Abstract: Aloe is used in various ways, in different forms and for a range of purposes of which some uses has been proven by scientific findings to be useful. The evidence for any proven benefits is somewhat limited whilst other proposed used are reported to have harmful effects on the body. Due to the documented benefits, the design study aims to test the effects of aloe on cancerous cells i.e. HL60 cells, from the bone marrow. This will be done through tissue cultures and whether or not the cells are replicating with addition of aloe will be monitored. The results of which will be plotted as a growth curve. complete
The genus Aloe comprises of over 275 species, four of which has commercial uses (Gage, 1996, p. 2). The most popular, Aloe barbadensis Miller (generally known as aloe vera) is used worldwide as it is reputed for its healing, medicinal and therapeutic qualities (Gage, 1996, p. 2). Its popularity is amplified as is it the most readily available of the species; although it was first documented in the African continent, nowadays it is farmed in most hot, dry areas. The aloe vera plant has characteristic 'fleshy' leaves that have thorns at their edges bearing a cactus-like resemblance. The thick 'fleshy' fillets are thought to be a veritable medicinal chest, however many of the thought properties have not yet undergone proper scientific experimentation or have insufficient evidence in support of this. Never mind the fact that, most of the reports are anecdotal so investigations are required to test their validity (12). The
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Aloe is often used for the treatment of dry skin, burns, radiation burns (radiation dermatitis), psoriasis, seborrhoea, wounds, ulcers and genital herpes. Its healing capacity is attributed to the fact that it has immune-stimulatory, anti-microbial, anti-inflammatory and anti-thromboxane activity (3). Two of the components of aloe; allantoin, and acemannan have been shown to have stimulatory effects on epithelialisation and macrophage product of IL-1 and TNF which are associated with wound healing respectively (Liptak 1997).
Dry skin: The inner clear gel is thought to have profound healing and rejuvenating properties for the skin. Consequently, it is traditionally used in most cosmetics and moisturisers. A study was carried out with the use of dry-coated aloe vera gloves by 30 women, all of whom had dry, cracked, hands. Women wore the gloves on one hand 8 hours daily for a period of 30 days then a rest period was allowed then a further 10 day of treatment. The final results reveal that aloe gloves caused a significant reduction in dry skin, redness, wrinkling, irritation, dermatitis and improvement in skin integrity. It would be interesting to see result of a repeated trial whereby the other hand had a 'non fortified aloe glove'. The reasoning behind the results is that, after aloe is absorbed into the skin, it increases the activity of fibroblasts i.e. increases their replication. This stimulates fibres such as collagen and elastin production which are important products that give the skin structure, plumpness and elasticity (13). When more collagen and elastin is produced, it gives the skin a younger-looking appearance.
Skin burns: Additionally when applied topically to burnt or chemically damaged skin, early evidence has suggested that aloe has healing effects on mild to moderate skin burns. A study was carried out involving 27 patients with partial- thickness burn injury. Through topical application of aloe gel the rate of healing significantly increased compared to the control group who used Vaseline gauze. The mean healing time was 11.89 days whilst that of the placebo group was 18.18 days (ref). Furthermore, treatment with aloe had full epithelialisation after 14 days 9 (ref).
On the contrary , it is thought to impair the healing process of second degree burns hence further research is required into this area (24). ....elaborate
Radiation dermatitis: In addition, some cancer sufferers use aloe gel on skin irritations (radiation dermatitis) caused by prolonged exposure to radiation during radiotherapy. Scientific evidence gathered from an open trial with 225 women has however revealed lack of benefit in this area. Furthermore, another study evaluated the use of aloe soap by 73 men and women with different types of cancer that were undergoing radiotherapy. The finding reported no actual benefit unless a higher dose of aloe extract was used (11).
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Wound Healing: There are mixed reviews in studies regarding the effectiveness of aloe in healing when applied topically onto wounds. Of the findings gathered, some are positive whilst others note no beneficial effects or that the condition may worsen. This was the case in a study whereby aloe vera was found to slow the rate of wound healing. The test was carried out on 22 women who had wound complications and therefore required healing by second intention after delivery by caesarean section (8). The protocol entailed the use of aloe in some women and a non use of aloe in others. The findings reported healing to take a mean 53 +/- 24 days without aloe whilst the use of aloe gel prolonged wound healing having an average at 83 +/- 28 days (8).
