Abstract
- Objectives
To summarize and critically appraise the methodological quality of evidence from systematic reviews and meta-analyses evaluating the therapeutic effectiveness of Moringa oleifera (MO) in managing inflammatory diseases, while identifying the primary molecular signaling pathways activated during exposure.
- Methods
A comprehensive systematic literature search was conducted from database inception until November 4, 2024, across Embase, Scopus, Web of Science, PubMed/Medline, and the Cochrane Library. Inclusion criteria encompassed systematic reviews examining Moringa oleifera in relation to inflammatory conditions, without restrictions on language, publication year, or experimental model. Literature screening, selection, and data extraction were independently performed by two reviewers. Methodological quality and reporting standards were assessed using the PRISMA checklist and an adapted AMSTAR-2 tool.
- Results and Discussion
Twenty-six systematic reviews encompassing a total of 573 primary articles met the inclusion criteria. Plant parts most frequently utilized were the leaves, predominantly prepared via decoction, encapsulated powders, tablets, or meal additives, using water and ethanol as primary extraction solvents. Phytochemical profiling highlighted flavonoids, phenolic acids, and isothiocyanates as the main active constituents driving therapeutic activities. While numerous reviews suggested promising efficacy for Moringa oleifera in ameliorating conditions such as diabetes mellitus, obesity, cancer, hypertension, and dyslipidemia, the overall methodological quality of the evaluated literature was questionable. Only six systematic reviews reported adherence to PRISMA guidelines, yet none achieved 80% compliance during evaluation, and the vast majority were classified as having low methodological quality ($\le 7/16$) according to AMSTAR-2 criteria. Mechanistically, NF-kappaB and Nrf2 pathways were identified as key mediators driving the anti-inflammatory and antioxidant activities of the plant.
- Conclusions
Moringa oleifera represents a promising herbal therapeutic agent beneficial for managing inflammatory diseases. However, due to widespread methodological limitations, protocol heterogeneities—such as unstandardized dosing, varying pharmaceutical forms, and a lack of precise phytochemical marker quantification—further rigorously designed studies are essential to confirm these conclusions.
https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2025.1572337/full