Abstract
Graviola (Annona muricata) is a small deciduous tropical evergreen fruit tree, belonging to the Annonaceae family, and is widely grown and distributed in tropical and subtropical regions around the world. The aerial parts of graviola have several functions: the fruits have been widely used as food confectionaries, while several preparations, especially decoctions of the bark, fruits, leaves, pericarp, seeds, and roots, have been extensively used in traditional medicine to treat multiple ailments including cancers by local communities in tropical Africa and South America. The reported therapeutic benefits of graviola against various human tumors and disease agents in in vitro culture and preclinical animal model systems are typically tested for their ability to specifically target the disease, while exerting little or no effect on normal cell viability. Over 212 phytochemical ingredients have been reported in graviola extracts prepared from different plant parts. The specific bioactive constituents responsible for the major anticancer, antioxidant, anti-inflammatory, antimicrobial, and other health benefits of graviola include different classes of annonaceous acetogenins (metabolites and products of the polyketide pathway), alkaloids, flavonoids, sterols, and others. This review summarizes the current understanding of the anticancer effects of A. muricata and its constituents on diverse cancer types and disease states, as well as efficacy and safety concerns. It also includes discussion of our current understanding of possible mechanisms of action, with the hope of further stimulating the development of improved and affordable therapies for a variety of ailments.
Highlights
Cancer is the second leading cause of mortality worldwide
Given that graviola leaves are used in Cameroon to manage diabetes, Florence et al tested an aqueous extract of graviola leaves in streptozotocin-induced diabetic rats [54]. This extract had no effect on normal rats, the aqueous extract was found to reduce blood glucose levels in diabetic rats. These authors found the following: (a) after 15 days of treatment with 100 mg/kg of extract, animals showed significant (46%) reductions in blood glucose compared to diabetic controls not treated with extract, (b) immunostaining at the end of treatment showed preservation of pancreatic β-cells in treated animals compared to diabetic controls not treated with extract, (c) activity of superoxide dismutase (SOD) and catalase in diabetic animals treated with extract (100 mg/kg) were normalized up to levels seen in nondiabetic controls, and (d) levels of tissue malondialdehyde and nitrites were reduced down to levels seen in nondiabetic animals
This current review demonstrates Annona muricata’s anticancer potential and other health-related benefits by providing insights into its bioactive chemical constituents as well as the in vitro and in vivo studies that have been carried out in order to elucidate the molecular mechanisms of action of these constituents
Summary
Cancer is the second leading cause of mortality worldwide. Over 10 million new patients are diagnosed with cancer annually with over 6 million associated deaths, representing roughly 12% of worldwide mortality [1]. The occurrence of new cancer cases is expected to grow by about 70% over the two decades and estimated to reach over 15 million new cases diagnosed annually by the year 2020 [2] This rapid increase is due to both an aging and growing population, along with carcinogens, infections, genetic mutations, hormones, immune conditions, and the adoption of behavioral and dietary risk factors, such as smoking, unhealthy diet, physical inactivity, and environmental pollutants [3]. This review summarizes the recent advances in the application and mechanisms of A. muricata extracts against several cancers both in vitro and in vivo
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