Moringa oleifera Lamk. as a Promising Adjunct Therapeutic Candidate: A Narrative Review of Human Studies and Published Case Reports

Erlia Anggrainy Sianipar,1,2,* Sri Adi Sumiwi,3,* Yasmiwar Susilawati,4,* Jutti Levita3,* 1Doctoral Program in Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, Indonesia; 2Department of Pharmacy, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Special Capital Region of Jakarta, Indonesia; 3Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, Indonesia; 4Department of Biology Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, Indonesia*These authors contributed equally to this workCorrespondence: Jutti Levita, Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, Indonesia, Email [email protected]: Moringa oleifera Lamk. a highly valued multipurpose plant, has gained increasing attention owing to its diverse pharmacological properties, including immunomodulatory, antioxidant, and antidiabetic effects. This narrative review evaluates published human studies and case reports from 2015 to 2025 to assess the efficacy and safety of M. oleifera and the underlying mechanisms of its pharmacological effects. A narrative review was chosen over a systematic review because it is flexible, broad-focused, and interpretive, and thus is suitable for mapping emerging fields. A total of 22 clinical trials and nine case reports met the inclusion criteria. This review focuses on five major clinical themes: immunological and nutritional effects, metabolic and endocrine disorders, inflammatory and oxidative stress-related diseases, maternal and child health outcomes, and other clinical applications. Evidence from human studies indicates consistent improvements in immune function, glycemic control, and antioxidant status, particularly among individuals with HIV infection, prediabetes, and malnutrition. Maternal supplementation also enhances the vitamin A content and nutritional outcomes in infants. Mechanistically, these effects are linked to the immune system (modulation of cytokine activity, activation of AMP-activated protein kinase, and antioxidant activity) and to metabolic pathways (inhibition of α-glucosidase and dipeptidyl peptidase IV). Although it is generally well tolerated, rare hypersensitivity and thrombotic events have been reported. Collectively, M. oleifera shows promising potential as a safe and accessible functional food and a nutraceutical or adjunct therapeutic candidate for immune and metabolic disorders, thus warranting further standardized, large-scale randomized controlled trials to confirm its long-term efficacy and safety.Keywords: antidiabetic, antioxidant, drumstick tree, horseradish tree, immunomodulator, metabolic disorders