Annona muricata in modern medicine and its broad spectrum therapeutic potential
DOI:
https://doi.org/10.12775/QS.2026.63.73264Keywords
Annona muricata, graviola, phytochemicals, bioactive compounds, ethnomedicine, natural medicine, antioxidant, antidiabetic, anticancerAbstract
Background: Bioactive compounds from plants have gained significant attention in modern medicine, demonstrating therapeutic potential in cardiovascular, dermatological and oncological conditions. Annona muricata is a candidate with documented multidirection therapeutic potential, especially when it comes to acetogenins.
Aim of the study: This review evaluates the status of Annona muricata (Graviola) in modern medicine, analyzes characteristics of the plant and its phytochemicals with their multidirectional activities, such as anticancer, antidiabetic and antinflammatory.
Materials and methods: A systematic review of PubMed (last 20 years) was conducted using the keywords: „Annona muricata”, „bioactive compounds”.
Conclusions: A. muricata’s extract demonstrates anticancer, antidiabetic, antioxidant and gastroprotective effects through mechanisms like oxidative stress modulation, apoptosis, cellular signalling pathways, inflammation. Anticancer activity has been the most studied. A. muricata represents a promising pharmaceutical, but further clinical studies are needed to establish its efficacy, safety and pharmacokinetic profile.
References
1. Moghadamtousi SZ, Fadaeinasab M, Nikzad S, Mohan G, Ali HM, Kadir HA. Annona muricata (Annonaceae): A review of its traditional uses, isolated acetogenins and biological activities. Int J Mol Sci. 2015;16(7):15625-15658. https://doi.org/10.3390/ijms160715625
2. Zubaidi SN, Mohd Nani H, Ahmad Kamal MS, Abdul Qayyum T, Maarof S, Afzan A, Mohmad Misnan N, Hamezah HS, Baharum SN, Mediani A. Annona muricata: Comprehensive review on the ethnomedicinal, phytochemistry, and pharmacological aspects focusing on antidiabetic properties. Life. 2023;13(2):353. https://doi.org/10.3390/life13020353
3. Coria-Téllez AV, Montalvo-González E, Yahia EM, Obledo-Vázquez EN. Annona muricata: A comprehensive review on its traditional medicinal uses, phytochemicals, pharmacological activities, mechanisms of action and toxicity. Arabian J Chem. 2018;11(5):662-691. https://doi.org/10.1016/j.arabjc.2016.01.004
4. Adewole SO, Caxton-Martins EA. Morphological changes and hypoglycemic effects of Annona muricata Linn. (Annonaceae) leaf aqueous extract on pancreatic B-cells of streptozotocin-treated diabetic rats. Afr J Biomed Res. 2006;9(3):173-187. https://doi.org/10.4314/ajbr.v9i3.48903
5. Abdul Wahab SM, Jantan I, Haque MA, Arshad L. Exploring the leaves of Annona muricata L. as a source of potential anti-inflammatory and anticancer agents. Front Pharmacol. 2018;9:661. https://doi.org/10.3389/fphar.2018.00661
6. Pelden D, Meesawat U. Foliar idioblasts in different-aged leaves of a medicinal plant (Annona muricata L.). Songklanakarin J Sci Technol. 2019;41(2):414-420. https://doi.org/10.14456/sjst-psu.2019.52
7. Okigbo RN, Obire O. Annona muricata — Root system and botanical overview. In: ScienceDirect Topics: Annona muricata. Elsevier; 2009. https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/annona-muricata
8. Alshaeri HK, Alasmari MM, Natto ZS, Pino-Figueroa A. Effects of Annona muricata extract on triple-negative breast cancer cells mediated through EGFR signaling. Cancer Manag Res. 2020;12:12519-12526. https://doi.org/10.2147/CMAR.S278647