Skin Ulcers: What's more, aloe vera is believed to aid in the healing process of skin ulcers (18). This idea is supported by early studies nevertheless more comprehensive studies may be required, perhaps with the monitoring and comparison of the effects of aloe vera to the use of a placebo in test subjects. Aloe vera is believed to impact pressure ulcers (16). A component (acemannan) of the aloe gel was applied topically in the human study and no benefits were found.
Seborrhoea: A study was conducted in which the usefulness of aloe was shown in relieving the symptoms of Seborrhoea, a common skin condition. The symptoms of this condition consist of oily, red, and scaly eruptions in such areas as the ears, eyebrows, chest and groin (9). The study, double blind and placebo controlled, comprised of 44 people who through the topical use of aloe ointment for 4 to 6 weeks found reduction and relief in the symptoms (9).
Psoriasis: Psoriasis is another chronic skin condition characterised by excess skin formations (patches) and areas of inflammation. Aloe vera is believed to have natural, anti-inflammatory and painkilling properties. A study was carried out to test if this was factual and aloe could therefore be used to treat the above condition. The 60 men and women recruited for this double-blind study had mild to moderate symptoms of Psoriasis (10). Some of the participants used aloe extract (0.5%) as a cream which was applied topically 3 times daily whilst others used a placebo cream. This was done over 4 week's duration. The trial revealed the results of aloe to better than the results retained by the placebo. Also after the treatment was halted, the results maintained for up to a year. Those that completed the study reported a 'high level of complete "cure"' (10), however this statement is unclear. What more, another study was carried out and failed to replicate the results of the above test. This trial, also done over 4 weeks, reported improvement in 72.5% of skin patches that had undergone treatment with aloe (19). On the other hand, the results of the placebo trial revealed improvement in 82% of skin patches (19). The retained results are different and favoured the placebo. From this it can be said that perhaps aloe is in fact beneficial for treatment of Psoriasis or maybe it inhibits the improvement of skin patches. Because of this more conclusive trials are required.
Herpes: Another use of an aloe extract is in the form of a hydrophilic cream for the treatment of genital herpes in men (17). A double blind placebo-controlled test had 60 recruits who had active genital herpes (5). The aloe cream (0.5% aloe) was tested in relation to the placebo cream over a period of 2 weeks. Topical application was done 3 times a day over the course of the treatment and it was found that the aloe cream caused a reduction in the time taken for lesions to heal (4.9 days versus 12 days) (5). 66.7% of the lesions in the participants who used aloe had fully healed after the 2 weeks had ended (5). This is a fairly large percentage to 6.7% healing of lesions in those that used the placebo. This study had been carried out previously by the same author which he used 120 men with genital herpes. In that study he found aloe worked much better as a cream than both the pure aloe gel and the placebo (4).
Mucositis (mouth sores) is a repercussion of radiotherapy; aloe vera is used as a preventative measure or to improve the condition, however early evidence has proved otherwise (18). Furthermore, early evidence pointed out that aloe vera taken orally decreases the risk of lung cancer development (ref). This claim requires more in-depth study. Also, highly concentrated aloe is used to make a product called T-UP to be taken orally or injected directly into either the bloodstream or tumour (15). Its use is dubbed as therapeutic for cancer although, injection of T-UP has lead to death in quite a few cancer patients. A component in aloe, acemannan when given to mice's in a study is shown to stimulate cytokines, bringing about an immune attack on implanted sarcoma cells, leading to necrosis and regression of cancer cells (Braun et al, 2007, p. 138).
