Aloe vera (L.) Burm. f.) (Gel) ++

HERBAL MEDICINES

by

RETTODWIKART THENU

ALOE

(Aloe vera (L.) Burm. f.) (Gel) ++

SUMMARY AND PHARMACEUTICAL COMMENT (Barnes, J et al., 2007)

Aloe vera is obtained from the mucilaginous tissue in the centre of the Aloe vera leaf and consists mainly of polysaccharides and lipids. It should not be confused with aloes, which is obtained by evaporation of water from the bitter yellow juice that is drained from the leaf. Unlike aloes, aloe vera does not contain any anthraquinone compounds and does not, therefore, exert any laxative action. Studies have reported an antiinflammatory and anti-arthritic action for total leaf extracts but the activity seems to be associated with anthraquinone compounds. Hypoglycaemic activity has been reported for aloe vera extract. Aloe vera is a source of gamolenic acid. The literature on burn management with aloe vera gel preparations is confused and further studies are required.

BOTANICAL DESCRIPTION (Ross, I. A. 2003)

A short-stemmed succulent perennial herb of the LILIACEAE family, the succulent leaves are crowded on the top of their stems, spreading grayish green and glaucous; spotted when young, 20 to 50 cm long, 3 to 5 cm wide at the base, tapering gradually to the pointed tip, 1 to 2.5 cm thick; having spiny edges and bitter latex inside. Flowers are borne in cylindrical terminal racemes on central flower stalks,S to 100 cm high. The yellow perianth is divided into 6 lobes, about 2.5 cm long, with scattered bracts. Each flower has 6 protruding stamens and three-celled ovary with long style. Forms of the species vary in sizes of leaves and colors of flowers.

Figure 1. Aloe (Aloe vera) (Duke, J. A. et al., 2003)

NOTES (ALOE):

And there came also Nicodemus, which at the first came to Jesus by night, and brought a mixture of myrrh and aloes, about an hundred pound weight. Then took they the body of Jesus, and wound it in linen clothes with the spices, as the manner of the Jews is to bury.    

 John 19:39–40 (KJV)

Nicode’mus also, who had at first come to him by night, came bringing a mixture of myrrh and aloes, about a hundred pounds’ weight. They took the body of Jesus, and bound it in linen cloths with the spices, as is the burial custom of the Jews.   

John 19:39–40 (RSV)

Nicode’mus also, the man that came to him in the night the first time, came bringing a roll of myrrh and aloes, about a hundred pounds [of it]. So they took the body of Jesus, and bound it up with bandages with the spices, just the way the Jews have the custom of preparing for burial. 

John 19:39–40 (RSV)

SPECIES (FAMILY) (Barnes, J et al., 2007)

*Aloe vera (L.) Burm.f., (Xanthorrhoeaceae)

A. africana Mill.

A. barbadensis Mill., A. perfoliata var. vera L., A. vulgaris Lam.

SYNONYM(S) (Barnes, J et al., 2007)

*Aloe barbadensis Mill., Aloe Gel

ORIGIN AND DISTRIBUTION (Ross, I. A. 2003)

Aloe vera is native to North Africa, the Mediterranean region of southern Europe, and to the Canary Islands. It is now cultivated throughout the West Indies, tropical America, and the tropics in general.

PART(S) USED (Barnes, J et al., 2007)

Leaf gel

PHARMACOPOEIAL AND OTHER MONOGRAPHS (Barnes, J et al., 2007)

Martindale 35th edition(G85)

WHO volume 1 1999(G63)

LEGAL CATEGORY (LICENSED PRODUCTS)

Aloe vera is not included in the GSL.

CONSTITUENTS (Barnes, J et al., 2007)

The following is compiled from several sources, including General References G2 and G6. Aloe vera is reported to contain mono- and polysaccharides, tannins, sterols, organic acids, enzymes (including cyclooxygenase),(1) saponins, vitamins and minerals.(2)

Carbohydrates   Glucomannan and other polysaccharides containing arabinose, galactose and xylose.

Lipids   Includes cholesterol, gamolenic acid and arachidonic acid.(1)

CHEMICAL CONSTITUENTS  (Duke, J. A. et al., 2003)

(ppm unless otherwise indicated)

l,8-Dihydroxyanthracene: PIAV151

1-1-2-Triphenyl cyclopropane: GelAV037

1-1-Bis-(2-hydroxy-3-S-dimethyl-phenyl)-2-

methyl propane: GelAV037

12-Methyl tridecanoic acid methyl ester:

GelAV037

13-Methyl pentadecanoic acid methyl ester:

GelAV037

14-Methyl pentadecanoic acid methyl ester:

GelAV037

.1S-Methyl hexadecanoic acid: GelAV037

16-Methyl heptadecanoic acid methyl ester:

GelAV037

2(3H)-Benzothiazolone: GelAV037

2-Methyl-2-phytyl-6-chromanol: PIAV151

3-3'-Bis para methane: GelAV037

4-4- D i methyl-3 -(2 -4- S -tri methoxyphenyl)

pentanoic acid ethyl ester:

GelAV037

7-Hydroxyaloin: PIAV150

7 -Hydroxy-chromone: PIAV151

8-Methyl-tocol: PIAV151

8-01eic acid methyl ester: GelAV037

9-Propanoyl-methoxy-methyl phenanthrene:

GeIAV037

Acemannan: LfAV182,AV194

Alanine: Lf 177 micromolsAV187

Aloctin I: LfAV212

Aloctin II: LfAV212

Alocutin A: PIAV151

Aloe emodin anthranol: PIAV150

MEDICINAL PLANTS OF THE WORLD

Aloe emodin: LfAV197,AV186

Aloe polypeptides (MW 4,000-70,000): LfAV183

Aloe vera compound HM: Lf 7.S%AV021

Aloe vera compound LM: Lf 47.S%AV021

Aloeferon: GelAV195

Aloemannan: LfAV214

Aloenin: PIAV151

Aloeride: JUAV202

Aloesin: LfAV198

Aloesone: PIAV150

Aloetic acid: PIAV151

Aloetin: PIAV151

Aloetinic acid: PIAV152

Aloin A,7 -hydroxy-6'-0-para-coumaroyl:

LfAV185

Aloin B,7 -hydroxy-6'-0-para-coumaroyl:

LfAV185

Aloin: LfAV074

Aloinose: PIAV151

Aloinoside-A: PIAV151

Aloins: PI 27_30%AV151

Alpha cellulose: PIAV151

Aluminum: Lf 22AV153

Anthranol: LfAV197

Anthraquinone glycoside: PIAV151

Anthraquinones: PIAV151

Anthrol: PIAV151

Apoise: PIAV151

Arabinan: PIAV151

Arabinose: LfAV187

Arachidic acid methyl ester: GelAV037

Arachidonic acid: AerAV196

Arginine: LfAV187

Ascorbic acid: Lf 0.63%AV153

Asparagine: Lf 344 micromolsAV187

Aspartic acid: Lf 237 micromolsAV187

Barbaloin: PIAV120

Behenic acid methyl ester: GelAV037

Benzaldehyde,4-hyd roxy- 3-S-d i -tert -butyl:

GelAV037

Benzylacetone: PIAV151

Beta barbaloin: LfAV003

Beta carotene: PI 7.2.mcgigmAV179

Beta sitosterol: Lf 148 micromolsAV187

Calcium oxalate: LfAV179

Campesterol: Lf 12.4 micromolsAV187

Carbohydrates: Lf 89.6%AV153

Casanthranol-I: PIAV151

Casanthranol-II: PIAV151

Catalase: PIAV151

Cholesterol: Lf 10.8 micromolsAV187, 5t EO

7.2 mcgigmAV179

Choline salicyclate: PIAV151

Choline: PIAV151

Chromium: LfAV153

Chrysamminic acid: PIAV151

Chrysazin: LfAV148

Chrysophanic acid: PIAV120

Chrysophanol glycoside: PIAV151

Chrysophanol: PIAV151

Cobalt: LfAV153

Coniferyl alcohol: PIAV151

Coumarin acid, para: LfAV018

Cycloeicosane: GelAV037

Cysteine: LfAV138

Cystine: Lf JuAV187

Decyl cyclohexane: GelAV037

Dehydro-abietal: GelAV037

Dehydro-abietic acid methyl ester: GelAV037

D-freidooleanan-3-one: GelAV037

D-galactan: PIAV151

D-galactose: LfAV191

D-galactouronic acid: PIAV151

D-glucitol: PIAV151

D-glucose: LfAV191

Di-(2-ethylhexyl)phthalate: PIAV151

Dibutyl phthalate: GelAV037

Diethylhexylphthalate: PIAV205

Diheptyl phthalate: GelAV037

Dioctyl phthalate: GelAV037

D-mannose: LfAV191

Dodecyl benzene: GelAV037

Emodin: PIAV151

Fat: Lf BOOOAV1 53

Fiber: Lf 17.7%AV153

Formic acid: PIAV151

Fructose: Lf, 5t, EOAV179

Galactan (Aloe vera): Lf Pu 0.01 %AV192

Galactose: LfAV187

Gluco-galacto mannan (Aloe vera): LfAV191

Glucomannan (Aloe vera): Lf PuAV193

Glucosamine: PIAV151

Glucose: Lf 21.2 mmolsAV187

Glutamic acid: Lf 294 micromolsAV187

Glutamine: LfAV187

Glycerol: PIAV151

Glycine: Lf 67 micromolsAV187

Hecogenin: PIAV151

Heneicosanoic acid methyl ester: GelAV037

Heptadec-1-ene: GelAV037

Hexauronic acid: PIAV151

Histidine: LfAV187

Homonataloin: PIAV151

Hydrocinnamic acid: PIAV151

Hydroxy proline: Lf JUAV187

Hydroxymethylanthraquinone: PIAV151

Isobarbaloin: PIAV154

Iso-citric acid: LfAV181

Iso-leucine: Lf 65 micromolsAV154

Kilocalories: Lf 2BOOAV153

L-asparagine: PIAV151

Lauric acid methyl ester: GeAV037

Lauric acid: GelAV037

Leucine: Lf 53 micromolsAV187

Lignin: PIAV151

Linoleic acid ethyl ester: GeIAV037

Linoleic acid: GelAV037

Lupeol: Lf 66.1 micromolsAV187

Lysine: Lf 53 micromolsAV187

Lysophosphatidyl inositol: AerAVl96

Magnesium: Lf 930AV153

Manganese: Lf 6AV153

Mannose: Lf B.3 mmolsAV187

Margaric acid methyl ester: GelAV037

Margaric acid: GelAV037

Mono-octyl phthalate: GelAV037

M-protocatechuic aldehyde: PIAV151

Mucilage (aloe vera): LfAV198

Mucopolysaccharides: PIAV151

Myristic acid methyl ester: GelAV037

Myristic acid: GelAV037

Nataloin: PIAV151

N-docosane: GelAV037

N-eicosane: GelAV037

N-heneicosane: GelAV037

N-heptadecane: GelAV037

N-hexadecane: GelAV037

Niacin: Lf 64AV153

N-nonadecane: GelAV037

N-octadecane: GelAV037

Nonadec-1-ene: GelAV037

Nonadec-trans-5-ene: GelAV037

Octadec-1-ene: GelAV037

Octadec-7-enoic acid: GelAV037

Octadeca-1 0-13-dienoic acid methyl ester:

GelAV037

Octadeca-6-9-dienoic acid methyl ester:

GelAV037

Octadeca-9-12-dienoic acid methyl ester:

GelAV037

Oleic acid ethyl ester: GelAV037

Oleic acid methyl ester: GeIAVl96

Oleic acid: AerAVl96

Oligosaccharide (aloe vera): Lf PUAV190

Oxidase: PIAV151

Palmitic acid ethyl ester: GelAV037

Palmitic acid methyl ester: GelAV037

Palmitic acid: GelAV037

Palmitoleic acid methyl ester: GelAV037

Palmitoleic acid: GelAV037

Para coumaric acid: LfAV018,AV187

P-coumaric acid: PIAV151

Pectic acid: PIAV151

Pentadecanoic acid: GelAV037

Phosphatidic acid: AerAVl96

Phosphatidyl choline: AerAV196

Phosphatidyl ethanolamine: AerAV196

Phosphatidyl inositol: AerAVl96

Phosphatidyl serine: AerAV196

Phosphorus: Lf 6_940AV153

Phytosterols: PIAV151

P-Methoxybenzylacetone: PIAV151

P-methoxy-hydrocinnamic acid: PIAV151

Polyphenols: PIAV151

Polysaccharide (Aloe vera):

LfAV180,AV188,AV189

Polyuronide: PIAV151

Proline: Lf 29 micromolsAV187

Protein: Lf Ju 2.S%AV187

Proteinase: PIAV151

Pteroylglutamic acid: PIAV151

Quinone: PIAV151

Resin: PIAV155

Rhamnose: LfAV187

Rhein: PIAV151

Riboflavin: LfAV153

Sapogenin: PIAV151

Saponins: PIAV155

Selenium: Lf 23AV153

Serine: Lf 224 micromolsAV187

Silicon: Lf 22AV153

Spingomyelin: AerAV196

Stearic acid ethyl ester: GelAV037

Stearic acid: GelAV037

Stigmasterol: AerAV196

Sulfoquinovosyl diglyceride: AerAV196

Tetradecyl benzene: GelAV037

Thiamin: Lf 0.8AV153

Threitol: PIAV151

Threonine: Lf 123 micromolsAV187

Tin: Lf 11AV153

Tricosanoic acid methyl ester: Gel AV037

Tridecyl benzene: Gel AV037

Trihydroxymethylanthraquinone: PI AV151

Triolein: AerAV037

Tyrosine: Lf 28 micromols  AV187

Undecyl cyclohexane: Gel  AV037

Uronic acid: PI  AV151

Valine: Lf 109 micromols  AV187

Xylose: Lf  AV187

FOOD USE (Barnes, J et al., 2007)

Aloe vera is not used in foods.

HERBAL USE (Barnes, J et al., 2007)

Traditionally, aloe vera has been used in ointments and creams to assist the healing of wounds, burns, eczema and psoriasis.(G2, G6,G41, G64)

TRADITIONAL MEDICINAL USES

Argentina. Hot water extract of leaves is taken orally to induce abortion and to facilitate menstruation^AV015.

Bimini. Leaf juice is used externally for skin irritations, cuts, boils and sunburn^Avo95.

Bolivia. Fresh leaf juice is used as an analgesic topically for burns and wounds. Orally, the juice is used as a laxative^Av1l6.

Brazil. Fresh leaf juice is taken orally as an anthelmintic and febrifuge. Infusion of dried root is taken orally to treat colicAv142.

Canary Islands. Fresh fruit juice (unripe) is taken orally as an antiasthmatic and purgativeAV141. Infusion of fresh leaf juice is taken orally as a laxative, for dental caries, and as a teniafugeAV124.

China. Hot water extract of leaf juice is taken orally as an emmenagogueAV021 .

Cook Islands. Fresh sap, in water, is taken orally regularly, to prevent high blood pressure, cancer and diabetes. Externally it is used to treat burns and cutsAV045.

Cuba. Water extract of leaf pulp is taken as an emmenagogueAV125.

Egypt. Fresh leaf juice, administered intravaginally, is a contraceptive before or after coitus. Data was obtained as a result of questioning 1200 puerperal women about their knowledge of birth control methods. 52.3% practiced a method, and 47.6% of these depend on indigenous methods and/ or prolonged lactationAV16J.

England. Hot water extract of dried leaves with a mixture of Zingiber officinale, Mentha phlegium (essential oil), Ipomoea purga, Glycyrrhiza glabra and Canella alba is taken orally for amenorrheaAVl14.

Guatemala. Hot water extract of dried leaves is used externally for wounds, ulcers, bruises, sores, skin eruptions, erysipelas, dermatitis, inflammations, burns, abscesses, furuncles and scrofulaAvlll.

Haiti. Hot water extract of dried leaves is taken orally as a purgative, for diabetes and intestinal worms^AVl01.

India. Decoction of dried leaves is taken orally to induce abortion^AVOJ5 and for sexual vitality^AV121. The dried leaf juice is taken orally as an emmenagogue^AV131. Decoction of root is taken orally for venereal disease and externally it is used to treat woundsAvoBl. Fresh fruit juice (unripe) is taken orally as a laxative, cathartic and for fevers^Av176. Fresh leaves are crushed and applied locally for guinea worms^AVOB3. Hot water extract of dried entire plant is taken orally as an emmenagogue, purgative, anthelmintic, and stomachic, for liver and spleen enlargement and piles. Hot water extract of fresh plant juice is taken orally for inflammation and amenorrhea^AV139. The pulp of the plant is mixed together with salt and fermented sugar cane juice then taken orally to treat pain and inflammation of the bodyAvo4B. Hot water extract of leaf juice is taken orally as a cathartic; pregnant women should not use it^AV005. Leaf pulp is taken orally regularly for 10 days by women to prevent conceptionAvo77 . Leaf juice is taken orally to treat viral jaundice. The juice is taken twice daily for 3 days^AVOB1.

Malaysia. Hot water extract of leaf juice is taken orally as a cholagogue and emmenagogueAV017. Hot water extract of leaves is taken orally as an emmenagogue^AVOO2.

Mexico. Fresh stem juice is taken orally for diabetesAvo31. Infusion of dried leaves is taken orally to treat ulcersAvo36.

Nepal. Fresh leaf pulp is taken orally to relieve amenorrhea. 10-15 gm of leaf pulp is given with sugar or honey once a dayAvo49. Hot water extract of dried entire plant is taken orally as a purgative and to terminate pregnancyA VI02 .

Panama. Fresh leaf, crushed with egg white, is taken orally as a laxative and demulcent. Sap is taken orally for stomach ulcers and externally for erysipelas and to treat swellings caused by injuriesAvo9B.

Peru. Hot water extract of fresh leaves is taken orally for asthma, as a purgative, and antivenin. Externally, the extract is used as an antiseptic for washing woundsAV136.

Puerto Rico. Drink made from fresh leaf pulp of Aloe vera and fruit pulp of Genipa americana is a popular remedy for coldsAvllB.

Saudi Arabia. Hot water extract of dried aerial parts is taken orally for liver complaints and piles, as an emetic and antipyretic, against tumors, for enlarged spleen, as a cooling agent and purgative, and for diabetes, skin diseases and asthmaAv14o. Hot water extract of dried leaves is taken orally for functional sterility, amenorrhea, piles, thermal burns, constipation, flatulence, intestinal worms and diabetes, to treat functional sterility, amenorrhea, constipation and piles. Externally the extract is used for burnsAV123.

South Korea. Hot water extract of whole dried plant is taken orally as a contraceptive, an abortifacient and emmenagogue. Use of the extract is contraindicated during pregnancyAV122.

Switzerland. Hot water extract of the leaf is taken orally as an abortifacientAVoo3.

Taiwan. Decoction of dried leaves is taken orally to treat hepatitisAVOB\

Thailand. Fresh leaf juice is used on burnsAv125. Hot water extract of dried resin is taken orally as a catharticAV17B.

Trinidad. Gum is taken orally as an abortifacientAVo26.

Tunisia. Hot water extract of the dried leaf is taken orally for diabetes, and to treat problems of venous circulation. Externally, the extract is used for eczemaAVll9.

USA. Fresh leaf juice is taken orally for stomach ulcers, and externally to heal woundsAv167. Fluidextract of the leaf juice is taken orally as an emmenagogueAV016. Hot water extract of dried leaves is taken orally as a catharticAV177. Hot water extract of gum is taken orally as an emmenagogue to promote and stimulate menstruationAV157. Water extract of leaves is used externally for insect bites, myopathies, arthritis, topical ulcers and other skin conditionsAvo22. Hot water extract is taken orally to increase menstrual flow; the extract should be avoided during pregnancyAV053.

Venezuela. Bitter latex is taken orally as a laxativeAvol4. Hot water extract of leaves is taken orally as an emmenagogueAV025.

Vietnam. Sap is taken orally as an emmenagogue^AV012 .

West Indies. Gum is taken orally as an abortifacientAVo96. Leaf juice is taken orally as an emmenagogue, anthelmintic and purgativeAVOIJ. Yellow latex from the epidermis is taken orally to prevent syphilis, as a purgative, to improve appetite, for intestinal worms, and to promote menstrual flow. Externally, split leaves are applied to wounds to promote healing^AVo96.

USES (Linda, 2010)

Aloe is used topically to treat minor burns, sunburn, cuts, abrasions, bedsores, diabetic ulcers, acne, and stomatitis. It is used internally as a stimulant laxative, a tonic, and to treat duodenal ulcers, renal calculi, and active bleeding ulcers. Aloe may also be used to relieve radiation burns suffered by cancer patients and may help slow the development of wrinkles.

ACTIVITIES (Duke, J. A et al., 2002)

Abortifacient (1; WO3); Analgesic (1; PH2); Antiaggregant (f; CRC); Antiaging (f; WO3); Antialcoholic (1; WO3); Antibacterial (1; APA); Antidote, alcohol (1; WO3); Antiedemic (1; CAN; WHO); Antiherpetic (1; AAB; PH2); Antihistaminic (1; APA); Antiinflammatory (1; AAB; CAN; PH2; WHO; WO3); Antiplaque (f; WO3); Antiprostaglandin (1; WHO); Antiseptic (1; CRC; PH2); Antithromboxane (1; PH2; WHO); Antiulcer (1; AAB; PH2); Antiviral (1; AAB; PH2; WO3); Antiwrinkle (f; WO3); Aperient (f; DAA; DEP); Arylamine-N-Acetyltransferase-Inhibitor (1; PH2); Bitter (f; PED); Cholagogue (f; CRC); Collagenic (1; PH2); Cyclooxygenase-Inhibitor (1; PH2); Demulcent (1; WAM); Depurative (f; CRC); Digestive (1; CRC; WAM); Emmenagogue (1; DAA; MPI); Emollient (1; WAM); Fungicide (1; APA; PH2); Hemostat (1; WO3); Hypocholesterolemic (1; WO3); Hypoglycemic (1; CAN); Immunomodulator (1; PH2); Insecticide (f; CRC); Larvicide (f; CRC); Laxative (1; PH2; WAM); Microcirculatory Stimulant (f; CAN); Mitogenic (1; WO3); Moisturizer (1; CRC); Nematicide (1; CRC); Phagocytotic (1; CAN; PNC); Propecic (f; KAP); Radioprotective (1; MPI); Stimulant (f; CRC); Stomachic (f; CRC; MPI); Tonic (f; MPI); Tyrosine-Kinase-Inhibitor (1; PH2); Vermifuge (1; MPI); Vulnerary (1; CAN; WAM; WHO; WO3).

