susie Jin RPh CDE CPT CGP Jennifer Haley BMSc MSC Robyn Evans BSc MD CCFP IIWCC. (Foundations of Best Practice for Skin and Wound Management)
(180) The efficacy of aloe vera used for burn wound healing: a systematic review by Maenthaisong R, Chaiyakunapruk N, Niruntraporn S, Kongkaew C.(PubMed)
(181) Formulation development, optimization and evaluation of aloe vera gel for wound healing by Khan AW, Kotta S, Ansari SH, Sharma RK, Kumar A, Ali J.(PubMed)
(108) Increased vascular smooth muscle cell stiffness: a novel mechanism for aortic stiffness in hypertension by Sehgel NL1, Zhu Y, Sun Z, Trzeciakowski JP, Hong Z, Hunter WC, Vatner DE, Meininger GA, Vatner SF. (PubMed)
(109) Emodin inhibits tonic tension through suppressing PKCδ-mediated inhibition of myosin phosphatase in rat isolated thoracic aorta by Lim KM1, Kwon JH, Kim K, Noh JY, Kang S, Park JM, Lee MY, Bae ON, Chung JH. (PubMed)
(110) Nutritional Modulation of Immune Function: Analysis of Evidence, Mechanisms, and Clinical Relevance by Dayong Wu1, Erin D. Lewis, Munyong Pae, and Simin Nikbin Meydani. (Frontiers In Immunology)
(111) Overview of Immunity by Cells and Organs of the Immune System by Boundless Microbiology
(112) Acute phase response in infectious disease by Gauldie J, Lamontagne L, Stadnyk A. (PubMed)
(113) Chronic Inflammation by Roma Pahwa; Ishwarlal Jialal. (NCBI)
(114) The immune protective effect of the Mediterranean diet against chronic low-grade inflammatory diseases by Casas R, Sacanella E, Estruch R. (PubMed)
(115) Effects of Aloe barbadensis Mill. extract (AVH200®) on human blood T cell activity in vitro by Ahluwalia B1, Magnusson MK2, Isaksson S3, Larsson F4, Öhman L5. (PubMed)
(116) Effects of Aloe barbadensis Mill. extract (AVH200®) on human blood T cell activity in vitro by Ahluwalia B1, Magnusson MK2, Isaksson S3, Larsson F4, Öhman L5. (PubMed)
(117) Aloe-emodin exerts a potent anticancer and immunomodulatory activity on BRAF-mutated human melanoma cells by Tabolacci C1, Cordella M2, Turcano L3, Rossi S2, Lentini A3, Mariotti S4, Nisini R4, Sette G5, Eramo A2, Piredda L3, De Maria R5, Facchiano F6, Beninati S3. (PubMed)
(118) Immunomodulatory effects of Aloe vera and its fractions on the response of macrophages against Candida albicans by Farahnejad Z1, Ghazanfari T, Yaraee R(PubMed)
(119) An anti-complementary polysaccharide with immunological adjuvant activity from the leaf parenchyma gel of Aloe vera by t' Hart LA, van den Berg AJ, Kuis L, van Dijk H, Labadie RP. (PubMed)
(120) Irritable Bowel Syndrome (IBS) by GI Society
(121) The epidemiology of irritable bowel syndrome by Caroline Canavan, Joe West, and Timothy Card. (PMC)
(122) A common cause of irritable bowel syndrome and diverticulitis: chronic distal colon distention from sedentary behavior and excessive dietary fiber by Robbins SE. (PubMed)
(123) The benefit of Aloe vera and Matricaria recutita mixture in rat irritable bowel syndrome: Combination of antioxidant and spasmolytic effects by Asadi-Shahmirzadi A, Mozaffari S, Sanei Y, Baeeri M, Hajiaghaee R, Monsef-Esfahani HR, Abdollahi M.(PubMed)
(124) Randomized double-blind placebo-controlled trial of aloe vera for irritable bowel syndrome.
