Mangosteen

Common Names

How It Works
Mangosteen has not been shown to treat cancer in humans.
The fruits of mangosteen are used in traditional medicine in Southeast Asia to treat skin infections, wounds, and diarrhea. Laboratory studies have shown that compounds present in mangosteen fruit are effective against bacterial and fungal infections and can reduce inflammation. Other studies have shown that mangosteen can inhibit the growth of various types of cancer cells. There is also evidence that some compounds in mangosteen act as free-radical scavengers to prevent damage by low density lipoprotein (LDL), more commonly known as bad cholesterol. However, it is not known at the present time if the same effects occur in the human body.
Purported Uses
- Wound healing
  Clinical data are lacking.
- Inflammation
  Laboratory studies suggest that mangosteen inhibits enzymes involved in inflammation.
- Diarrhea
  This use is not supported by clinical trials, and in an animal study appeared to worsen ulcerative colitis.
- Ulcers
  There are no clinical data to support this use.
- Antibacterial
  Laboratory studies have shown that mangosteen has antibacterial properties.
- Antifungal
  Several studies have indicated that the compounds present in mangosteen are effective against some fungi.
Do Not Take If
- You are taking cytochrome P450 substrate drugs: Mangosteen may increase the risk of side effects of these drugs.
- You are taking calcineurin inhibitors (cyclosporine, tacrolimus): Compounds isolated from mangosteen may have additive immunosuppressant effects if used with related drugs.
- You are undergoing chemotherapy or radiation therapy: Mangosteen products have antioxidant effects and may therefore interfere with the intended effects of cancer treatments.
- You have diabetes: Mangosteen is high in sugar content.
- You have ulcerative colitis: Animal studies show that it can exacerbate symptoms of ulcerative colitis.
Side Effects
Case Report: Severe lactic acidosis following consumption of mangosteen juice daily for 12 months.
Scientific Name
Garcinia mangostana
Clinical Summary
Mangosteen is a tropical plant native to Southeast Asia. The fruits are consumed as food but also used in traditional medicine to treat skin infections, wounds, and diarrhea. Mangosteen juice is marketed as a health drink and the pericarp, or fruit hull, can be found in many dietary supplements for their antioxidant activity. Preliminary evidence shows that xanthones from mangosteen exhibit antibacterial ⁽³⁾, antifungal ⁽⁴⁾, anti-inflammatory ⁽⁵⁾, antiatherosclerotic ⁽⁷⁾, anti-asthmatic ⁽²⁶⁾, antiangiogenic ⁽²⁷⁾, cytotoxic ⁽¹²⁾, aromatase-inhibitory ⁽¹⁴⁾, and anticancer ⁽¹⁷⁾ ⁽¹⁸⁾ properties. They may also provide protection against doxorubicin-induced neurotoxicity ⁽¹⁹⁾ and cisplatin-induced nephrotoxicity ⁽¹⁶⁾.
Small studies in humans suggest benefits with mangosteen-containing products as an adjunct for periodontal treatment ⁽²⁰⁾ and for control of halitosis ⁽²¹⁾. An herbal formula containing mangosteen extract may be helpful in weight management ⁽²⁸⁾ ⁽²⁹⁾, but confirmatory studies are needed.
Mangosteen products may interfere with certain chemotherapeutic drugs. Patients with diabetes or ulcerative colitis should also avoid mangosteen due to high sugar content and hypothetical potential for exacerbation of symptoms, respectively.