PHARMACOLOGICAL ACTIVITIES AND CLINICAL TRIALS

(Ross, I. A. 2003)

Abortifacient effect. Ethanol (95%), water, and petroleum ether extracts of fresh leaves, administered orally to female rats at doses of 150.0, 150.0, and 100.0 mg/kg, respectively, were inactive^AV158.

Adjuvant activity. Aqueous (dialyzed) fraction of freeze-dried leaf juice, administered intraperitoneally to mice at variable dosage levels, was active^AV068.

Alkalinizing activity. Undiluted fresh leaf juice, applied externally on female adults with dermatitis caused by X-ray treatment, was active^AV161.

Analgesic activity. Ethanol (95%) extract of aerial parts, administered intragastrically to mice at a dose of 500.0

mg/kg, was active vs hot plate method^Avo67. Fresh leaf gel, at a concentration of 0.125% formulated into toothpaste that also contained sodium fluoride, was equivocal. Alleviation of root pain was not significantly greater in treatment group vs controlsAvo42. Fresh leaf pulp, used externally on patients with chronic and acute athletic injuries 3 times per week for 3 weeks, was activeAvo66. Water extract of dried leaf juice, administered intraperitoneally to rats at a dose of 250.0 mg/kg, was active vs tail flick response to radiant heatAVll7. Water extract of fresh leaf juice, administered subcutaneously to mice at a dose of 100.0 mg/kg, was active. Decolorizing Aloe vera extract was given daily for 7 days to normal and diabetic test groups. The treated normal group showed a doubling of the time to pain response relative to untreated diabetics (13.7 vs 10.7 seconds) vs carrageenin-induced pedal edema and hot plate method^Avo62.

Anesthetic activity (local). Undiluted fresh leaf juice was active as an analgesic for insect stings on human adults. The biological activity has been patented^Avo99.

Anti-asthmatic activity. Fresh leaf extract, administered orally to human adults, was active^AVI3B.

Antibacterial activity. Chromatographic fraction of fresh leaves, on agar plate, was active on Bacillus subtilisAv134. Decoction of dried fruit, on agar plate, produced weak activity on Streptococcus mutans, MIC 62.5 mg/ml^Avo70. Dried entire plant juice, on agar plate, was active on Proteus vulgaris and Pseudomonas aeruginosa^AV120. Ethanol (95%) and water extracts of leaves, on agar plate, were inactive on Escherichia coli and Staphylococcus aureus^AV020. Fresh leaf juice, at a concentration of 1:50 on agar plate, was active on Streptococcus pyogenes, Corynebacterium xerosis and Staphylococcus aureUSj and inactive on Escherichia coli and Salmonella schottmuelleri. The activity was lost quickly as the juice darkened in color. Whole leaf minus the juice, the leaf mesophyll and leaf epidermis was devoid of activityAV156. Tincture of dried leaves, at a concentration of 30.0 ml/disk (10 gm of leaves in 100 ml ethanol) on agar plate, was inactive on Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus^AV137. Undiluted fresh leaf juice, in broth culture, was active on Bacillus subtilis, Enterobacter species, Escherichia coli, Serratia marcescens, Staphylococcus aureus, Streptococcus agalactiae, and Streptococcus pyogenes, and inactive on Klebsiella species^AVlOl .

Antiburn effect. Dried entire plant juice, applied externally to guinea pigs, was active vs experimental burn^AV120. Fresh undiluted leaf juice, applied externally to human adults of both sexes, was active. Three cases of burn caused by hot water and 2 cases of severe sunburn were treated^Av103. Undiluted fresh leaf juice, applied externally to human adults of both sexes with X-ray-inducedulcers, was active^AV162. Undiluted fresh leaf juice, applied topically to X-ray-induced, acute third degree burns, was active^AV160. Undiluted leaf gel, applied externally, was inactive. Twelve volunteers received UVB irradiation from a light pen at 2 sites on each arm. Aloe leaf gel was applied to 2 sites on 1 arm. Blood flow and redness of irradiated areas did not differ from controls at 6 and 24 hours post_burn^AvoBo. Water extract of dried leaves, applied externally to third degree burns induced by X-rays on rats at a concentration of 10.0%, was active. The inner rind of the leaf was dried before being extracted^Av160.

Anticancer activity. Aloe-emodin, a hydroxyanthraquinone present in the leaves, has a specific in vitro and in vivo antineuroectodermal tumor activity. The growth of human neuroectodermal tumors was inhibited in mice with severe combined immunodeficiency without any appreciable toxic effects on the animals. The compound does not inhibit the proliferation of normal fibroblasts or that of hemopoietic progenitor cells. The cytotoxicity

mechanism consists of the induction of apoptosis, whereas the selectivity against neuroectodermal tumor cells is found on a specific energy-dependent pathway of drug incorporation^Av20B.

Antichemopreventive effects. Gel extract was evaluated using in vitro shortterm screening methods associated with both initiation and promotion processes in carcinogenesis. In B[a]P-DNA adduct formation, 180 micrograms/ml of the extract inhibited B[a]P binding to DNA in mouse liver cells. Oxidative damage by 8-hydroxydeoxyguanosine was significantly decreased by the extract. In screening antitumor promoting effect, the extract significantly inhibited phorbol myristic acetate-induced ornithine decarboxylase activity in Balb/3T3 cells. In addition, the extract significantly inhibited phorbol myristic acetate-induced tyrosine kinase activity in human leukemic cells. Superoxide anion formation was also significantly inhibited^AV213 .

Anticomplement activity. Aqueous (dialyzed) fraction of freeze-dried leaf juice, at a concentration of 300.0 mg/ml, was active on human serum. Inhibition of alternate pathway complement activity was observed. The effect resulted from depletion of complement factor 3^AV068. Water extract and polysaccharide fraction ofleaves were active in human serum^AV133 . Water extract of fresh leaves, at variable concentrations, was active^AV021.

Anticrustacean activity. Ethanol (95%) extract of dried plant juice was inactive on Artemia salina. The assay system was intended to predict for antitumor activity^AVo29.

Antidiabetic effect. Leaf pulp and gel extracts, administered orally to non-diabetic, Type I and type II diabetic rats, were ineffective on lowering the blood sugar level in non-diabetic rats. The leaf pulp extract showed hypoglycemic activity on type I and type II rats. The effectiveness being enhanced for type II diabetes in comparison with glibenclamide. On the contrary, the leaf gel extract showed hyperglycemic activity on type II rats. It has been concluded from this study that the leaves devoid of the gel could be useful in the treatment of noninsulin dependent diabetes mellitus^Av2ol.

Antifertility effect. Ethanol (95%) and petroleum ether extracts of leaves, administered orally to female mice, were active. Positive data was reported, but they are of questionable significance to fertility regulation. Water extract was inactive. Ethanol (95%), water and petroleum ether extracts of root, administered orally to female mice, were inactive^AV006.

Antifungal activity. Anthraquinone fraction of fresh leaf juice, on agar plate, was active on Trichophyton mentagrophytes^AV04J. Dried juice from entire plant, applied externally to human adults, was active in treating trichophytiasis^AvI20.

Antihypercholesterolemic activity. Hot water extract of dried leaf juice, administered intragastrically to rats at a dose of 0.5 gm/kg for 7 days, was active. A mixture of Nigella sativa, Commiphora, Ferula assafoetida, Aloe vera, and Boswellia serrata vs streptozotocin-induced hyperglycemia tested the effect^AV065.

Antihyperglycemic activity. Twenty-five percent aqueous extract of decoction and hot water extract of dried leaves, administered intragastrically to mice at a dose of 0.5 ml/animal, were inactive vs alloxan-induced hyperglycemiaAVl2l. Chromatographic fraction of a commercial sample of leaves, administered intraperitoneally to mice at a dose of 5.0 mg/kg daily for 4 days, was active vs alloxan-induced hyperglycemia. Leaf exudate, administered intragastrically to mice at a dose of 500.0 mg/kg, was inactive. When administered twice daily for 4 days, the exudate was active vs alloxan-induced hyperglycemiaAvo7Z. Fresh leaf gel, administered intragastrically to male rats at a dose of 2.0 ml/kg, was inactive. The gel did not lower blood glucose in alloxan treated rats. Blood glucose rose with the treatmentAV044. Fresh sap, administered intragastrically to mice at a dose of 1.0 gm/kg, was active vs alloxan-induced hyperglycemiaAvo69. When administered orally to 5 diabetic patients for 4-14 weeks, the sap was activeAV069. Hot water extract of dried leaf juice, administered intragastrically to rats at a dose of 0.5 gm/kg for 7 days, was active. The effect was tested by a mixture of Nigella sativa, Commiphora, Ferula assafoetida, Aloe vera, and Boswellia serrata vs streptozotocininduced hyperglycemiaAvo65 .

Anti-implantation effect. Ethanol (95%) and petroleum ether extracts of leaves, administered orally to female rats, were active. Positive data was reported, but they are of questionable significance to fertility regulation. The water extract was inactiveAV006. Ethanol (95%) extract of leaf pulp, administered orally to female rats at a dose of 100.0 mg/kg, was inactive^AV009. Ethanol (95%), water and petroleum ether extracts of root, administered orally to female mice, were inactive^AV006.