Davis K, Philpott S, Kumar D, Mendall M.(PubMed)
(125) Antimicrobial by Wikipedia
(126) Everything you need to know about infections by By Christian Nordqvist. Reviewed by Michael Charles, MD. (Medical News Today)
(127) Evaluation of antimicrobial efficacy of Aloe vera and Meswak containing dentifrices with fluoridated dentifrice: An in vivo study by Bhati N1, Jaidka S1, Somani R1(PubMed)
(128) The antimicrobial capacity of Aloe vera and propolis dentifrice against Streptococcus mutans strains in toothbrushes: an in vitro study by Bertolini PF1, Biondi Filho O, Pomilio A, Pinheiro SL, Carvalho MS.(PubMed)
(129) Diversity, antimicrobial and antioxidant activities of culturable bacterial endophyte communities in Aloe vera by Akinsanya MA1, Goh JK2, Lim SP2, Ting AS3.(PubMed)
(130) Neurological Disorders by UCSF
(131) Low Back Pain Fact Sheet by NIH
(132) NEUROLOGICAL DISORDERS of public health challenges by WHO
(133) Effects of Drugs and Alcohol on the Brain: Causes of Brain Damage by American Addiction Center
(134) Neuroprotective potential of Aloe arborescens against copper-induced neurobehavioral features of Parkinson's disease in the rat by Abbaoui A1, Hiba OE2, Gamrani H3.(PubMed)
(135) Protective effects of aloe-emodin on scopolamine-induced memory impairment in mice and H₂O₂-induced cytotoxicity in PC12 cells by Tao L, Xie J, Wang Y, Wang S, Wu S, Wang Q, Ding H.(PubMed)
(136) Effect of aloe polysaccharide on caspase-3 expression following cerebral ischemia and reperfusion injury in rats by Lu ZQ1, Deng YJ, Lu XJ.(PubMed)
(137) Mucositis by the Oral Cancer Foundation
(138) Prevention And Treatment Of Oral Mucositis In Cancer Patients (Best Practice)
(139) The Molecular Immunology of Mucositis: Implications for Evidence-Based Research in Alternative and Complementary Palliative Treatments by Francesco Chiappelli. (PMC)
(140)) Potential prevention: Aloe vera mouthwash may reduce radiation-induced oral mucositis in head and neck cancer patients. by Ahmadi A.(PubMed)
(141)) Comparative Efficacy of Aloe vera and Benzydamine Mouthwashes on Radiation-induced Oral Mucositis: A Triple-blind, Randomised, Controlled Clinical Trial by Sahebjamee M, Mansourian A, Hajimirzamohammad M, Zadeh MT, Bekhradi R, Kazemian A, Manifar S, Ashnagar S, Doroudgar K.(PubMed)
(142) Comparative Efficacy of Aloe vera and Benzydamine Mouthwashes on Radiation-induced Oral Mucositis: A Triple-blind, Randomised, Controlled Clinical Trial by Sahebjamee M, Mansourian A, Hajimirzamohammad M, Zadeh MT, Bekhradi R, Kazemian A, Manifar S, Ashnagar S, Doroudgar K. (PubMed)
(143) Polycystic Ovary Syndrome (PCOS)(Hyperandrogenic Chronic Anovulation; Stein-Leventhal Syndrome) By JoAnn V. Pinkerton. (Merck Manual)
(144) Polycystic ovary syndrome by Genetics Home References
(145) Obesity and Polycystic Ovary Syndrome by Susan Sam, MD. (PMC)
(146) Evaluation and Treatment of Polycystic Ovary Syndrome by Richard S Legro, M.D. (NCBI)
(147) Effect of Aloe barbadensis Mill. the formulation of Letrozole induced polycystic ovarian syndrome rat model (PubMed)
(148) Aloe barbadensis Mill. formulation restores lipid profile to normal in a letrozole-induced polycystic ovarian syndrome rat Model (PubMed)
(149) What to know about psoriasis By Adam Felman, Reviewed by Debra Sullivan, Ph.D. (Medical News Today)
(150) Psoriasis: Who gets it and causes by the American Academy Dermatology Association
(151) Psoriasis and smoking: links and risks by Luigi Naldi. (PMC)
(152) Evaluation of the antipsoriatic activity of Aloe vera leaf extract using a mouse tail model of psoriasis by Dhanabal SP, Priyanka Dwarampudi L, Muruganantham N, Vadivelan R.(PubMed)
(153) A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis by Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P.(PubMed)
(154) Why your face ages and what you can do by Harvard Medical School
