The world's scientific and social network for malaria professionals
Subscribe to free Newsletter | 10206 malaria professionals are enjoying the free benefits of MalariaWorld today

Is Moringa bad for malaria ?

June 8, 2015 - 20:26 -- Pierre Lutgen

Moringa oleifera is called the „miracle tree“, and has a strong reputation for curing many diseases, but it is impossible to find any peer reviewed paper on PubMed which describes antimarial properties for this plant. This probably does not exclude the presence in the plant of a few molecules which could demonstrate antiplasmodial properties in vitro.

Dry leaves of the plant do not inhibit beta-hematin (G Mergeai, personal communication) in the assay which is often used to screen for antimalarials.

The plant is very rich in proteins, vitamins, polyphenols, minerals, but some recent studies (A Gychye et al., J of Toxicol. 2014, ID786979 ; A Odunlade et al., 5th World Congress on Biotechnology, june 25-27, 2’14) suggest to limit the daily consumption to 70 g because some deterioration in liver functions (increased ALT and AST) has frequently been noticed.

But this hardly explains why the plant has no or only insignificant antimalarial properties.

One of the reasons might be the high concentration of the amino acids methionine and glutamate in Moringa olifeira. The plant is much richer in aminoacids than in polyphenols.

Moringa contains 350 mg/100g methionine in dry leaves vs 50 in Artemisia annua . Methionine is an amino acid which increases the production of lecithin in the liver, it is a precursor of choline and phospholipids (V du Vigneaud et al., Nutrition Reviews 1974, 32, 144-46), the major constituants of lecithin. The latter definitely play a role in hemozoin crystallization on the inner membrane of the food vacuole (Nguyen t Huy et al., PlosOne, 2013, 8, e70025). Plasmodium uses specific carriers to import methionine and choline into the parasitized erythrocyte (ML Ancelin et al, BJ Letters, 1991, 283, 619-621 ; SA Cobbold et al., Int J Parasitol. 2011, 41, 125-35). There is even a bio-assay based on the beta-hematin formation promoted by lecithin for screening new antimalarial drugs (DT Trang et al., Anal Biochem 2006, 349, 292-296). There are not many plants rich in phospholipids and its precursor choline, except soya. Moringa contains 423 mg/100g of choline. A Malaysian study shows that Moringa oleifera oil contains 6.07% of phospholipids and soybean oil 7.15 %. Moringa leaf powder is used as replacement in soybean food for fishes.

Another molecule which boosts malaria is folate. The average folate in vegetables is 40 microg/100g but in Moringa oleifera it goes up to 540 microg/100g (K Witt Echo Research Note No 1, 2012). Several antifolate drugs, like pyrimethamine, are on the market since 50 years. Moringa is rich in glutamic acid – 5 times more than Artemisia- and para-aminobenzoic acid (PABA), two of the building blocks of folate (G Magnani et al., Biochem J, 2013455, 149-155). PABA is a major constituent in Moringa oleifera contains and soya (L Mbanga et al., Adv Biochem & Biotechnol., 2015, 1, 1-13). It was never detected in Artemisia annua. Plasmodium badly needs PABA and folate, And unlike humans, it can use PABA for de novo synthesis of folate. In fact humans do not need PABA. The parasite also eagerly salvages the glutamate provided in the plasma of the host. Parasitized erythrocytes activate a specific high-affinity glutamate transporter (M Winterberg et al., Blood, 2012 119, 3604-3612). This transporter is activated by sodium. Moringa is rich in sodium but the complete absence of sodium in Artemisia annua may contribute to the strong antimalarial properties of this plant. This transporter is also activated by glucose (Ping Wang et al., Mol Biochem Parasitol 2007, 154, 40-51).

The detrimental role of PABA on malaria has been described 60 years ago (F Hawking, British Medical Journal, 1954, Feb, 425-429). Rats fed on a milk diet were insusceptible to infection with Plasmodium berghei. Milk does not contain PABA or only traces. This insusceptibility was reversed by the addition of PABA or folic acid. The same experiences were repeated on monkeys and gave the same results. It is likely that the relative immunity to malaria shown by infants in many parts of the Tropics may be due to a deficiency of PABA in their mother’s milk.

The excellent nutritional properties of Moringa could be related to folates, aminoacids, choline, lecithin and phospholipids. Which unfortunately promote hemozoin formation and help the parasite to thrive. And if the resistance of the antifolate drugs like sulfadoxine-pyrimethamine is increasing and already well documented (R Abdul-Ghani et al., Acta Tropica, 2013, 2, 163-190) the promotion of Moringa olifeira plantations might lead to a disaster.

Pierre Lutgen and Mutaz Akkawi

Comments

Submitted by Marc Vanacker (not verified) on

The blog of Dr Mutaz Akkawi and Dr Pierre Lutgen opens the door for more questions.
Considering the avalanche of claims posted on internet, the support of severals associations (UNICEF, Anamed, Church World Service, Peace Corps…) and the huge market developing around creams and powders based on Moringa oleifera, several research groups have launched in-depth studies on these claims. The result is often frustrating, sometimes frightening. Except for a few peer-reviewed studies confirming the water purification properties of grinded Moringa oleifera seeds no scientific proof has been established for the numerous auto-proclaimed health benefits of this plant.

