Therapeutic Potential of Moringa oleifera in Alzheimer’s Disease: A Review of Neuroprotective Mechanisms

Alzheimer’s disease (AD) is characterized by features such as progressive cognitive decline, memory loss, and tau hyperphosphorylation, all of which are observed in Alzheimer’s disease. Moringa contains phytochemicals, including flavonoids (Quercetin and kaempferol), phenolic acids, alkaloids, and isothiocyanates, with antioxidant and anti-inflammatory activities. These bioactives prevent oxidative neuronal damage by directly scavenging free radicals and by potently inhibiting the release of proinflammatory cytokines by blocking the nuclear factor kappa-light-chain-enhancer of activated B cells NF-κB pathway. It has also been reported that some agents, such as isothiocyanates, can activate the nuclear factor erythroid 2–related factor 2 Nrf2/ARE system, leading to up-regulation of cytoprotective enzymes and the promotion of brain endogenous antioxidant defences. Indeed, in vivo studies have shown that Moringa extracts possess anti-AchE activity and improve cholinergic transmission by reducing Aβ levels and enhancing cognitive performance in AD models. The modus of action comprises an inhibition of beta-site amyloid precursor protein cleaving enzyme 1 BACE1 activity and, in addition, a direct inhibition of the Aβ peptide aggregation into neurotoxic oligomers. It also functions as a modulator of mitochondrial activity. It increases the activity of endogenous antioxidant enzymes, such as superoxide dismutase SOD and catalase, enhancing neuronal energy metabolism while attempting to block apoptosis. These results suggest that Moringa oleifera M.O. is a useful approach for AD therapy through the modulation of major pathogenic factors. Further investigations, including similar cell studies and pharmacokinetics/pharmacodynamics studies, as well as the design of new human delivery devices for this valuable natural therapy, will be needed to confirm its efficacy, safety, and dosing schedule. Accordingly, this review focuses on clarifying the neuroprotective mechanisms of Moringa oleifera and assessing its potential as a multi-target therapeutic strategy for Alzheimer’s disease.