Anti-inflammatory activity. Water extract of fresh leaf juice, applied externally to mice at a concentration of 1.0%, was active. Decolorized Aloe vera extract was applied to the ear 30 minutes after the application of croton oil. The extract reduced ear swelling by 67% relative to controlsAvo61. The extract was also active in rats vs mustardinduced pedal edema. Inhibition of edema was greater with RNA and vitamin C added. When administered subcutaneously to rats at a dose of 10.0 mg/kg, the extract was active. Decolorized Aloe vera extract was given 1 day before induction of edema by plantar injection of 2% mustard solution. A 60% reduction of edema was seen in treated diabetic animals relative to untreated diabetics vs carrageenin-induced pedal edema. A dose of 400 mg/kg was inactive vs cotton pellet granulomaAvo58. Ethanol (95%) extract of fresh leaf juice, applied externally on mice, was active vs croton oil-induced edema and carrageenin-induced pedal edemaAvo43. Ethanol/water (1:1) extract of leaf juice, applied externally to mice at a concentration of 5.0%, was active vs croton oil-induced edemaAvoo4. Fresh leaf gel, administered intraperitoneally to male rats at a dose of 2.0 ml/kg, was active vs carrageenin-induced pedal edemaAvo4o. Fresh leaf juice, administered by means of injection to 50 patients with first-third stage of parodontosis, yielded a satisfactory effect only in the first and second stages of the disease. The content of calcium elevated in the blood serum in parodontosis normalizes in the treatment with Aloe extractAV1J5 . Fresh leaf juice, applied externally to female mice at a dose of 5.0%, was active vs croton oilinduced edema^AV07J. The decolorized extract, at a concentration of 1.0%, was active vs croton oil-induced edemaAvo79. When administered subcutaneously to rats at a dose of 25.0 mg/kg, the extract was active vs mustard-induced pedal edema, 46% decrease in paw volume; when combined with 1.0 mg/kg hydrocortisone, 66% decrease in paw volume; 86% inhibition of edema for combination with 0.1 % hydrocortisone vs croton oil-induced edema^Avo79. Ethanol/water (1: 1) extract of fresh leaves, administered subcutaneously to mice at a dose of 150.0 mg/kg, was active vs croton oil-induced edemaAvl48. Fresh leaf pulp, administered via drinking water and intragastrically to rats at a dose of 100.0 mg/kg, were active vs croton oil-induced ear swelling. A time study showed that food grade Aloe vera administration reduced swelling to a large degree when used over a 21-day period as opposed to 7 or 14 days. Decolorized Aloe vera was inactive when administered through the drinking water as well as intragastrically. A dose of 150.0 mg/kg, administered subcutaneously to rats, was active vs gelatin, kaolin-, albumin-,carrageenin-, dextran-, and mustard-induced pedal edemaAvo75. Leaf juice, injected into mice at a dose of 10.0%, was active. Inflammation was introduced by the administration of air under the skin producing a pouch followed by administration of 1 % carrageenin directly into the 7 -day-old air pouch, which produced an inflammation characterized by an increase in mast cells and wall vascularity. After administration of the extract, vascularity was reduced by 50% and the number of mast cells was decreased by 48%^AV090. Water extract of dried leaves, administered subcutaneously to male mice at a dose of 20.0 mg/kg, was active^AV076. Water extract of fresh leaf gel (undiluted) was active when applied externally on human adults^AVl49. Fresh leaf gel, applied externally on mice at a dose of 300.0 mg/kg, was active^Avo33.

Antileukemic effect. The effect of diethylhexylphthalate on apoptosis of human leukemic cell lines K562, HL60 and U937 was investigated for its pharmacological activity. At doses of 10 microgram/ml diethylhexylphthalate a significant antileukemic effect was observed for all of the cell lines, as measured by clonogenic assay. After treatment with 10 microgram/ml for 4 hours, agarose gel electrophoresis and flow cytometric analysis confirmed the occurrence of apoptosis. These results indicated that diethylhexylphthalate extracted from Aloe vera has a potent antileukemic effect, and thus represents a new type of pharmacological activity with respect to human leukemic cells^Av205.

Antileukopenic activity. Dried entire plant juice was active vs cobalt-60 or X-ray radiation^Avl2o.

Antimutagenic acitivity. DiethylhexylphthaIate produce anti-mutagenic activity on Salmonella typhimurium mutation assay. The number of mutant colonies of Salmonella typhimurium strain T A98 upon exposure to AF-2 (0.2 microgram/plate) decreased in a concentration-dependent manner in the presence of different concentrations of diethylhexylphthalate. Concentrations of 100, 50, 10, 5, and 1 microgram/plate, reduced AF-2-induced mutagenicity at 91.5%, 89.0%, 80.0%, 77.5%, and 57.4%, respectivelyAV206.

Antimycobacterial activity. Ethanol (95%) and water extracts of fresh leaves, in broth culture, was active on Mycobacterium tuberculosisAvol8. Ethanol (95%) and water extracts, of leaves on agar plate, were inactive on Mycobacterium tuberculosisAvo20. Ethyl acetate extract of dried leaves, on agar plate, was active on Mycobacterium tuberculosis ^AVOI9.

Antipyretic activity. Ethanol (95%) extract of aerial parts, administered intragastrically to mice at a dose of 500.0 mg/kg, was active vs yeast-induced pyrexia^Avo67.

Antitumor activity. Acid/water extract of dried leaves, administered subcutaneously to mice of both sexes at a dose of 0.005 gm/kg, and dried-leaf, administered as a powdered suspension at a dose of 1.0 gm/kg, were inactive on Sarcoma 3?AVI77. Dried juice from the entire plant, administered intraperitoneally to mice, was active on CA-Ehrlich-Ascites and Sarcoma 180 (solidyvl20. Leaf gel of dried gland (ink), administered intraperitoneally to male mice at doses of 10.0 and 50.0 mg/kg, were inactive on Sarcoma 180 (solid). The relative change in the tumor weight was not statistically significant^AVOJ8.

Antiulcer activity. Aqueous slurry (homogenate) of dried exudate, administered by gastric intubation to rats at doses of 0.5 and 1 gm/kg, was inactive vs phenylbutazone-, cysteamine-, and reserpine-induce ulcers; the 500.0 mg/kg dose was inactive vs stressinduced ulcers. Aqueous slurry (homogenate) of fresh leaves, administered by gastric intubation to rats at a dose of 1.0 gm/kg, was inactive vs phenylbutazone- and cysteamine-induced ulcers; a dose of 0.5 gm/kg was inactive vs aspirin-, reserpine-, and stressinduced (restraint) ulcersAvl26. Fresh leaf gel, administered intragastrically to male rats at a dose of 2.0 ml/kg, was inactive. The gel did not prevent ethanol-induced or coldrestraint gastric ulcers. Also, neither pre nor post-treatment accelerated healing of ulcersAvo44. Fresh leaf pulp juice, administered intragastrically to rats at a dose of 2.0 ml/animal daily for 7 days after induction of lesions, was active vs stress-induced (restraint) ulcers and aspirin-inducedulcers^AVIIJ. Blended fresh leaf pulp, administered orally to rats at a dose of 2.0 ml/animal twice daily for 6 days, was active. Ulcer reduction of 50% relative to control was observed vs aspirin-induced ulcersAvI04 . Water extract of leaf pulp, administered orally to rats at a dose of 4.0 ml/animal, was active. Gastric ulcers were produced byvforced immobilization. The effect was both prophylactic and therapeutic^Avo23 .

Antiviral activity (plant pathogens).vEthanol (95%) extract of dried leaves, invcell culture, was active on distortionvringspot, mild mosaic and ringspotvviruses^AVl52.

Antiviral activity. Aloe polymannose, a high mannose biological response modifier purified from the plant, was tested for activity in enhancing antibody titres against coxsackie virus B3 and coxsackie virus B3- induced myocarditis in murine models of the disease. Inoculation of mice with the polymannose over a range of 3 nontoxic doses and in varying schedules did not reduce virus titres in heart tissues or ameliorate virus-induced cardiopathological alterations during acute disease. However, the biological response modifier was found to significantly enhanced titres of anticoxsackie virus- B3 antibodies produced during acute infection of 3 strains of mice with coxsackie virus- B3. Simultaneous intraperitoneal inoculation of the polymannose, at a dose of 0.5 mg/kg body weight per mouse with purified coxsackie virus-B3, significantly increased ELISA titres of anti-coxsackie virus-B3 antibodies and the proportion of mice with these titres, compared with similar parameters in mice inoculated only with coxsackie virusB3. The data indicated that the polymannose can immunopotentiate antibody production against capsid protein epitopes of a nonenveloped picornvirus and suggest this biological response marker might be of benefit in enhancing antibody titres against other enteroviruses during a natural infection and poliovirus vaccine strains^AV20i .

Antiviral activity. Anthraquinone fraction of fresh leaf juice, in cell culture, was active on herpes simplex virus (HSY) 1 AV04J. Methanol extract of dried leaves, applied externally, was active on HSY 1 and 2. The biological actiVity reported has been patented^Avl28.

Antiyeast activity. Ethanol (60%) extract of dried leaves, on agar plate, was inactive on Candida albicansAv091 • Tincture (extract of 10 gm leaves in 100 ml ethanol), at a concentration of 30 microliters/disk on agar plate, was inactiveAV137 . Undiluted fresh leaf juice, in broth culture, was active on Candida albicansAvlol.

Aphthous stomatitis effect. An open study was performed with 31 pediatric outpatients; age 6-14 years, affected by mouth ulcers. For each case, data on case history and clinical profile, patterns of the lesion, presence of spontaneous or provoked pain were collected at baseline, and a bioadhesive patch ("Alovex patch") was administered on the basis of a daily regimen of not less than 3 patches for 4 days. Data on modification of the above-mentioned parameters, with patients and physicians opinion on the therapeutical efficacy, were collected during a control visit (4 days later). Moreover, by means of a daily diary, patients recorded information on the course of the symptoms during the 4 days and were also asked to compare the current treatment with other previous therapies. At the control visit 77% of the patients have shown a marked resolution of spontaneous pain, while in the other patients, pain was significantly decreased to a mild or moderate level. No one declared to suffer from severe pain. Also, provoked pain resulted to be significantly decreased after treatment. Global efficacy was judged positively, being the therapeutic effect in more than 80% of cases as evaluated by physicians and patients. A positive improvement of symptomatology started within the second day of treatment in 74% of the patients. The compliance (adhesive, acceptability and palatability) of the formulation was judged largely favorable in more than 90% of the patients. The results of the investigation underlined the efficacy and compliance of the patch for the treatment of aphtous stomatitis; also the limit of topical available therapies, linked to the "contact time", to develop their therapeutic action, seems not to be evinced on the basis of this investigation, so the application of this patch seems to be more easy and beneficial^Av209.

Arachidonate metabolism inhibition. Anthraquinone fraction of fresh leaf juice was active on calf skin^Av043.

ATP-ase (Na+/K+) inhibition. Anthraquinone fraction of fresh leaf juice increases permeability across colonic mucosa^AV043.

Bradykinin antagonist activity. Exudate of fresh leaf juice was active^Av043.

Bronchodilator activity. Hot water extract of dried leaves, administered intravenously to guinea pigs at a dose of 1.5 ml/animal, was inactive^AVOB6 .

Burn wound effect. In a study comparing moist exposed burn ointment (containing aloe) with conventional management with respect to wound healing, antibacterial and analgesic effect, and hospital costs was investigated in 115 patients between the ages of 12 and 80 who had partial-thickness thermal burns covering less than 40% of body surface area. Fifty seven patients were assigned the moist exposed burn ointment and 58 patients to the conventional method. The latter group received twicedaily dressing changes; moist exposed patients received treatment every 4 hours. The patients were hospitalized until 75% of the body surface area had healed. Body surface area was determined by visual inspection and charted on Lund and Browder charts regularly. Wound healing rate, bacterial infection rate, pain score, and hospitalization costs were recorded. The median time to 75% healing was 17.0 and 20.0 days with the ointment and conventional, respectively. Bacterial infection rates were similar between the 2 groups. The ointment imparted greater analgesic effect in the first 5 days of therapy and reduced hospital cost by 8%. The ointment is as effective as the conventional management but is not the panacea for all burn wounds. The use of the ointment eases the management of face and neck burns and facilitates early institution of occupational therapy in hand burns. It confers better pain relief such that fewer opiates are used during the first 5 days after burn injury^AV21B.

