Moringa oleifera, also known as the “tree of life” or “miracle tree,” is classified as an important herbal plant due to its immense medicinal and non-medicinal benefits. The Moringa family comprises 13 species,[2,3].

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Morphology

The tree grows rapidly in loamy and well-drained sandy soils, preferring a height of 500 m above sea level [1]. Normally, the tree is small to medium in size, the leaves are naturally trifoliate, the flowers are born on an inflorescence 10–25 cm long [14], and the fruits are usually trifoliate and commonly referred to as “pods” [3]. The trunk usually grows straight but is occasionally poorly formed, the branches are usually disorganized, the canopy is umbrella-shaped; the brown seeds have a semi-permeable hull, and each tree has a capacity of about 15,000–25,000 seeds per year [10].

Botanical and Geographical Distribution

M. oleifera is widely distributed worldwide, but its indigenous origin is in India, Arabia and the East Indies. It is common in Asia, Africa, the Caribbean, Latin America, the Pacific Islands, Florida, Madagascar, Central America, Cuba, the Philippines, Ethiopia, and Nigeria [2,15]. The history of the plant explains that M. oleifera was introduced from India to Africa, Southeast Africa, and the Philippines in ancient times [16,17] (Figure 3).

Ethnomedicinal/Traditional Properties

People worldwide have included M. oleifera in their diet since ancient times because of its vital therapeutic values (Table 1). Various medicines made from the plant are said to have ethnomedicinal properties for curing diseases and have been used for centuries. Approximately every part (leaf, pod, bark, gum, flower, seed, seed oil, and root) of this plant has been used to treat one disease or another [20]

Name of Ayurvedic Text	Form of Plant Used	Treatment	References
Charaka Samhita (1000 BC- 4th Cent. AD)	Powder Decoction	Used for treatment of worms and headache, Ascites, edema Hiccough and asthma, deafness, tinnitus in the ear, worm’s manifestation.	[38]
Ashtanga Hridaya (7th Cent. AD)	Oil	Ear ache, deafness, and tinnitus in the ear	[39]
Kashyapa Samhita (6–7th Cent AD)	Decoction Oil	Puerperal disorder, sleeplessness Edema	[40]
Sharangadhara Samhita (13 Cent. AD)	Decoction	Conjunctivitis	[41]
Yogaratnakara (17th Cent. A.D.)	Decoction	Enlargement of spleen, worm edema, Ascites, fever, abscess.	[42]

Pharmacological Uses

Recent pharmacological studies have revealed that different extracts of M. oleifera exhibit different pharmacological activities, such as antimicrobial [43], pharmacological activities mentioned below (Table 2). Phytoconstituents of Moringa and their relevant therapeutic effects

Plant Part	Compound	Class	Structure	Therapeutic Activity	References
Leaves	Rutin (555.6 µg/g)	Flavonoid		Found to have maximum affinity and interaction towards BRAC-1 gene.	[49,50]
Leaves	Kaempferol (197.6 µg/g)	Flavonoid		Oxidative damage protective activity.	[51]
Leaves	Quercetin (2030.9 µmol/100 g)	Flavonoid		Exerts an excellent effect as anti-diabetic agent.	[52]
Leaves	O coumaric acid (0.536 mg/g)	Phenolic acid		Antioxidant and anti-microbial	[53,54]
Leaves	Myricetin (5.804 mg/g)	Flavonoid		Potential prevention of diabetes mellitus and other diabetic complications	[54]
Leaves	Ellagic acid (0.078 to 0.128 mg/g)	Polyphenol		Prevents viral and bacterial infections, potential antioxidant	[54,55]
Leaves	Ferulic acid (0.078 to 0.128 mg/g)	Phenol		Promising results as anti- cancer, antioxidant, antithrombotic, anti-arrhythmic, and anti-inflammatory.	[54,56]
Leaves	Caffeic acid (0.409 mg/g)	Phenol		Boosts athletic performance, reduces fatigue, helps weight loss, protects against herpes, HIV, cancer.	[54,57]
Leaves	Sinapic acid (trace amount)	Phenol		Cardioprotective, renoprotective, anxiolytic, neuroprotective.	[54,58]
Leaves	Gallic acid (1.034 mg/g)	Phenol		Anti-inflammatory, anti-neoplastic, anti-oxidant	[54,59]
Leaves	Syringic acid (trace amount)	Phenol		Anti-oxidant, antimicrobial.	[54,60]
Leaves	Isorhamnetin (0.118 mg/g)	Flavonoid		Anti-oxidant	[54,61]
Seeds	Myricetin (5.804 mg/g)	Flavonoid		Potential prevention of diabetes mellitus and other diabetic complications	[54]
Seeds	Glucomoringin	Glucosinolates		Anti-inflammatory, pain relieving, anti-oxidant, antihypertensive.	[62]
Seeds	β-sitosterol	Phytosterol		Anti-inflammatory	[63]
Seeds	Arachidic acid	Fatty acid		Increased breast milk production	[64]
Seeds	Oleic acid (70% w/w)	Fatty acid		Reduces blood pressure and reduces free radical damage to the cell.	[65]
Seeds	Myristic acid	Fatty acid		Anxiolytic effect, used in membrane localization of the enzyme.	[66]
Seeds	Palmitic acid	Fatty acid		Trypanocidal and anti-leukemic effect	[67]
Seeds	Procyaniadin	Flavonoid		Cardioprotective	[68]
Flower	D-mannose	Carbohydrate		Treatment of deficiency caused by genetic defects, and acute urinary tract infections.	[69]
Stem	β-sitosterol	Phytosterol		Anti-oxidant, cardiovascular, immunomodulatory	[63]

