Pharmacological Potential of Moringa stenopetala: A Comprehensive Review of Evidence from In Vitro and In Vivo Studies

1. Introduction

Moringa stenopetala is a multipurpose plant of medicinal and nutritional importance (Demisse et al., 2024). It is extensively grown in southern Ethiopia and parts of northern Kenya. It is commonly found in communities such as the Konso, Gamo, Wolayita, and Borana. In these areas, it plays an essential role in traditional food systems, primary healthcare practices, and household food security strategies (Hamza and Azmach, 2017). The species is highly drought-tolerant and thrives in arid and semi-arid regions (Khater et al., 2025). It produces leafy biomass even during environmental stress and food shortages. Because of its adaptability, nutritional value, and medicinal importance, it is often described as a “life-saving tree” in ethnobotanical literature (Redae et al., 2025).

Traditionally, the leaves of Moringa stenopetala are consumed as a cooked vegetable (Seifu and Angassa, 2026). They are often prepared in local stews (wot) or mixed with cereal-based foods. This improves dietary diversity and micronutrient intake. In addition to their nutritional use, different plant parts are used in traditional medicine. These include leaves, seeds, bark, and roots. They are used to treat hypertension, diabetes mellitus, gastrointestinal disorders, infections, inflammatory conditions, and parasitic diseases (Tesfaye et al., 2022). The seeds are also used for household water purification (Pareek et al., 2023). This shows the plant’s multifunctional role in rural livelihoods. This wide ethnomedicinal use has attracted scientific interest to validate its traditional claims.

Phytochemical studies show that Moringa stenopetala contains many bioactive compounds (Dessalegn and Rupasinghe, 2021). These include flavonoids such as quercetin and kaempferol derivatives, phenolic acids such as chlorogenic and caffeic acids, glucosinolates and their hydrolysis products (isothiocyanates), as well as saponins, tannins, alkaloids, and phytosterols. These compounds are linked to several pharmacological activities. These include antioxidant, anti-inflammatory, antimicrobial, antidiabetic, antihypertensive, hepatoprotective, and neuroprotective effects (Chauhan and Namdev, 2022). This wide range of secondary metabolites supports its use as both a functional food and a medicinal plant (Hamada et al., 2024).

In recent years, many in vitro and in vivo studies have investigated the pharmacological potential of Moringa stenopetala (Tesfaye et al., 2022). Animal studies have shown significant antidiabetic effects (Nova et al., 2020). These include reduced blood glucose levels, improved lipid profiles, and partial restoration of pancreatic β-cell function. Other reported activities include antihypertensive, diuretic, antioxidant, anti-inflammatory, antimicrobial, antidiarrheal, analgesic, anticonvulsant, hepatoprotective, and anticancer effects (Hadis, Gebreyohannes, and Gemeda, 2020). In vitro studies also support these findings. They show strong antioxidant activity, antimicrobial effects, cytotoxicity against cancer cell lines, and neuroprotective effects (Adefegha et al., 2024). Although evidence is increasing, pharmacological data on Moringa stenopetala are still scattered across various experimental models, extraction methods, and biological systems (Tesfaye et al., 2022).

There is a need to comprehensively synthesize the available findings to better understand the pharmacological profile of the plant and identify consistent therapeutic effects, mechanisms of action, and research gaps. Therefore, this review aims to critically summarize and integrate in vitro and in vivo experimental evidence on the pharmacological activities of Moringa stenopetala, highlighting its therapeutic potential and future research directions. This review integrates pharmacological, phytochemical, and toxicological evidence of Moringa stenopetala. It presents a unified summary of safety data in one framework. Unlike previous studies, it compares therapeutic effects with dose-dependent toxicity findings. It also highlights differences across biological systems. The review quantifies evidence across major pharmacological areas. It shows the balance between strong preclinical efficacy and limited safety confirmation. In addition, it synthesizes regulatory concerns, long-term toxicity data, and reproductive safety findings. This provides a clearer translational perspective for future clinical studies and standardization.