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Aloe vera is often used for the treatment of disorders of the mouth, one of which is Canker sores (aphthous stomatitis). This is a recurrent condition so it is thought that aloe gel reduces pain and increases that amount of time before the sores reappear (18). The evidence that this is the true effect of aloe is quite weak so further study is necessary before recommendations can be made. Another mouth condition is Oral Lichen planus (OLP); a chronic inflammatory disease that affects the mucus membrane of the mouth (21). A study was carried out in order to assess and make comparison between the efficacy of aloe and a placebo as a topical treatment of OLP. 54 randomised patients suffering for OLP participated in the double-blind placebo controlled study; half were given aloe vera gel or the placebo for use over an 8 weeks period. The findings reported aloe vera gel to be more effective than the placebo in alleviating the symptoms (6). For that reason it is deemed as an alternative measure for the treatment of OLP.
Laxative: Upon breaking of the crisp outer skin of the aloe, there is strong smelling, bitter tasting yellow sap 'aloe latex'. When this is dried and made into a powder, it has strong laxative effects and therefore has been used and employed by the pharmaceutical industry as an ingredient in commercial laxatives. Dried latex is taken orally as a preventative measure of constipation. Aloe vera and its effect on humans have undergone few studies, although, there are strong scientific evidence in support of the laxative property of 'aloin (barbaloin)' which is a component of aloe vera (Park et al, 2006, p. 171). On the contrary, 'Medical sources such as the American Medical Association and the American Pharmaceutical Association has recommended that aloe vera not be used as a laxative as it causes intestinal griping and cramping' (Gage, 1996, p. 4).Nevertheless, further study is required to designate dose amounts, affectivity, and safeness of aloe vera for the purpose outlined above.
Digestion: Aloe aids in healthy digestion i.e. it helps substances and nutrients (especially protein) to be absorbed more efficiently into the bloodstream.
Its use, spanning thousands of years, this 'miracle plant' possesses 19 of the 20 amino acids that are required by the human body including the essential ones that body cannot itself synthesise (13). The body gains sufficient amino acids allowing complex enzyme systems to work well so the body can function to its maximum capacity leading to an overall feeling of well being (13). As well as this, there are also bountiful amounts of vitamins and minerals present within the aloe. Traces of vitamin B12 can be found which is an odd occurrence as is it is almost never found in plants, however this along with vitamin A, B-group vitamins, Vitamin C, E and folic acid are present (Park et al, 2006, p.127 ). Vitamins are needed by the body so it can operate efficiently and allow body systems to function properly. The mineral content consists of calcium, sodium, potassium, iron, chromium, magnesium, manganese, copper zinc and finally selenium (an anti-oxidant) (13). These are all useful in the proper functioning of complex enzyme system as well as metabolic pathways. Vitamin E, vitamin C and selenium all act as antioxidants and builds up the body against oxidative stress (25). The role of the antioxidants is to 'mop up' free radicals that may harm the body cells and lead to cancer (25).
Bowel: Research is promising in the area for the use of oral aloe vera to treat active Ulcerative colitis (UC); an inflammatory bowel disease. The double-blind, placebo controlled study comprised of 44 people, all of which had UC. As before, aloe gel was used in doses of 100ml twice a day for duration of 4 weeks. The results concluded that, half of the users or aloe responded well to the treatment; and 30% had complete remission (7). The occurrence of beneficial effects was rare within the placebo controlled group. Due to the study being quite small, the results cannot be deemed conclusive therefore more studies are required.
Diabetes: Evidence gathered from two testing has suggested that aloe gel taken orally is capable of causing an improvement in the control of blood sugar levels in persons with type 2 diabetes. The potential beneficial impact of aloe vera was assessed in a single-blind placebo-controlled test of 72 or 40 people with diabetes over 2 week duration. The conclusion drawn from the results of the trial is that blood sugar levels are significantly improved in diabetic when treated with aloe. The other single-blind placebo-controlled study aimed to make assessment in the benefits of aloe vera in 36 diabetic people who had failure in responding to an oral diabetic drug (glibenclamide) (22). A number of people who were taking both glibenclamide and aloe had noticeable improvements in their blood sugar levels after the 42 day trial in comparison to those who only took the glibenclamide and placebo (22). Even though these results seem promising, larger studies that are double blinded would have been preferable in order for aloe to be established as an effectual treatment of hypoglycaemia.
