From plant to patient: a comprehensive review of the molecular mechanisms, clinical efficacy, and industrial applications of Aloe vera.

The Aloe vera is a succulent plant of arid and subtropical climates that has a rich history in traditional medicine and is garnering significant scientific attention for its multifaceted therapeutic potential. This review provides an in-depth analysis of the phytochemistry, pharmacological characteristics, mechanisms of action and clinical application of Aloe vera. Its bioactivity is attributed to a diverse array of compounds, like polysaccharides (acetylated mannans, especially acemannan), anthraquinones (barbaloin, isobarbaloin, aloin, emodin, and aloe-emodin), chromones (aloeveraside A and B, feroxidin, and aloinoside B), enzymes (alliase, alkaline phosphatase, amylase, and bradykinase), and glycoproteins (aloctin A and B). Hydroxyanthracene compounds in aloe latex pose risks of carcinogenicity, genotoxicity, laxative effects, electrolyte imbalance, and organ toxicity, leading to modern safety and filtration laws. This review examines scientific evidence supporting the anti-inflammatory, immunomodulatory, antimicrobial, antioxidant, anti-diabetic, and wound-healing efficacies of Aloe vera, both preclinical and clinical. The molecular pathways involved in these effects are NF-kB, MAPK, PI3K/AKT, and TGF-β signaling pathways and apoptosis induction in cancer cells, which provides a multidimensional anti-cancer effect. Its dermatological uses, such as burns, psoriasis, and wound care; its use in gastrointestinal health; as well as its new application as a functional ingredient and preservative are also reviewed. Although promising, translation into evidence-based medicine is thwarted by challenges of standardization, variability in product quality, and the safety of anthraquinone. The research needs to focus on more rigorous clinical trials, standardized extract development, and more thorough characterization of the interactions between bioactive compounds in Aloe vera to realize the full therapeutic potential of Aloe vera.