2. Methods

This narrative review was conducted to systematically and comprehensively summarize the available scientific evidence on Moringa stenopetala. The focus was on its nutritional composition, phytochemical profile, and pharmacological activities. A narrative review design was selected. This allowed the inclusion of diverse study types. It also enabled an integrated interpretation of findings across different experimental and clinical contexts. A comprehensive literature search was performed using major electronic databases. These included PubMed, Google Scholar, ScienceDirect, Scopus, and Web of Science. Additional relevant articles were identified through manual searching of the reference lists of eligible studies. The search covered publications from January 2000 to December 2026. This ensured the inclusion of both foundational and recent evidence. The search strategy used combinations of keywords and Boolean operators. These included “Moringa stenopetala,” “Ethiopian moringa,” “phytochemicals,” “bioactive compounds,” “nutritional composition,” “pharmacological activities,” “antidiabetic,” “antioxidant,” “anti-inflammatory,” and “antimicrobial.” Synonyms and related terms were also included. This increased the sensitivity and coverage of the search.

Studies were included if they investigated the nutritional, phytochemical, or pharmacological properties of Moringa stenopetala. All experimental models were considered. These included in vitro studies, in vivo animal studies, and human-based research. Review articles were also included when they provided synthesized evidence. Studies focusing only on other Moringa species were excluded. Exceptions were made when comparative data were available. Data extraction was performed manually from full-text articles. The extracted information included author and year of publication, study design, experimental model, type of extract or compound used, dosage (where applicable), duration of intervention, outcomes assessed, and key findings. The methodological quality and reporting clarity of the narrative review were assessed using the Scale for the Assessment of Narrative Review Articles (SANRA) (Baethge et al., 2019). This tool evaluates the justification of importance, clarity of objectives, literature search transparency, referencing quality, scientific reasoning, and presentation quality. Quality appraisal enhanced interpretative rigor but was not used as an exclusion criterion.

The data were then organized into thematic categories. These included nutritional composition, phytochemical constituents, and pharmacological activities. A qualitative synthesis approach was used due to heterogeneity among studies. Differences existed in design, methodology, and outcome measures. Therefore, no meta-analysis or statistical pooling was performed. Instead, findings were summarized narratively. They were grouped according to biological activity and chemical classification. The quality and reliability of included studies were assessed. This was based on study design, methodological clarity, sample size (for experimental studies), use of controls, and appropriateness of outcome measures. Peer-reviewed studies with strong experimental or analytical design were prioritized. Finally, the synthesized evidence was structured into thematic sections. This provided a comprehensive overview of Moringa stenopetala. It highlighted nutritional value, phytochemical diversity, pharmacological activities, and existing research gaps. The chemical structures were searched from PubChem (https://pubchem.ncbi.nlm.nih.gov/).

3. Traditional Uses of Moringa stenopetala

Moringa stenopetala has been deeply incorporated into indigenous dietary practices, traditional healthcare systems, and rural socioeconomic activities for generations (Bania et al., 2023). In customary use, the foliage is the most frequently utilized part of the plant. It is typically cooked as a leafy vegetable, added to stews (wot), blended into sauces, or combined with staple cereals such as maize and sorghum (Seifu and Angassa, 2026). This use becomes especially important during drought periods or seasonal food shortages. During these times, the plant remains green and productive when other vegetables are unavailable. Therefore, it plays a key role in household food security. Beyond the leaves, tender shoots are also occasionally consumed as vegetables. The seeds are traditionally used for water purification (Redae et al., 2025). They are crushed and added to turbid water, where they help flocculate suspended particles and improve water clarity.

In addition to its nutritional value, the species is highly important in ethnomedicine. Leaf preparations, usually taken as decoctions or infusions, are traditionally used to manage chronic diseases such as hypertension and diabetes mellitus (Tesfaye et al., 2022). They are also believed to improve digestion, relieve gastrointestinal discomfort, and act as a general tonic. In some communities, seed extracts are used to treat intestinal parasitic infections. Bark and root preparations are used less frequently due to sustainability concerns (Tesfaye et al., 2022; Elghandour et al., 2023). However, they are still applied in traditional medicine for fever, pain relief, and infectious diseases.