Cardiac depressant activity. Tincture of leaf juice produced weak activity in rabbit heart perfusionAvOO4.

Cell attachment enhancement effect. Fresh leaf homogenates, in cell culture, was active vs human embryonic-lung cells and inactive vs CA-ME-180Av135. Fresh leaves were active on human lung cells and CAcervical- squamous cells^Av170. Leaf homogenate, in cell culture, was active on CA-ME-180 and human embryonic lung cellsAv135. Leaf juice (commercial sample) was active on CA-cervical-squamous and human-lung cells^Av127. Fresh leaf homogenate, in cell culture, was active vs human embryonic lung cells, and inactive vs CAME_180^Av135. Fresh leaves were active on human lung cells and CA-cervical-squamous cells^Av127.

Cell proliferation stimulation. Water extract of fresh leaf gel, in cell culture at a concentration of 0.162 mcg/ml, was active on pheochromocytoma-rat-PC12 cells. A concentration of 0.325 mcg/ml was active on human fibroblast lung-HEL. The result was seen only in long-term culture^Avo46.

Cell transformation inhibition. Freezedried gel, in cell culture, was active on C3H-10Tl/2 cells vs methylcholantrene-induced transformation^Avo37.

Chemomodulatory activity. Fresh leaf pulp extract, administered orally to mice at doses of 30 and 60 microliter/day for 14 days, was effective. The extract was examined on carcinogen-metabolizing phase-I and phase-II enzymes, antioxidant enzymes, glutathione content, lactate dehydrogenase, and lipid peroxidation in the liver. The modulatory effect of the extract was also examined in the lung, kidneys, and forestomach for the activities of glutathione Stransferase, DT -diophorose, superoxide dismutase, and catalase. The positive control mice were treated with butylated hydroxyanisole. Significant increases in the levels of acid soluble sulfydryl content, NADPH-cytochrome P450 reductase, NADH-cytochrome b5 reductase, glutathione S-transferase, DT  diaphorase, superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase were observed in the liver. The extract significantly reduced the levels of cytochrome P450 and cytochrome b5. Thus, the extract is clearly an inducer of phase-II enzyme system. Treatment with both doses produced a decrease in malondialdehyde formation and the activity of lactate dehydrogenase in the liver, suggesting its role in protection against prooxidant-induced membrane and cellular damage. The microsomal and cytosolic protein was significantly enhanced, indicating the possibility of its involvement in the induction of protein synthesis. BHA, an antioxidant compound, provided the authenticity of the assay protocol and response of animals against modulator. The extract was effective in inducing glutathione S-transferase, DT -diaphorase, superoxide dismutase, and catalase as measured in extrahepatic organs. Thus, besides the liver, the lung, kidney, and forestomach were also influenced favorably in order to detoxify reactive metabolites, including chemical carcinogens and drugs^AV204.

CNS depressant activity. Hot water extract of leaves, administered intraperitoneally to rabbits at a dose of 10.0 mg/kg, was active^AV1l4.

Conditioned taste aversion. Frozen stem and leaves, administered intragastrically to rats at a dose of 925.0 mg/kg, was inactive. Administration of test substance was temporally paired with introduction of sodium saccharin solution. Consumption of saccharin solution 2 days after test was used to estimate aversiveness of the test substance^AV127 .

Cosmetic activity. A mixture of Aloe vera, Mentha piperita extract and allan to in was active when applied externally on human adults. The biological activity has been patented^Avo64.

Cytotoxic activity. Ethanol/water (1: 1) extract of leaves, in cell culture, was inactive on CA-9KB, EDso > 20.0 mcg/mIAvoll. Ethanol/water (1: 1) extract of the entire plant, in cell culture, was inactive on CA-9KB, EDso >20.0 mcg/mIAvoo7. Leaf gel of dried gland (ink), in cell culture, produced weak activity on human colorectal cancer cell line SNU-C2A, lCso 5.0 mg/ml and on human SNU-l cells, lCso 5.25 mg/mI^Av038.

Death. Ethanol (95%) extract of the aerial parts, administered intragastrically to mice at a dose of 3.0 gm/kg, was inactive^AV067.

Diarrhea induction and the effect of nitrous oxide. Leaf, administered orally to rats at a dose of 5 gm/kg and 20 gm/kg, produced diarrhea in 20% and 100% of the rats, respectively. Pretreatment with nitrous oxide synthase inhibitor N (G )-nitroL- arginine methyl ester at a dose of 2.5-25 mg/kg reduced the diarrhea induced by 20 gm/kg of aloe 9 hours after its oral administration. It also reduced the increase in fecal water excretion. L-arginine, administered to rats pretreated with N(G)-nitro-L-arginine methyl ester (25 mg/kg) intraperitoneally at a dose of 1500 mg/kg, drastically reduced the effect of N (G )-nitro-L-arginine methyl ester on diarrhea and increase in fecal water excretion induced by 20 mg/kg of aloe. Given alone, L arginine did not modify aloe-induced diarrhea. Basal Ca2+ -dependent nitrous oxide synthase activity in the rat colon was dose dependently inhibited by 0.1-20 gm/kg of aloe and by aloin (0.2-1 gm/kg), the active ingredient of aloe^AV216.

DNA synthesis inhibition. Chromatographic fraction of fresh leaf gel, in broth culture, was active on Bacillus subtilis^AVl14•

Embryotoxic effect. Benzene, water, petroleum ether and ethanol (95%) extract, of leaves, administered orally to pregnant rats at doses of 100.0 mg/kg, were active. 50%, 85%,37%, and 85% reduction in fertility, respectively, were observed. The chloroform extract was equivocal, 28% reduction in fertility^AVo94. Ethanol/water (1: 1) extract, administered orally to female rats at a dose of 200.0 mg/kg, was active^AV1S9. Ethanol (95%) extract of leaf pulp, administered orally to female rats at a dose of 100.0 mg/kg, was inactive^AV009. Ethanol (95%), water and petroleum ether extracts of fresh leaves, administered orally to female rats at doses of 150.0, 150.0, and 100.0 mg/kg, respectively, were inactive^AV1S8. Ethanol! water (1: 1) extract of dried leaves, at a dose of 150.0 mg/kg, water extract at a dose of 125.0 mg/kg and benzene extract at a dose of 100.0 mg/kg, administered by gastric intubation to pregnant rats, were inactive^AV109. Water extract of dried entire plant, administered intragastrically to pregnant rats at a dose of 125.0 mg/kg, was equivocal^AV06J.

Emollient effect. Undiluted leaf juice, applied externally on human adults, was active^Avosl.

Estrogenic effect. Leaf juice, administered orally to immature rats at a dose of 10.0 ml/kg, produced weak activity^AVos2.

Glucose-6-phosphate dehydrogenase inhibition. Anthraquinone fraction of fresh leaf juice was activeAV043.

Hair conditioner. Water extract of dried leaves, applied externally on human adults at a concentration of 86.6%, was active^AV028.

Hair loss inhibition. Fresh leaf gel, applied externally to human adults at a concentration of 6.8 ml/day, was active. Biological activity has been patented^AV014 .

Hair loss stimulant effect. Fresh leaf gel, applied externally to human adults at a concentration of 6.8 ml/day, was active. Biological activity has been patented^Avo34. Fresh, undiluted leaf juice, applied externally to human adults, was active. There was improvement of hair growth in patients with alopecia areata^AV173 .

Hemagglutinin activity. A commercial sample of leaf juice was active^AV127 . Chromatographic fraction of fresh leaf gel was active on human red blood cellsAvo47. Fresh leaf homogenates was active^AV135 . Aloctin I and II, precipitated at 50% ammonium sulphate concentration from crude leaf pulp. Hemagglutinating activity was estimated visually by adding a 4% rabbit erythrocyte suspension to serial two-fold dilutions of the lectins in microtitration plates. None of the 20 sugars tested inhibited hemagglutinating activity of aloctin I up to a concentration of 500 mM. Aloctin II was inhibited by Nacetly- D-galactosamine at 250 mM concentration. Of 10 metal ions tested, only AP+salts were found to activated aloctin I and II. On the other hand, it was shown that neither lectin possessed any alpha and beta galactosidase or alpha and beta glucosidase activity^AV212 .

Histamine release inhibition. Water extract of dried leaves was active on mast cells of rats, ICso 0.14 mg/ml vs antigeninduced histamine release, and ICso 0.92 mg/ml vs compound 48/80-induced histamine release^AV041.

Hypoglycemic activity. Fresh sap, administered intragastrically to mice at a dose of 1.0 gm/day for five days, was active^AV069. Fresh stem juice, administered intragastrically to rabbits at a dose of 4.0 ml/kg, was active. Glucose levels were decreased 27.9%^AVOll. Polysaccharide fraction of dried whole plant was active on mice^AVOS4. Polysaccharide fraction of fresh leaves, administered intraperitoneally to mice at a dose of 100.0 mg/kg, was activeAvoss. Polysaccharide fraction of fresh leaves, administered intraperitoneally to mice at a dose of 100.0 mg/kg, was active^AVi38. Polysaccharide fraction of fresh leaves, administered intraperitoneally to mice at a dose of 100.0 mg/kg, was active^Avoss.

Hypolipemic activity. Hot water extract of dried leaf juice, administered intragastrically to rats at a dose of 0.5 gm/kg for 7 days, was active. The effect was tested by a mixture of Nigella sativa, Commiphora, Ferula assafoetida, Aloe vera, and Boswellia serrata vs streptozotocin- induced hyperglycemia^Av06s.

Hypotensive activity. Tincture of leaf juice, administered intravenously to rabbits, was inactiveAvoo4.

Immunomodulatory activity. Acemannan, a major constituent of Aloe vera gel, was tested on dendritic cells, which are the most important accessory cells for the initiation of primary immune responses. Immature dendritic cells were generated from mouse bone marrow cells by culturing in a medium supplemented with GM-CSF and IL-4, and then stimulated with acemannan, sulfated acemannan, and LPS, respectively. Phenotypic analysis for the expression of class II MHC molecules and major co-stimulatory molecules such as B7-1, B7-2, CD40, and CD54 confirmed that acemannan could induce maturation of immature dendritic cells. Functional maturation of immature dendritic cells was supported by increased allogeneic mixed lymphocyte reaction and IL-12 production. The differentiation-inducing activity of acemannan was almost completely abolished by chemical sulfationAvl99.

Immunostimulatory activity. Lyophilized extract of leaves, applied externally on mice at a concentration of 1.67%, was active vs UV irradiation-induced suppression of contact hypersensitivityAvlSl. Aloeride, at 0.5 microgram/ml, increased NF-kappa B directed luciferase expression in THP-1 human monocytic cells to levels 50% of those achieved by maximal concentrations (10 microgram/ml) of LPS. Aloeride induced the expression of the mRNA encoding IL-beta and TNF-alpha to levels equal to those observed in cells maximally activated by LPS. Acemannan, at 200 microgram/ml in the macrophage assay, resulted in negligible NF-kappa B activation. Analysis of acemannan and aloeride, using size-exclusion chromatography, indicated that the low activity of acemannan is due to trace amounts of aloeride. Although aloe ride comprises only 0.015% of the aloe juice dry weight, its potency for macrophage activation accounts fully for the activity of the crude juiceAV 202 .