Antimicrobial and Antifungal Activity

M. oleifera ethanolic root extract contains a compound N-benzylethyl thioformate (an aglycone of deoxyniazimincin) responsible for the antimicrobial and antifungal effect toward an extensive array of microbes and fungi [44]. M. oleifera methanolic leaf extract may exert inhibition of urinary tract infections caused by Gram-negative and Gram-positive bacteria such as Klebsiella pneumoniae, Staphylococcus aureus, Escherichia coli, and Staphylococcus saprophyticus [69].[70].[43].[71].[72].[73].[74].

Anti-Inflammatory Activity

A significant anti-inflammatory effect was observed in different parts of M. oleifera (leaf, pods, flowers, and roots). It was observed that the isolated compound (4-[2-o-Acetyl-alpha -l-rahamnoslyloxy) benzyl] thiocynate from Moringa possessed nitric oxide inhibitory activity and was subsequently found to be effective in Raw264.7 cell lines [75].

Oxidative Stress

The antioxidant activity of ethanolic extract M. oleifera stems exhibited a protective effect against epidermal oxidative stress injury induced by H₂O₂ in keratinocytes. The result displayed that the stems showed antioxidant potential, and, therefore, can be used as an excellent and preventive source in animal epidermal oxidative stress injury [80].

Anti-Oxidant Activity

Bioactive compounds such as glycosylates [82], isothiocyanates [62], thiocarbamates [83], flavonoids [84], and certain other compounds from Moringa pods have been investigated for reactive oxygen spices. The aqueous extract has been shown to be a potent free radical scavenger against free radicles [45].[85].[86].[87].

Anti-Cancer Activity [15,47].

Fertility and Anti-Fertility Activity [44].[89].

Hepatoprotective Activity [90].[91].

Cardiovascular Activity [92].[93].

Anti-Ulcer/Gastroprotective Activity [96].[97],

Neuropharmacological Activity [98,99].

Neuropathic Pain [100].

Wound Healing Effect [102].[103].

Immunomodulatory Activity [104].

Hematological Activity [105].

Anti-Obesity Activity [106].[107].

Anti-Allergic Activity [32].

Anti-Diabetic Activity [45].[108].[109].

Diuretic Activity [23].

Angiotensin Converting Enzyme (ACE) Activity [111].[112].

Conclusions and Future Perspective

The review summarizes various aspects of M. oleifera, including its worldwide research, ethnopharmacology, pharmacology activities, phytochemistry, phytopharmaceutical formulations, clinical studies, toxicology, and other miscellaneous parameters. The presence of alkaloids, phenolic acid, glycosides, sterols, glucosinolates, flavonoids, terpenes and fatty acids are responsible for the medicinal effects of M. oleifera. In addition, M. oleifera is also rich in compounds such as vitamins, micronutrients, and carotenoids which increase its medicinal value and consumption as a superfood. Pharmacological studies show that the active constituents of the plant have effectively cured various diseases such as neuropathic pain, cancer, hypertension, diabetes, obesity etc. Nevertheless, several phytochemicals have yet to be explored for their possible therapeutic benefits. In addition to its clinical use, the plant is also used as an effective biostimulant for farmers in their fields and has proven to be a cost-effective alternative. Overall, M. oleifera signifies its name, “Miracle tree,” and appears to be a phytopharmaceutical and functional food that, if consumed daily, can potentially treat various chronic diseases in humans and could be used by medical practitioners as a safer alternative to treat various ailments.