Purported Uses
- Infections
- Diarrhea
- Inflammation
- Wound healing
Mechanism of Action
Many compounds isolated from mangosteen fruit and pericarp have been used in lab studies. Xanthones alpha- and beta-mangostins and garcinone B exhibit strong inhibitory effects against Mycobacterium tuberculosis ⁽³⁾, as well as aromatase-inhibitor activity ⁽¹⁴⁾. Alpha- and gamma-mangostins act as histamine and serotonin receptor blockers ⁽⁸⁾ and inhibit HIV-1 protease ⁽⁹⁾. In animal models, they reduced major features of allergic asthma including airway inflammatory cell recruitment and hyperresponsiveness, increased Th2 cytokine levels, and attenuated increases in phosphoinositide 3-kinase (PI3K) activity, phosphorylation of Akt, and NF-kappaB ⁽²⁶⁾. The ability of alpha-mangostin to inhibit fatty acid synthase may occur via stronger action on the ketoacyl synthase domain and weaker effects on the acetyl/malonyl transferase domain ⁽²²⁾. It also reduced prostaglandin synthesis by inhibiting COX-1 and -2 enzyme activities ⁽⁵⁾, and prevented oxidative damage of LDL by functioning as a free-radical scavenger ⁽⁷⁾. The compound isogarcinol isolated from mangosteen induces anti-inflammatory and immunosuppressant effects in animal models ⁽³⁰⁾ ⁽³¹⁾. Mangosteen extract may have antiobesity effects by increasing AMP-activated protein kinase and Sirtuin 1 activities in the liver ⁽⁴²⁾.
Chemopreventive properties of mangosteen xanthones against specific human cancer cell lines have also been demonstrated, including: alpha-mangostin in leukemia ⁽¹⁾ ⁽⁶⁾ ⁽³²⁾, breast ⁽³³⁾ ⁽³⁴⁾, gastric ⁽³⁵⁾, and pancreatic cancer cells ⁽³⁶⁾ ⁽³⁷⁾; gartanin in urinary bladder cancer ⁽³⁸⁾; and gamma-mangostin ⁽³⁹⁾ and garcinone E ⁽¹⁰⁾ in liver cancer cells. Extracts from the pericarp of mangosteen also exhibit antioxidant ⁽¹³⁾, antiproliferative, and apoptotic effects ⁽¹¹⁾.
The preventive effect of alpha-mangostin on cisplatin-induced apoptotic death is associated with the inhibition of p53 expression and generation of reactive oxygen species ⁽²³⁾. Alpha-mangostin inhibited growth of leukemia HL60 cells by inducing caspase-3-dependent apoptosis ⁽¹⁾ ⁽⁶⁾. It reduced matrix metalloproteinase MMP-2 and -9 expression, increased E-cadherin expression, and suppressed the ERK signaling pathway in pancreatic cancer cell lines ⁽³⁶⁾. In chronic myeloid leukemia cells, it induced autophagy via increased expression of the autophagosome marker LC-3II and accumulation of autophagic vacuoles, in addition to antiproliferative and apoptotic effects ⁽³²⁾. Another study also attributes the antitumor activity of alpha-mangostin to autophagy and not endoplasmic reticulum stress induction ⁽²⁴⁾.
Beta-mangostin decreased the proliferation of human cervical cancer HeLa cell by inhibiting cellular polymerases ⁽⁴³⁾.
Gamma-Mangostin demonstrated free radical scavenging activity in human liver cancer cells ⁽³⁹⁾.
In bladder cancer cell lines, activities of gartanin suggest mTOR pathway inhibition, downregulation of Bcl-2 expression, and p53 pathway activation leading to apoptotic induction ⁽³⁸⁾.
Contraindications
Patients with ulcerative colitis should avoid products high in alpha-mangostin as animal studies suggest this constituent may actually exacerbate symptoms ⁽⁴⁰⁾.
Adverse Reactions
Case Report: Severe lactic acidosis was reported following consumption of mangosteen juice daily for 12 months ⁽¹⁵⁾.
Herb-Drug Interactions
Chemotherapy: Mangosteen products have antioxidant effects ⁽⁷⁾ ⁽¹³⁾ ⁽³⁷⁾ ⁽⁴¹⁾ and may interfere with the action of anthracyclines, platinum compounds, and alkylating agents.
Calcineurin inhibitors (cyclosporine, tacrolimus): Isogarcinol isolated from Garcinia mangostana inhibits calcineurin. It may have additive immunosuppressant effects if used with related drugs.
Cytochrome P450 substrates: Mangosteen inhibits CYP1A1, CYP1A2, CYP2E1 and CYP3A11 and can affect the intracellular concentration of drugs metabolized by these enzymes ⁽²⁵⁾.
References
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