Irritant activity. Water extract of dried leaves, applied externally to guinea pigs in a 6-week cutaneous irritation study at a concentration of 5.0%, was inactive^AVllS.

Lectin activity. Chromatographic fraction of fresh leaf gel was active. The fraction bound to alpha-D-glucose and mannose sites^AV047.

Leukocyte migration inhibition. Decolorized extract of fresh leaves, administered subcutaneously to rats at a dose of 25.0 mg/kg, was active vs mustard-induced pedal edema, resulting in 64% reduction in migration and 84% reduction of migration for combination with 0.1 mg/kg hydrocortisoneAvo79.

Metabolism. Aloemannan, administered orally and intravenously to mice at a dose of 120 mg/kg, indicated that aloemannan was metabolized in to smaller molecules that mainly accumulated in the kidneys. Aloemannan was catabolized by the human intestinal microflora to catabolites 1 and 2 with molecular weights of 30 and 10 KD, respectively^AV214.

Mitogenic activity. Chromatographic fraction of fresh leaf gel was active^Avo47.

Molluscicidal activity. Aqueous slurry (homogenate) of fresh entire plant was inactive on Lymnaea columella and Lymnaea cubensis, LDlOo > 1000 ppm^AVlO6.

Mutagenic activity. Ethanol (95%) extract of dried plant juice, on agar plate at a concentration of 10.0 mg/plate, was inactive on Salmonella typhimurium T A98 and produced weak activity on Salmonella typhimurium TA102^AV029.

Neurotransmission effect. The effect of aloe extract on neurotransmission processes in crayfish neuromuscular junction was investigated. The concentration-response relationships of the extract on excitatory junctional potentials at the opener muscle of the dactyl in the first and second walking limbs were studied. Concentration-dependent depolarizations of the muscle fiber membrane resting potential, depression of excitatory junctional potential amplitudes and an increase in latency to onset of the of the excitatory junctional potential following electrical stimulation of the isolated excitatory axon in the meropodite were observed. The effects occurred with concentrations within 1 %-1 0% (wt/vol) range. Effects of lower concentrations, ranging to a minimum of 0.01 % were equivocal. The effects of the extract were at least partially, and in a majority of cases totally, reversible. Excitatory junctional potential reduced by the extract could be restored by increasing the nerve stimulation amplitude. This along with the latency increase suggests a depression of action potential generation and conduction. The results provide a preliminary characterization of the effects of he extract on the neurotransmission process and suggest that these effects may at least partially account for analgesic and antiinflammatory effects of aloe^Av211.

Ovulation inhibition effect. Ethanol/ water (1: 1) extract of leaves, administered orally to female rabbits at a dose of 100.0 mg/kg, was equivocal vs copper acetateinduced ovulation^Avl59.

Oxygen radical inhibition. Water extract of fresh leaf juice, in cell culture, was active on polymorphonuclear leukocytes vs stimulated release. The effect was antagonized by Ca2+ ionophore^AV04J.

Peptidyl transferase inhibition. Dried leaves, at a concentration of 10.0 mg, were active^AV014.

Peroxidase activity. Leaf extract and commercial gel, where it is notably stable, have been investigated for the relevant properties of peroxidase. In vitro, the activity is localized in the vascular system of inner aqueous leaf parenchyma. The acid optimum pH (5.0) for activity and the low KM for HlOl (0.14 mM) suggested that, when topically applied, aloe peroxidase may scavenge H20 2 on the skin surface^AVlO3 .

Phagocytosis inhibition. Aqueous (dialyzed) fraction of fresh leaves, at a concentration of 0.5 mg/ml, was inactive on polymorphonuclear leukocytes. Phagocytosis and intracellular killing of Staphylococcus aureus and Candida albicans were not inhibited^Avl45.

Phagocytosis stimulation. Fresh leaf juice, at a concentration of 4.0 mg/ml, was active^AVll8.

Phorbol ester antagonist. Aqueous (dialyzed) fraction of fresh leaves, at a concentration of 0.5 mg/ml, was active on polymorphonuclear leukocytes vs phorbol myristate acetate activation. Low M-R gelextract- constituents were examined, and oxygen uptake and oxygen and hydrogen peroxide release were inhibited^Avl45.

Hypersensitivity effect. Aloe oligosaccharides prevented suppression delayedtype hypersensitivity responses in vivo and reduced the amount of interleukin-10 observed in UV-irradiated murine epidermis. Aloe oligosaccharide also prevented suppression of immune responses to alloantigen in mice exposed to 30 kJ/ml UVB radiation. To assess the effect of the carbohydrates on keratinocytes, murine Pam212 cells were exposed to 300 Jm2 UVB radiation and treated for 1 hour with the oligosaccharides. The treatment reduced IL-10 production by approximately 50% compared with the cells treated with UV radiation alone and completely blocked UV activated phosphorylation at SAPK/ JNK protein but had no effect on p38 phosphorylation^Avzl7.

Plant germination inhibition. Water extract of dried leaves, at a concentration of 500.0 gm/liter, produced strong activity on Cuscuta ref/exa seeds after 6 days of exposure to the extract. Water extract of dried stem, at a concentration of 500.0 gm/liter, was active on Cuscuta ref/exa seeds after 6 days of exposure to the extract^AV089.

Plant growth inhibitor. Water extract of dried leaves, at a concentration of 500.0 gm/liter, was active on Cuscuta reflexa seedlings length; weight and dry weight were measured after 6 days of exposure to the extract. Water extract of the dried stem, at a concentration of 500.0 gm/liter, was active on Cuscuta reflexa seedlings after 6 days exposure to the extract. Seedling length, weight and dry weight were measured^Av089.

Polymorphonuclear leukocyte activation inhibition. Water extract of fresh leaves, at variable concentrations, was active^AVOZl.

Protein kinase inhibition. Polysaccharide fraction of fresh leaves was active^AVOS7.

Protein synthesis inhibition. Chromatographic fraction of fresh leaf gel, in broth culture, was active on Bacillus subtilisAVl34. Dried leaves, at a concentration of 1.0 mg, were active. Incorporation of leucine into protein was inhibited, as well as elongation factors EF-1 and EF_2^AV074.

Skin pigmentation effect. Water extract of undiluted leaf gel, applied externally to human adults, was active. A preparation containing extract was patch-tested on skin exposed to UVA radiation for 30-180 seconds. Areas treated with preparation showed pigmentation for more than 1 year after treatment^AV088.

Smooth muscle stimulant activity. Tincture of leaf juice was active on rabbit intes-tine, and produced weak activity on the b ladder^AVOO4.

Teratogenic activity. Water extract of dried entire plant, administered intragastrically to pregnant rats at a dose of 125.0 mg/kg, was activeAV063. Water extract of dried leaves, administered intragastrically to pregnant rats at a dose of 125.0 mg/kg, was active^AV03S.

Toxic effect (general). Ethanol (95%) extract of the dried aerial parts, in the drinking water of mice at a dose of 100.0 mg/kg for 3 months, was active. Toxic signs included alopecia, degeneration, and putrefaction of the sex organs, sperm damage and decreased RBC levels. When the extract was administered intragastrically at a concentration of 3.0 gm/kg to mice, it was inactiveAvl4o. Frozen leaf and stem, administered intragastrically to rats at a dose of 925.0 mg/kg, was inactive. Administration of test substance was temporally paired with introduction of sodium saccharin solution. Consumption of saccharin solution 2 days after test was used to estimate aversiveness of test substance, which is related to its toxicityAV127.

Toxicity assessment (quantitative). Ethanol/ water (1: 1) extract of dried leaves, administered intraperitoneally to mice, produced LDso > 1.0 gm/kgAVOll. Ethanol/water (50%) extract of the entire plant, administered intra peritoneally to mice, produced LDso 250.0 mg/kg. The maximum tolerated dose was 100.0 mg/kgAVOO7.

Ultraviolet B protective activity. Gel, applied topically immediately after exposure of shaved abdominal skin of mice to 2.4 Kj/mz ultraviolet B, resulted in suppression of contact sensitization through the skin to 41.1 %, compared to normal irradiated skin. The percentage of recovery of ultraviolet B-suppressed contact hypersensitivity response was 52.3, 77.3, and 86.6% when irradiated skin was treated once with 0.1, 0.5, and 2.5 mg/ml of gel-containing cream, respectively. The gel did not show nonspecific stimulatory activity on contact hypersensitivity responseAV215.

Uterine stimulant effect. Tincture of leaf juice was active on the non-pregnant uterus of rabbits. Stimulation of amplitude of contraction with tonic contraction and loss of rhythmic contraction was observedAvo04. Water extract of leaves, at a concentration of 250.0 mg/liter, was active on guinea pig uterusAVOOB.