Moringa oleifera leaves contain important phytochemicals, such as gallic tannins, catechol tannins, steroids and triterponoids, flavonoids, saponins, anthraquinones, alkaloids and reducing sugars. It also contains proteins, vitamins, beta-carotene and amino acids. When taken in large quantities they can cause adverse effects in rats. Many families worldwide consume the leaves over varying periods of time, without knowing the possibility of causing organ toxicity.
Assays made in Uganda showed that Moringa oleifera leaves aqueous extract given to rats orally in a single dose of LD50 for 30 days was associated with mild organ toxicity (JN Kasolo et al., Int J Plant Res., 2012, 1-6, 75-81). A study from Nigeria showed that albino rats had observable lesions in several organs (AA Ambi et al., Int J Pharmaceut Res and Innovat. 2011,4, 22-24). The authors conclude that indiscriminate consumption of the leaves of Moringa oleifera as both food and medicine is not safe for a long period of time. The aqueous seed extract after water purification affects the bile canaculi around the portal vein of the liver and this leads to a significant increase of the enzymes ALT, AST ALP and ACP in serum (A Oludoro et al., Afr J Microb Res. 2009, 3, 537-540). High dose treatment increases bilirubin increase which suggests that the extract which may predispose to jaundice (O Akwari et al., Inter J Of Pharma sciences and Research, 2015, 6 777-82). Another study showed that leaves and seeds contained toxic substances extractable with organic solvents. But a significant depletion in ATP and GSH only occurred at high concentrations (N Mekonnen et al., Phytother Res. 2005, 19-10, 870-75). Moringa oleifera contains glucosinolates which have shown toxicity at high consumption in animal feed. (M.K.Tripathi, A.S.Mishra, Animal Feed Science and Technology, vol. 132,‎ 2007, p. 1-27). Moringa oleifera is genotoxic at supra-supplementation levels (GA Asare et al. J Ethopharmacol 2012 139 265-272).

Several authors studied the impact on blood parameters and found that Moringa oleifera only raised the white blood cell count (AL Asomugha et al., Int J Biomed and Adv Res., 2015, 6, 98-102). Contrary to the hypothesis of the book “Moringa oleifera: the miracle tree”, daily consumption of Moringa oleifera dried leaf powder did not improve iron status and ferritin level in lactating women (N Idohou-Dossou et al. Afr J Food, Agric, Nutrition and Debvelpment, 2011, 11, 4985-90).
The main claim is that this is the plant on our planet with the highest concentration of nutrients of all kinds. So it would be ideal against malnutrition. Some trials had already been run in 1969 on the interaction between, methionine, choline and fat in young rats in respect to weight gain. There are strong interactions, leading in some cases to weight losses (GS Percival et al., 1969, J Nutrition 100, 664-670). A more recent study on broiler chicken confirms these results, including Moringa oleifera leaf powder in a cassava based diet. It was found that above 5% Moringa oleifera powder decreased the weight gain. It is thus not strange to find on the American markets Moringa extracts claiming that choline burns fat and reduces weight. In South Africa it is sold with the claim to cause weight loss as it’s been found to slow the rate at which sugar is released into the bloodstream.

Fresh Moringa oleifera leaves are very rich in Vitamin C, 7 times more than orange juice. The malaria belt of the world (tropical regions) with rich sources of vitamin C constitutes malaria endemic zones, where vitamin C rich food such as citrus fruits and green vegetables abound, a mutual relationship between the two appears to exist.
Ascorbic acid affects malaria in several pathways. Ascorbic acid is probably the most effective absorption enhancer of non-haem iron. This may be beneficial against anemia but is detrimental for malaria. Ascorbic acid may increase parasitemia. The uptake of ascorbic acid into erythrocytes is increased as a result of malaria infection (R Stocker et al., Biochim Phyys Acta 1986, 881, 391-7). Vitamin C particularly enhances the development of young parasites (E Marva et al., Trop J Med Parasitol 1992, 43 , 17-23). It appears that the Plasmodium parasite needs vitamin C.

The most disturbing issue is that several papers find an impact of Moringa oleifera on cancer. The plant is rich in amino-acids known as the building blocks of life, some amino acids may also be important for the spread of cancer.
Methionine for example is an essential amino acid with many key roles in mammalian metabolism such as protein synthesis, methylation of DNA and polyamine synthesis. Restriction of methionine may be an important strategy in cancer growth control particularly in cancers that exhibit dependence on methionine for survival and proliferation (P Cavuoto et al., Cancer Treat Rev. 2012, 38, 726-36). It was found that leucine supplementation differentially enhances pancreatic cancer growth in lean and overweight mice (Kristyn A Liu,#1 et al Cancer Metab 2014, 2 :6 doi: 10.1186/2049-3002-2-6). Another study targeted arginine metabolism pathway to treat arginine-dependent cancers. (Qiu F, Huang J, Cancer Lett. 2015 Aug 1;364(1):1-7. doi: 10.1016). Arginine is a semi-essential amino acid because normal cells can not only synthesize arginine de novo but also take up extracellular arginine. Several types of tumors have abnormalities in arginine metabolism enzymes and completely rely on extracellular arginine to support necessary biological processes. Arginine deprivation demonstrated promising efficacy against arginine-auxotrophic tumors. AICR researcher Gary Meadows, Ph.D., is investigating how restriction of two essential amino acids, tyrosine and phenylalanine, might help prevent cancer metastasis.

More information, caution and research is needed !