Beyond food and medicinal uses, the tree has important ecological and agricultural functions (Bania et al., 2023). It is commonly planted around homesteads as a living fence, a shade tree, and a soil-conservation species. This is due to its drought resistance, rapid regrowth after pruning, and ability to improve microclimate and soil stability. From a socio-cultural and economic perspective, it is regarded as a “life-sustaining tree.” This is because it continuously provides food, medicine, and environmental services in harsh and drought-prone areas. It also enhances household resilience and nutritional security (Redae et al., 2025).

4. Bioactive Compounds of Moringa stenopetala

Moringa stenopetala is a highly nutritious and pharmacologically significant plant (Ntshambiwa, Seifu, and Mokhawa, 2023) (Table 1). It is characterized by a wide spectrum of biologically active phytochemicals and nutrients. These properties explain its long-standing traditional use as both food and medicine. The leaves are the most commonly utilized part of the plant. They are rich in essential primary metabolites. These include proteins, essential amino acids, carbohydrates, and dietary fiber. They also contain vitamins, particularly vitamins A, C, and E, as well as important minerals such as calcium, potassium, magnesium, iron, and zinc (Melesse et al., 2012). This makes the plant a valuable functional dietary resource. Beyond nutritional components, the plant contains a wide range of secondary metabolites (Tesfaye et al., 2022). These are mainly responsible for its therapeutic effects. Among the most important are phenolic compounds. These include flavonoids such as quercetin, kaempferol, isorhamnetin, and their glycosidic forms. They exhibit strong antioxidant, anti-inflammatory, antihypertensive, and cardioprotective activities (Dessalegn and Rupasinghe, 2021).

The plant also contains several phenolic acids. These include chlorogenic, caffeic, ferulic, and related derivatives. They play important roles in regulating oxidative stress, glucose metabolism, and inflammatory pathways (Dessalegn and Rupasinghe, 2021). Another important group of bioactive compounds is glucosinolates (Mekonnen and Dräger, 2003). These are enzymatically converted by myrosinase into isothiocyanates. These metabolites are known for their antimicrobial, antidiabetic, hepatoprotective, and potential anticancer activities. They act through modulation of detoxification enzymes and cellular signaling pathways. The plant also contains alkaloids. These may contribute to analgesic and physiological regulatory effects. Saponins are also present and are associated with cholesterol-lowering, immunomodulatory, and antimicrobial activities (Tamrat et al., 2017). In addition, tannins are present and contribute to antioxidant, antimicrobial, and astringent effects, particularly in gastrointestinal health (Dessalegn and Rupasinghe, 2021).

The combined and synergistic interaction of these phytochemical groups enhances the overall biological activity of the plant (Tesfaye et al., 2022). This supports its traditional use in managing hypertension, diabetes mellitus, gastrointestinal disorders, infections, and inflammatory conditions. Compared with many commonly consumed leafy vegetables, Moringa stenopetala contains exceptionally high levels of both nutrients and bioactive compounds (Tesfaye et al., 2022). This justifies its classification as both a “functional food” and a “medicinal food plant”.

Table 1. Nutritional and Phytochemical Profile of Moringa stenopetala and Its Biological Functions.

Category	Constituents	Examples / Key Compounds	Biological / Pharmacological Activities	References
Primary metabolites (Nutritional components)	Proteins, amino acids, carbohydrates, dietary fiber	Essential amino acids; plant proteins	Growth support, energy supply, metabolic regulation	Melesse et al. (2012)
	Vitamins	Vitamin A, C, E	Antioxidant activity, immune support, vision, and skin health
	Minerals	Calcium, potassium, magnesium, iron, zinc	Bone health, electrolyte balance, oxygen transport, and enzyme function
Phenolic compounds	Flavonoids	Quercetin, kaempferol, and isorhamnetin glycosides	Antioxidant, anti-inflammatory, antihypertensive, cardioprotective	Dessalegn and Rupasinghe (2021)
	Phenolic acids	Chlorogenic acid, caffeic acid, ferulic acid	Antioxidant, antidiabetic, anti-inflammatory, metabolic regulation
Glucosinolates system	Glucosinolates → isothiocyanates	Myrosinase-derived isothiocyanates	Antimicrobial, antidiabetic, hepatoprotective, and anticancer potential	Mekonnen and Dräger (2003)
Alkaloids	Alkaloid compounds	Various plant alkaloids	Analgesic, physiological regulatory effects	Tamrat et al. (2017)
Saponins	Triterpenoid glycosides	Saponin fractions	Cholesterol-lowering, immunomodulatory, and antimicrobial effects	Tamrat et al. (2017)
Tannins	Polyphenolic compounds	Hydrolysable and condensed tannins	Astringent, antioxidant, antimicrobial (GI protection)	Dessalegn and Rupasinghe (2021)
Overall effects (synergistic activity)	Combined phytochemical interaction	Multiple bioactive classes	Antioxidant, antidiabetic, antihypertensive, anti-inflammatory, and antimicrobial effects	Tesfaye et al. (2022)
Functional classification	Nutraceutical profile	High nutrient + bioactive density	Functional food and medicinal food plant	Tesfaye et al. (2022)