Coronary Heart Disease: Coronary Heart disease, characterised by blood fat accumulation within arterial walls has lead to many deaths within the population. Studies carried out, both in animals and humans have proposed that ingestion of aloe may effective in lowering concentrations of serum cholesterol, triglyceride and phospholipids. This proves useful as when levels of these substances are high they seem to speed of the deposition of fat in arteries, including the coronary artery. This proposal is supported by an animal model experiment whereby albino laboratory rats were used. Their diet had of high cholesterol intake whilst the control group were fed glucomannan (a polysaccharide) from aloe vera (12).
In one study, fractions of aloe were show to stimulation the production of antibodies as well as phagocytes when injected into guinea pigs (12).
HIV: Another thought property of aloe vera is in the counteraction of HIV infection, this is due to the fact that it is proved to have anti-viral qualities. Within the mucilage layer of the leaf that surrounds the inner gel, there is a long chain of sugar polysaccharide. This acts as an immune-modulator and therefore helps to defect against attacks from various viruses. Additionally a component of aloe vera (acemannan) was found to increase the activity of an anti-HIV drug AZT in clinical trials ((Braun et al, 2007, p. 141). Also 'the polysaccharide was given to 8 patients with ARC (Aids related complex), Walter Reed staging 3-6 (13). This was consumed in portions of 450 milligrams four times daily (13). After the 90 day therapy, all of the patients had noticeable improvements with a reduction of 2 Walter Reed stages on average (13).
Used internally, researchers is China reported aloe to have a protective role for liver cells as extracts of aloe were given to 38 patients who had chronic hepatitis and their symptoms were alleviated i.e. the was an 87% reduction is inflammation (23). This is due to the fact that there are anti-inflammatory agents such as salicylic acid within the aloe.
A test carried out by Doctor Peter Atherton revealed that people who were suffering from Arthritis, after taking aloe vera had a reduction in the anti-inflammatory and painkilling tablets which they used (ref). This was because through the use of aloe they experienced less abdominal pain and had less indigestion.
Moreover of the Asthmatics that were tested, a lot of them (after using aloe vera), were able to cut down on their use of inhalers (13). The conclusion drawn from the positive result experienced by those suffering from arthritis and asthma was put down to aloe vera having anti-inflammatory effect as well boosting the immune system.
Allergy: An online survey was done, from the overall observed result it can be said that aloe vera is effective for the treatment of hay fever in 40% of those surveyed whilst 60% had not effects (14).
Dr. Ivan Danhof who had worked in the cosmetics industry for 30 years thus had used topical aloe products. When testing new aloe product for texture, smell and penetrability, he always applied a small amount to the back of his left hand (13). Because of this he declared himself to have one hand with the appearance of a 70 year old; thin, wrinkled, and blemish filled whilst the other retained the appearance of someone 30 years younger, smooth and clear.
Uses based on scientific evidence
Diabetes (type II)
Key to Grades:
A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence against this use
F: Strong scientific evidence against this use
Aloe contains many amino acids including a few of the essential ones, along with minerals, proteins and vitamins. These components aids oxidative stress prevention and also allow complex enzyme systems and metabolic pathways to function effectively and efficiently leading to overall good health and a feeling of well being. It has medicinal and therapeutic qualities when used in vivo or through topical application. It is able to heal ulcers, both internally and externally as well as burns, wounds and lesions of the skin. Irritations of the skin such as Psoriasis and Seborrhoea can be treated through topical application of aloe. In addition it is used to treat conditions such as arthritis, diabetes, and asthma although it does have some implications. It also had positive effects on disorders of the mouth such as, canker sores. Treatment include that of more serious conditions consists of HIV, and cancer due to having immune regulator function as well as, anti viral and anti bacterial capabilities.
The retained results of many of the trials were fairly inconclusive due to a few reasons i.e. the patient numbers that were tested are quite small. Also results vary depending on the type of aloe used i.e. the form whether gel or cream as well as the aloe percentage in that particular product. Furthermore the majority of the findings reported states that further research is still required regardless of what was concluded. All the components work well in combination i.e. there effects are amplified and are even more powerful when used together than when they are separate.