(155) Effect of Smoking and Sun on the Aging Skin by Science Direct
(156) Effect of the sun on visible clinical signs of aging in Caucasian skin by Flament F1, Bazin R, Laquieze S, Rubert V, Simonpietri E, Piot B. (PubMed)
(157) Discovering the link between nutrition and skin aging by Silke K. Schagen, Vasiliki A. Zampeli, Evgenia Makrantonaki, and Christos C. Zouboulis. (PubMed)
(158) Dietary Aloe Vera Supplementation Improves Facial Wrinkles and Elasticity and It Increases the Type I Procollagen Gene Expression in Human Skin in vivo. by Cho S, Lee S, Lee MJ, Lee DH, Won CH, Kim SM, Chung JH. (PubMed)
(159) A Comparative Study of Baby Immature and Adult Shoots of Aloe Veraon UVB-Induced Skin Photoaging in vitro. by Hwang E, Kim SH, Lee S, Lee CH, Do SG, Kim J, Kim SY. (PubMed)
(160) Skin: The Human Body's Largest Organ By Kim Ann Zimmermann (Live Science)
(161) Plants used to treat skin diseases by Nahida Tabassum and Mariya Hamdani. (PMC)
(162) Nutrition: What is it and why is it important? By Christian Nordqvist, Reviewed by Natalie Butler, RD, LD. (Medical News Today)
(163) ALLERGIC SKIN CONDITIONS by the American Academy Allergy Asthma & Immunology (164) The Autoimmune Disease Edited by Noel R. Rose and Ian R. Mackay. (Science Direct)
(165) Diet and Dermatology. The Role of Dietary Intervention in Skin Disease by Rajani Katta, MD
and Samir P. Desai, MD. (PMC)(166) Aloe vera in dermatology: a brief review. by Feily A, Namazi MR (PubMed)
(167) 14 Foods That Fight Inflammation By AMANDA MACMILLAN, Health.com
(168) Ulcerative colitis by Mayo Clinic
(169) Chronic ulcerative colitis: incidence and prevalence in a community C M STONNINGTON, S F PHILLIPS, L J MELTON III, AND A R ZINSMEISTER
(170) Westernized Diet is the Most Ubiquitous Environmental Factor in Inflammatory Bowel Disease by Chiba M, Nakane K, Komatsu M. (PubMed)
(171) Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis by Langmead L1, Feakins RM, Goldthorpe S, Holt H, Tsironi E, De Silva A, Jewell DP, Rampton DS. (PubMed)
(172) Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis by Langmead L1, Feakins RM, Goldthorpe S, Holt H, Tsironi E, De Silva A, Jewell DP, Rampton DS. (PubMed)
(173) Dietary aloin, aloesin, or aloe-gel exerts anti-inflammatory activity in a rat colitis model by Park MY1, Kwon HJ, Sung MK. (PubMed)
(174) The protective and healing effects of a natural antioxidant formulation based on ubiquinol and Aloe vera against dextran sulfate-induced ulcerative colitis in rats by Korkina L1, Suprun M, Petrova A, Mikhal'chik E, Luci A, De Luca C.(PubMed)
(175) Wound Healing and Repair by Michael Mercandetti, MD, MBA, FACS; Chief Editor: Joseph A Molnar. (Netscape)
(176) Inflammatory responses and inflammation-associated diseases in organs by Linlin Chen,#1 Huidan Deng, Hengmin Cui, Jing Fang, Zhicai Zuo,Junliang Deng,Yinglun Li, Xun Wang, and Ling Zhao. (PMC)
(177) Medical Microbiology, Chapter 95Microbiology of the Gastrointestinal Tract by Sherwood L. Gorbach. (NCBI)
(178) Immune Dysfunction and Bacterial Co-Infections following Influenza by Dennis W. Metzger and Keer Sun. (PMC)
(179) Skin: Anatomy, Physiology and Wound Healing Heather L. Orsted RN BN ET MSc David H. Keast BSc MSc Dip Ed MD CCFP FCFP Louise Forest-Lalande RN MEd ET Janet L. Kuhnke RN BA BScN MSc ET Deirdre O’Sullivan-Drombolis BScPT MClSc (Wound Healing) Susie Jin RPh CDE CPT CGP Jennifer Haley BMSc MSC Robyn Evans BSc MD CCFP IIWCC. (Foundations of Best Practice for Skin and Wound Management)
(180) The efficacy of aloe vera used for burn wound healing: a systematic review by Maenthaisong R, Chaiyakunapruk N, Niruntraporn S, Kongkaew C.(PubMed)
(181) Formulation development, optimization and evaluation of aloe vera gel for wound healing by Khan AW, Kotta S, Ansari SH, Sharma RK, Kumar A, Ali J.(PubMed)
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