9. Yajid AI, Ab Rahman HS, Wong MPK, Wan Zain WZ. Potential benefits of Annona muricata in combating cancer: A review. Malays J Med Sci. 2018;25(1):5-15. https://doi.org/10.21315/mjms2018.25.1.2
10. Mutakin M, Fauziati R, Fadhilah FN, Zuhrotun A, Amalia R, Hadisaputri YE. Pharmacological activities of soursop (Annona muricata Lin.). Molecules. 2022;27(4):1201. https://doi.org/10.3390/molecules27041201
11. Moghadamtousi SZ, Kadir HA, Paydar M, Rouhollahi E, Karimian H. Annona muricata leaves induced apoptosis in A549 cells through mitochondrial-mediated pathway and involvement of NF-κB. BMC Complement Altern Med. 2014;14:299. https://doi.org/10.1186/1472-6882-14-299
12. Zorofchian Moghadamtousi S, Karimian H, Rouhollahi E, Paydar M, Fadaeinasab M, Abdul Kadir H. Annona muricata leaves induce G₁ cell cycle arrest and apoptosis through mitochondria-mediated pathway in human HCT-116 and HT-29 colon cancer cells. J Ethnopharmacol. 2014;156:277-289. https://doi.org/10.1016/j.jep.2014.08.011
13. Ilango S, Sahoo DK, Paital B, et al. A review on Annona muricata and its anticancer activity. Cancers. 2022;14(18):4539. https://doi.org/10.3390/cancers14184539
14. Gavamukulya Y, Wamunyokoli F, El-Shemy HA. Annona muricata: Is the natural therapy to most disease conditions including cancer growing in our backyard? A systematic review of its research history and future prospects. Asian Pac J Trop Med. 2017;10(9):835-848. https://doi.org/10.1016/j.apjtm.2017.08.009
15. Torres MP, Rachagani S, Purohit V, et al. Graviola: a novel promising natural-derived drug that inhibits tumorigenicity and metastasis of pancreatic cancer cells in vitro and in vivo through altering cell metabolism. Cancer Lett. 2012;323(1):29-40. https://doi.org/10.1016/j.canlet.2012.03.031
16. Pizano-Andrade JC, Vargas-Guerrero B, Vargas-Radillo J, et al. Photoprotective effect of Annona muricata L. extracts in rats exposed to ultraviolet radiation via P53 and RB gene expression. Molecules. 2025;30(17):3518. https://doi.org/10.3390/molecules30173518
17. Kouki O, Lasram MM, Abidi A, et al. Synergistic anticancer activity of Annona muricata leaf extract and cisplatin in 4T1 triple-negative breast cancer cells. Cells. 2026;15(3):213. https://doi.org/10.3390/cells15030213
18. Cabrera-Licona A, Hernández-Fuentes GA, Pineda-Urbina K, et al. In vitro evaluation of Annona muricata leaf infusion as a modulator of antineoplastic drug-induced cytotoxicity in cancer cell lines. Pharmaceuticals (Basel). 2025;18(8):1177. https://doi.org/10.3390/ph18081177
19. Sindi ER, Polash MJI, Alves GB, et al. Assessment of Annona muricata phytochemicals as 17β-HSD1 inhibitors through molecular docking, dynamics simulation, DFT, and ADMET analyses. J Cell Mol Med. 2025;29(21):e70904. https://doi.org/10.1111/jcmm.70904
20. Ogbu PN, Ugota EO, Onwuka RU, Ogbu IM, Aloke C. Effect of acetogenin fraction of Annona muricata leaves on antioxidant status and some indices of benign prostatic hyperplasia in rats. Redox Rep. 2020;25(1):80-86. https://doi.org/10.1080/13510002.2020.1804711
21. Gavamukulya Y, Maina EN, El-Shemy HA, et al. Annona muricata silver nanoparticles exhibit strong anticancer activities against cervical and prostate adenocarcinomas through regulation of CASP9 and the CXCL1/CXCR2 genes axis. Tumour Biol. 2021;43(1):37-55. https://doi.org/10.3233/TUB-200058
22. Ali MY, Asha AJ, Riti FA, et al. Identification and in silico evaluation of natural compounds from Annona muricata (soursop) leaves for colon cancer treatment. Sci Rep. 2025;16(1):602. https://doi.org/10.1038/s41598-025-30151-w