Wound healing acceleration. Ethanol (95%) extract of fresh leaf gel, applied externally on guinea pigs at a concentration of 5.0%, was active. Partial thickness bum healing assessed. Similar effect was seen in the use of antithromboxane U38485, lipid peroxidation inhibitor U75412E, and xanthine oxidase inhibitor U4285pv032. A concentration of 5.0% applied externally to human adults was active on intra-arterial drug use-induced injury, frostbite injuries, and partial thickness bums. When applied externally to rabbits, at a concentration of 5.0% the extract, was active alone and in combination with methimazole improved tissue survival in intra arterial drug abuse in rabbit ear model. The extract was not as effective against frostbite injury as methylprednisolone or acetylsalicyclic acid. In rats, 5.0% concentration of the extract alone and in combination with methimazole, improved tissue survival in electrical injury modelAvo32. Ethanol/water (1:1) extract of fresh leaves, administered subcutaneously to mice at a dose of 150.0 mg/kg, was activeAV14B. Fresh leaf homogenates in cell culture was active on CA-ME-180 and human embryonic lung cellsAv135. Fresh leaves, applied topically to human adults, were active. Eighteen dermabrasion patients with acne vulgaris were included in the studyAv143. Fresh leaf juice, applied topically at a concentration of 25.0% and in the drinking water at a dose of 100.0 mg/kg, were active. Both groups were dosed daily for 2 months; the wound healing (6-mm punch biopsy wounds) was significantly faster than the untreated controlAv146.  Fresh leaf juice, applied topically to human adults at a concentration of 40.0%, was active in several cases of Roentgen ray dermatitisAv172. Undiluted leaf juice was active in one case of radiation ulcers of the tongue, floor of the mouth and mandible resulting from intraoral radium therapy and external deep X-ray therapy^AV17o. Fresh leaf gel, administered intragastrically to male rats at a dose of 2.0 ml/kg, was activeAvo4o. Fresh leaf juice, applied to wounds induced with sterile sandpaper in tips of the fingers. of human adults at a concentration of 50.0% in the form of an ointment using petroleum as a base, was activeAV16B. Juice, administered subcutaneously to mice at a dose of 300.0 mg/kg, was active. The juice blocked 100% of the wound healing suppression of hydrocortisone acetateAV039. When applied, undiluted from 1-4 weeks externally on cats, dogs and horses for a variety inflammatory condition, the juice was activeAvlOB. A case of Roentgen ray dermatitis with ulceration in human adults was treated with undiluted fresh leaf juice with positive results. External application produced weak activity on surgically induced skin woundsAv165. It was active in rats vs dermatitis produced by 14,000 Rep of beta radiation and in rabbits on 28,000 Rep of beta radiation^AV17l. The juice, when applied for 14 days, was equivocal in rat vs third degree Roentgen radiation^Av166. Leaf pulp, applied externally on human adults at a concentration of 20.0%, was active. Epidermal cell proliferation was 168% of untreated skin^AV173. Ophthalmic application of undiluted fresh leaf juice was active in rabbits. Traumatic corneal ulcers were produced in 30 animals, and the juice was used as eye drops 3 times dailyAVo97. The juice increased the rate of wound healing in patients with chronic leg ulcers and improved skin conditions in human patients with acne vulgaris, seborrheic alopecia and alopecia areata^AVl7l. Water extract of fresh leaves, applied externally to human adults of both sexes, was active ^AV!OS. Fresh leaf pulp, applied externally to patients with chronic and acute injuries 3 times per week for 3 weeks, was active^AV066. Leaf gel cream was applied to frostbitten rabbit ears. Recovery of tissue was enhanced. The effect was increased by co-administration of pentoxyphyllineAvolo. Undiluted leaf juice, applied externally on female human adults, was active. In one patient with roentgen dermatitis, treatment with fresh leaf juice subsided itching and burning in 24 hours. After 5 weeks, there was complete regeneration of skin, new hair growth, complete restoration of sensation, and lack of scar tissueAVlS3. After treatment of Roentgen ray ulcers in a 40-year-old man by daily application of fresh leaf juice, healing began 4-6 weeks after initiation of treatment, with no pain relief for 2-3 weeks after start of treatment. In the treatment of Roentgen ray dermatitis in a 46-year-old man, pain subsided 48 hours following initiation of treatment. Epithelization started in 48-72 hours after start of treatmentAVlI5. Leaf juice, applied externally on rabbits at a concentration of 30%, was active. When ointment was applied twice daily on experimentally induced thermal burns on the back of rabbits, the lesions healed in 2 weeks without gross evidence of scarringAVlS4. Undiluted leaf juice was active on human adultsAV!3O. Water extract of fresh leaf gel (undiluted), applied externally, was active. The treatment was found to promote fibroblast generation, fibrocytic activity and collagen proliferation in patients who have undergone nasal surgeryAVl49. The leaf gel, administered subcutaneously to mice at a dose of 300.0 mg/kg, was activeAVOll. Water extract of fresh leaf juice, administered subcutaneously to mice at a dose of 1.0 mg/kg, was active. The decolorized extract was used. A 6-mm circular piece of skin was removed from both sides of bodies of normal and diabetic rats. Test groups were dosed daily for 7 days. Treated diabetic animals showed a wound reduction of 47% after 7 days, relative to a 35% reduction in untreated normal controls and 28% for untreated diabetic controls vs carrageenin-induced pedal edema^Avo62. Water extract, administered subcutaneously to mice at a dose of 10.0 mg/kg, was active. Wound healing was more rapid when decolorized aloe (e.g. with anthraquinone removed) was used. When administered subcutaneously to rats, aloe powder (anthraquinone fraction present) was more effective than aloe powder combined with RNA and vitamin CAVOSS. Water extract of fresh leaves, applied topically to human adults at a concentration of 0.5%, was active. The biological activity reported has been patentedAvo81. Undiluted water extract of leaves, applied externally to human adults following dental surgery, was active^AV024. When applied externally on guinea pig, the extract was active vs burn inj ury^Avo43. On human adults, the juice improved laparotomy wounds healing by secondary intention^AV043. Lyophilized gel, applied to induced second degree wounds in rats, was effective. A total of 48 male rats were equally divided into sham controls, untreated burn wound, those treated with once-daily application of normal saline, and those treated with once-daily application of the gel. The animals in each group were equally subdivided into 2 subgroups for the study of cutaneous microcirculation and wound healing on day 7 and 14 after burn. Dorsal skin fold chamber preparation and intravital fluorescence microscopic technique were performed to examine dermal microvascular changes, including arteriolar diameter, postcapillary venular permeability and leukocyte adhesion on postcapillary venules. On day 7, the vasodilation and increased postcapillary venular permeability was encountered in the untreated burn were found to be reduced significantly (P < 0.05) in both the normal saline and gel treated groups, but to a greater extent in the latter. Leukocyte adhesion was not different among the untreated, saline and gel treated groups. On day 14, vasoconstriction occurred after the wound had been left untreated. Only in the gel treated groups was arteriolar diameter increased up to normal condition and postcapillary venular permeability was not different from the sham controls. The amount of leukocyte adhesion was also less observed compared to the untreated and saline treated groups. The healing area of the gel treated wound was better than that of the untreated and saline treated groups at 7 and 14 days after burn. It was evident that the gel exhibits the actions of both wound healing and anti-inflammatory activity when applied on a seconddegree burn wound^AV21o •

INDICATIONS (ALOE; GEL ONLY) (Duke, J. A et al., 2002)

Abrasion (1; WHO); Abscess (f; CAN); Acne (f; CRC; WHO); Acrochordon (f; CRC); Adenopathy (f; DEP); Alcoholism (1; WO3); Alopecia (f; CRC; KAP); Amenorrhea (f; CRC; PH2); Anemia (f; WHO); Apoplexy (f; DEP); Arthrosis (1; CAN; WO3); Asthma (1; CAN; KAP; PNC); Bacteria (1; APA; PH2); Bleeding (1; CRC; WO3); Blindness (f; WHO); Boil (f; AAB); Bronchosis (1; CAN; WO3); Bruise (1; WHO); Bug Bite (1; APA); Burn (1; AAB; CAN; WAM; WHO); Cancer (1; FNF, JAD; JLH; PH2); Cancer, anus (1; CRC; JLH); Cancer, breast (1; CRC; JLH); Cancer, larynx (1; CRC; JLH); Cancer, lip (1; CRC; JLH); Cancer, liver (1; CRC; JLH); Cancer, lymph (f; DEP); Cancer, nose (1; CRC; JLH); Cancer, skin (1; CRC; JLH); Cancer, stomach (1; CRC; JLH; PH2); Cancer, tongue (f; JLH); Cancer, uterus (f; CRC; JLH); Childbirth (f; CRC; DAA); Cold (f; CRC); Colic (f; KAP; PH2); Condyloma (f; CRC; JLH); Conjunctivosis (f; DEP; PHR); Constipation (adult only) (2; DAA; PH2; WAM); Convulsion (f; CRC); Cough (f; APA; CRC; KAP); Decubitis (f; AAB); Dermatosis (1; PH2; WHO; WO3); Diabetes (1; APA; CAN); Dysmenorrhea (f; KAP); Dyspepsia (f; CRC); Eczema (f; CAN; CRC); Enterosis (f; CRC; WO3); Epilepsy (f; KAP); Erysipelas (f; CRC); Fever (f; DEP); Frostbite (1; APA; PH2; WHO); Fungus (1; AAB; APA; MPI; PH2); Gastrosis (f; CRC; WO3); Gingivosis (f; WO3); Glaucoma (f; WHO); Hemorrhoid (f; APA; CRC; WHO); Hepatosis (f; CRC; DEP); Herpes (1; AAB; PH2); High Cholesterol (1; WO3); HIV (1; WO3); Hyperglycemia (1; CAN); Hysteria (f; CRC); Immunodepression (1; CAN; PNC); Indigestion (1; WAM); Infection (1; APA; PH2); Infertility (1; CRC; MPI); Inflammation (1; AAB; CAN; CRC; PH2; WHO; WO3); Ischemia (1; PH2); Itch (f; DAA); Jaundice (f; CRC); Leukemia (f; CRC; JLH); Mouth Sore (1; CAN); Mycosis (1; APA; FNF; PH2; WHO); Ophthalmia (f; DEP); Pain (1; PH2); Peptic Ulcer (1; CAN; CRC); PMS (f; APA); Proctosis (f; CRC); Psoriasis (2; CAN; PH2; WHO); Radiation Burn (1; CRC; DAA; WHO); Rash (1; AAB); Rheumatism (f; WO3); Ringworm (1; APA); Salmonella (1; CRC); Seborrhea (f; WHO); Splenosis (f; DEP); Staphylococcus (1; CRC; PH2); Stomatosis (f; JLH); Streptococcus (1; CRC); Sunburn (1; AAB; PNC; WAM); Swelling (1; CAN; WHO); Syphilis (f; PHR); Trachosis (f; WO3); Tuberculosis (1; DAA; KAP); Tumor (1; CRC); Ulcer (1; AAB; APA; PH2; WAM; WHO; WO3); Uterosis (f; CRC); Vaginosis (f; APA); VD (f; CRC); Virus (1; AAB; PH2; WO3); Wart (f; CRC; JLH); Worm (1; CRC; MPI; PH2); Wound (1; APA; CAN; CRC); Wrinkle (f; WO3).

PRODUCT AVAILABILITY (Linda, 2010)

AVAILABLE FORMS

Capsules: 75, 100, 200 mg extract or powder; cream; gel: 98%, 99.5%, 99.6%; jelly; juice: 99.6%, 99.7%; tincture (1:10, 50% alcohol) shampoo and conditioner

PLANT PARTS USED: Large, blade-like leaf, secretory cells below leaf epidermis, roots (rarely)

DOSAGES (ALOE) (Duke, J. A et al., 2002)

50–200 mg powder (APA); 50–300 mg powder in a single dose at bedtime (AHP); 1 tbsp gel 3 ×/day (APA); 25 mg in 701 mg soybean oil, 1–2 softgels 3 ×/day; apply topically; or 1 tbsp juice after meals (SF). Aloe gel, Barbados aloe, and Aloe powder contain, respectively 4.87, 4.65, and 4.21% aloin, and 2.2, 2.1, and 2.03% aloe emodin.

DOSAGES (ALOE):  (Duke, J. A et al., 2003)

FNFF = !

I would not myself think of it as food but TAN calls it a vegetable and FAC says the gel is often added to juices and jellies; bitter extracts are used in some beverages and candies and Dr. Samst Swedish bitters (FAC; TAN); 50–300 mg powder in a single dose at bedtime (AHP); 50–200 mg powder (APA); 1 Tbsp gel 3 x/day (APA); 25 mg in 701 mg soybean oil, 1–2 softgels 3 x/day; apply topically; or 1 tsp juice after meals (SF).