23. Indrawati L, Ascobat P, Bela B, Abdullah M, Surono IS. The effect of an Annona muricata leaf extract on nutritional status and cytotoxicity in colorectal cancer: a randomized controlled trial. Asia Pac J Clin Nutr. 2017;26(4):606-612. https://doi.org/10.6133/apjcn.062016.02
24. Paparo SM, Mendoza RM, Jethi S, et al. Unlocking nature's potential: soursop in the battle against resistant acute myeloid leukemia. Biochem Biophys Rep. 2025;44:102354. https://doi.org/10.1016/j.bbrep.2025.102354
25. Ballesteros-Ramírez R, Fuenmayor D, Martínez-Ramos N, Duque-Grisales E, Murillo R. In silico evaluation of soursop (Annona muricata) leaf compound interactions with CYP450 and their potential impact on systemic cancer therapies. Toxicol Rep. 2026;16:102258. https://doi.org/10.1016/j.toxrep.2026.102258
26. Slawny N, O'Shea KS. Geminin promotes an epithelial-to-mesenchymal transition in an embryonic stem cell model of gastrulation. Stem Cells Dev. 2013;22(8):1177-1189. https://doi.org/10.1089/scd.2012.0050
27. Balderrama-Carmona AP, Silva-Beltrán NP, Gálvez-Ruiz JC, Ruíz-Cruz S, Chaidez-Quiroz C, Morán-Palacio EF. Antiviral, antioxidant, and antihemolytic effect of Annona muricata L. leaves extracts. Plants (Basel). 2020;9(12):1650. https://doi.org/10.3390/plants9121650
28. Moghadamtousi SZ, Rouhollahi E, Karimian H, Fadaeinasab M, Abdulla MA, Kadir HA. Gastroprotective activity of Annona muricata leaves against ethanol-induced gastric injury in rats via Hsp70/Bax involvement. Drug Des Devel Ther. 2014;8:2099-2110. https://doi.org/10.2147/DDDT.S70096
29. Matano F, Patra A. Annona muricata (soursop) and hematopoiesis: ethnomedicinal insights, immunomodulatory mechanisms, and translational challenges. Antioxidants (Basel). 2026;15(5):579. https://doi.org/10.3390/antiox15050579
30. Rahman SA, Sulaimon LA, Arogundade OL, Osifade OA, Akinolye OA. Therapeutic efficacy of Annona muricata in counteracting nephrolithiasis-induced electrolyte imbalance and antioxidant disruption in ethylene glycol-treated rats. Sci Rep. 2026;16(1):5161. https://doi.org/10.1038/s41598-026-35535-0
31. Al Syaad KM, Elsaid FG, Abdraboh ME, Al-Doaiss AA. Effect of graviola (Annona muricata L.) and ginger (Zingiber officinale Roscoe) on diabetes mellitus induced in male Wistar albino rats. Folia Biol (Praha). 2019;65(5-6):275-284. https://doi.org/10.14712/fb2019065050275
32. Ojo OA, Grant S, Amanze JC, et al. Annona muricata L. peel extract inhibits carbohydrate metabolizing enzymes and reduces pancreatic β-cells, inflammation, and apoptosis via upregulation of PI3K/AKT genes. PLoS One. 2022;17(10):e0276984. https://doi.org/10.1371/journal.pone.0276984
33. Zubaidi SN, Wong PL, Qadi WSM, et al. Deciphering the mechanism of Annona muricata leaf extract in alloxan-nicotinamide-induced diabetic rat model with ¹H-NMR-based metabolomics approach. J Pharm Biomed Anal. 2025;260:116806. https://doi.org/10.1016/j.jpba.2025.116806
34. Oufquir S, Agouram F, Kabdy H, et al. Novel insights into the bioactive profile and therapeutic potentials of Indonesian Annona muricata leaves. Chem Biodivers. 2025;22(12):e01606. https://doi.org/10.1002/cbdv.202501606
35. Bento EB, Júnior FEB, de Oliveira DR, et al. Antiulcerogenic activity of the hydroalcoholic extract of leaves of Annona muricata Linnaeus in mice. Saudi J Biol Sci. 2018;25(4):609-621. https://doi.org/10.1016/j.sjbs.2016.01.024
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