·         Arabs rub fresh leaves or juice over the body to cool fevers (GHA). Ayurvedics regard the plant as alexiteric, alterative, anthelmintic, aphrodisiac, and useful for asthma, bronchitis, dermatitis, erysipelas, fever, hepatosis, jaundice, leprosy, ophthalmia, splenomegaly, and tumors (KAB).

·         Caribbeans eat the “jelly” for constipation, cough, and sore throat (JFM).

·         Chinese as early as 100 A.D. used aloe for convulsions, dermatosis, fever, and sinusosis (NP9(2):8).

·         Curacaons take the sap for gallbladder ailments (JFM).

·         Greeks in Dioscorides’ time used the sap for boils, dermatosis, itch, sores, and took it internally for infections and stomach disorders (NP9(2):8).

·         Haitians make a hot aqueous extract of dried leaves as an antidiabetic, purgative, and vermifuge (VOD).

·         Jamaicans take the “jelly” in decoction for biliousness and cold (JFM).

·         Kenyans taught me how to use the gel as an efficacious sunscreen (JAD).

·         Latinos eat jelly-like flesh to relieve sore throat (JFM).

·         Omani apply the gel to swollen eyes (GHA).

·         Peruvians apply the gel to burns, conjunctivitis, erysipelas, inflammation, and sores (EGG).

·         Trinidadans steep the flesh in stout, for jaundice; in rum, for pneumonia (JFM).

·         Unani consider the plant antiinflammatory, carminative, digestive, purgative, tonic, and useful for biliousness, hemorrhoids, lumbago, myalgia, ophthalmia, splenitis (KAB).

·         Yucatanese apply heated leaves to abscesses, bruises, erysipelas, and gum boils (JFM).

DOSAGES (Linda, 2010)

Active Bleeding Ulcer

• Adult PO juice: 1 L/day (Murray, Pizzorno, 1998)

HIV/AIDS

• Adult PO: 800-1600 mg/day (acemannan) (Pizzorno, Murray, 2006)

Laxative

• Adult PO dried juice: 50-300 mg at bedtime (Federal Register, 1985)

• Adult PO aloe latex extract: 100-200 mg aloe or 50 mg aloe extract at bedtime (Jellin et al, 2008)

Renal Calculi

• Adult PO dried juice: take a dose just below that of the laxative dose (Murray, Pizzorno, 1998)

Psoriasis vulgaris

• Adult topical cream: 0.5% of a 50% ethanol extract of aloe, combined with castor/ mineral oil tid _5 days/wk _ 1 month

Genital Herpes

• Adult topical cream: 0.5% of a 50% ethanol extract of aloe, combined with castor/mineral oil tid _ 5 days/wk _ 2 wk

Skin Irritation/Wounds

• Adult and child PO capsules: 100-200 mg at bedtime

• Adult and child PO extract: 50-100 mg at bedtime

• Adult and child topical leaf gel: apply prn; do not use on deep wounds

PHARMACOLOGICAL ACTIONS (Barnes, J et al., 2007)

Aloe vera refers to the mucilaginous tissue located in the leaf parenchyma of Aloe vera or related Aloe species. However, many documented studies for Aloe vera have utilised homogenised leaf extracts which therefore combine aloe vera with aloes, the laxative preparation obtained from the bitter, yellow juice also found in the leaf (see Aloes). Unless otherwise specified, the following refers to a total leaf extract.

In vitro and animal studies. Gel preparations have been reported to be effective against radiation burns, skin ulcers and peptic ulcers.(2) However, the gel was also found to be ineffective against drug- and stress-induced gastric and peptic ulcers in rats.(2)

Anti-inflammatory activity has been observed in various rat and mouse models that received subcutaneous injections of Aloe vera leaf extract.(3) A positive response was noted in wound-healing (10 mg/kg, rat; 100 mg/kg, mouse), mustard oedema (10 mg/kg, rat) and polymorphonuclear leukocyte infiltration (2 mg/kg, mouse) tests, although no activity was demonstrated in the antifibrosis test (cotton pellet granuloma) (400 mg/kg, rat).

           

                 Figure 2.  Aloe vera (Aloe vera)                 Figure 3. Aloe vera – dried drug substance (leaf gel)

Anti-arthritic and anti-inflammatory activity have been documented for a cream containing homogenised Aloe africana leaves, ribonucleic acid, and ascorbic acid, following topical application to rats which had been injected (day 0) with Mycobacterium butyricum to cause adjuvant arthritis.(4) This model is considered a good experimental tool for studying rheumatoid arthritis.(4) The cream was found to be active when applied both as a prevention (days 1–13) and as a regression (days 21–35) treatment.(4) Subsequent work suggested that anthraquinone compounds (anthraquinone, anthracene and anthranilic acid) may be the active components in the aloe leaf mixture.(5) These compounds are, however, constituents of aloes rather than aloe vera (see Aloes). Aloe vera juice (presumably containing the anthraquinones contained in aloe preparation) has been applied directly to open pressure sores to assist in their healing.(6) The aloe vera extract exhibited an anaesthetic reaction, antibacterial action and increased local microcirculation.(6) Endogenous cyclooxygenase in Aloe vera has been found to convert endogenous arachidonate to various prostanoids, namely PGE2 (major), TXB2, PGD2, PGF2a, and 6-keto-PGF1ba.(1) The production of these compounds, especially PGE2, has been associated with the beneficial effect of an aloe vera extract on human bronchial asthma(8) (see Clinical studies). Hypoglycaemic actions have been documented for aloes extracts (see Aloes).

CLINICAL STUDIES (Barnes, J et al., 2007)

Enhancement of phagocytosis in adult bronchial asthma has been attributed to a non-dialysable fraction of the extract, consisting of active components that are a mixture of polysaccharide and protein or glycoprotein.(7) Despite the nature of these proposed active components, it has been proposed that activity of the fraction may be related to the previous observation that aloe vera synthesises prostaglandins from endogenous arachidonic acid using endogenous cyclooxygenase.(1) In this study,(7) activity of the aloe vera extract required dark storage at 4–30^oC for a period of 3–10 days.(3) These conditions are reported to be favourable for the hydrolysis of phospholipids, thus releasing arachidonic acid for synthesis of prostanoids.(1) In addition, activity was dependent on patients not having received prior treatment with a corticosteroid.(8) The gel has been reported to be effective in the treatment of mouth ulcers.(8) The literature on burn management with aloe vera gel preparations is confused and further studies are required.(9)

OTHER POSSIBLE ACTIONS (Linda, 2010)

At this time research is minimal on the use of aloe to treat asthma and peptic ulcer. However, studies are underway, and action for these disorders is possible. Aloe has also been shown to inhibit cell transformation and to be antimutagenic (Woo et al, 2002). In Davis et al (2006), no improvement was shown in irritable bowel syndrome in a group of 58 patients, and Shah (2007) reports it is best to wait until further studies have been conducted to use aloe vera for infl ammatory bowel disease.

DOWNSIDES (ALOE): (Duke, J. A et al., 2003)

Gel Class 1 Internally; Gel Class 2d Externally (AHP); Class 2b, 2c, 2d for the powder. Dermatosis; Diarrhea; Intestinal Cramps; Nephrosis; Ulcers. Newall, Anderson, and Phillipson caution that anthraquinones may be purgative, and an irritant to GI tract. Because of its cathartic and reputed abortifacient actions, its use in pregnancy and lactation should be avoided. However, they suggest that topical, but not oral, application might be okay during pregnancy and lactation (CAN). The latex can be a drastic cathartic. Contraindicated for pregnant women and children (LRNP). Do not use internally in pregnancy (WAM). Do not use with undiagnosed abdominal pain (WAM). Do not use internally for more than 10 days (WAM). Epidemiological studies in Germany reveal that abusers of anthranoid laxatives have three times higher rate of colon carcinoma (AEH). May cause allergic dermatosis. Taken in excess it may result in ulcers or irritated bowels (TMA, 1996).

Hypoglycemic. Commission E reports contraindications, adverse effects, and interactions of anthranoid laxatives (AEH). Naturopaths Yarnell and Meserole (1996) state that people allergic to aloe may develop a severe rash following its application. Alcoholic extract at 100 mg/kg for 3 months is toxic in mice (AAB). While not indicting this species, Neuwinger (1996) notes several fatalities from other species of Aloe. Few botanists can identify the species of aloe with nothing but the latex there, no leaf, no flower, etc. (JAD).

EXTRACTS (ALOE): (Duke, J. A et al., 2003)

Aloe gel, Barbados aloe, and aloe powder contain, respectively, 4.87, 4.65, and 4.21% aloin, and 2.2, 2.1, and 2.03% aloe emodin. Gel preparations are reportedly effective against peptic ulcers (unless stress induced), radiation burns, and skin ulcers, and ineffective against stress-induced gastric and peptic ulcers. Healing wounds (10 mg/kg scu rat; 100 mg/kg scu mus); Bezakova et al. (X15751795), finding antilipoxygenase activity for aloe extracts, further rationaliz use of aloe extracts in acute inflammation, especially minor burns and skin ulcers (X15751795). Paulsen et al.  (2005), in a double-blind, placebo-controlled study of commercial Aloe vera gel, found it useful in psoriasis vulgaris. In 41 patients with stable plaque psoriasis, erythema, infiltration, and desquamation decreased in 72.5% [but 82.5% improved on placebo, making it better than the aloe. Sounds like placebo and Zoloft (X15857459).]. Mijatovic et al. (2005) reported antigliomic action of aloe emodin, a chemical found in aloe and many other unrelated species. The antigliomic activity involves induction of both apoptosis and autophagy, as well as differentiation of glioma cells (X15747063). Biswas and Mukherjee (2003) proved vulnerary activity of several folkloric wound healers, including aloe, found effective in experimental models (X15866825).

CONTRA-INDICATIONS, WARNINGS (Barnes, J et al., 2007)

Hypoglycaemic activity has been documented for an aloe vera extract, although it is unclear whether this is associated with the true aloe vera gel or aloes extract.(10) Pregnancy and lactation The external application of aloe vera gel during pregnancy is not thought to be any cause for concern. However, products stated to contain aloes extracts or aloe vera may well contain gastrointestinal stimulant anthraquinone components that are well recognised as the active constituents in aloes (laxative). As such, ingestion of such preparations during pregnancy and lactation should be avoided.

REFERENCE

Barnes, J., Anderson, L. A., and Phillipson, J. D.  2007.  Herbal Medicines Third Edition. Pharmaceutical Press. Auckland and London.

Duke, J. A. with Mary Jo Bogenschutz-Godwin, Judi duCellier, Peggy-Ann K. Duke. 2002.  Handbook of Medicinal Herbs 2nd Ed. CRC Press LLC. USA.

Duke, J. A. with Mary Jo Bogenschutz-Godwin, Judi duCellier, Peggy-Ann K. Duke. 2003.  Handbook of Medicinal Spices. CRC Press LLC. USA.

Linda S-Roth. 2010. Mosby’s Handbook Of Herbs & Natural Supplements, Fourth Edition. Mosby Elsevier. USA.

Ross, I. A. 2003. Medicinal Plants of the World Vol. 1. Chemical Constituents, Traditional and Modern Medical Uses. Human Press. Totowa, New Jersey.\