Table 1. Nutritional and Phytochemical Profile of Moringa stenopetala and Its Biological Functions.

Category	Constituents	Examples / Key Compounds	Biological / Pharmacological Activities	References
Primary metabolites (Nutritional components)	Proteins, amino acids, carbohydrates, dietary fiber	Essential amino acids; plant proteins	Growth support, energy supply, metabolic regulation	Melesse et al. (2012)
	Vitamins	Vitamin A, C, E	Antioxidant activity, immune support, vision, and skin health
	Minerals	Calcium, potassium, magnesium, iron, zinc	Bone health, electrolyte balance, oxygen transport, and enzyme function
Phenolic compounds	Flavonoids	Quercetin, kaempferol, and isorhamnetin glycosides	Antioxidant, anti-inflammatory, antihypertensive, cardioprotective	Dessalegn and Rupasinghe (2021)
	Phenolic acids	Chlorogenic acid, caffeic acid, ferulic acid	Antioxidant, antidiabetic, anti-inflammatory, metabolic regulation
Glucosinolates system	Glucosinolates → isothiocyanates	Myrosinase-derived isothiocyanates	Antimicrobial, antidiabetic, hepatoprotective, and anticancer potential	Mekonnen and Dräger (2003)
Alkaloids	Alkaloid compounds	Various plant alkaloids	Analgesic, physiological regulatory effects	Tamrat et al. (2017)
Saponins	Triterpenoid glycosides	Saponin fractions	Cholesterol-lowering, immunomodulatory, and antimicrobial effects	Tamrat et al. (2017)
Tannins	Polyphenolic compounds	Hydrolysable and condensed tannins	Astringent, antioxidant, antimicrobial (GI protection)	Dessalegn and Rupasinghe (2021)
Overall effects (synergistic activity)	Combined phytochemical interaction	Multiple bioactive classes	Antioxidant, antidiabetic, antihypertensive, anti-inflammatory, and antimicrobial effects	Tesfaye et al. (2022)
Functional classification	Nutraceutical profile	High nutrient + bioactive density	Functional food and medicinal food plant	Tesfaye et al. (2022)

5. Pharmacological Activities of Moringa stenopetala

Moringa stenopetala is associated with a wide range of pharmacological properties (Hadis, Gebreyohannes, and Gemeda, 2020; Ntshambiwa, Seifu, and Mokhawa, 2023) (Table 2; & Table 3). These effects are mainly attributed to its diverse phytochemical constituents, including flavonoids, phenolic acids, and glucosinolates. The plant shows strong antioxidant potential. It helps neutralize free radicals and protects cells from oxidative damage. It also has hypoglycemic activity. This effect reduces blood glucose levels and improves glucose utilization and metabolic regulation. In addition, it demonstrates cardiovascular benefits (Geleta et al., 2016). These include antihypertensive and cardioprotective effects, with improvements in blood pressure and lipid profiles. Furthermore, the plant has anti-inflammatory and antimicrobial properties (Assaye et al., 2025). These activities support its traditional use in treating infectious and inflammatory conditions. Evidence also suggests hepatoprotective effects (Ghebreselassie et al., 2011). This indicates a possible role in supporting and protecting liver function.

5.1. Antidiabetic/Antihyperglycemic Activity

Moringa stenopetala leaves are commonly consumed as food and are traditionally used for the management and control of diabetes mellitus (Derbo and Debelew, 2024). Preclinical studies have shown increasing evidence of its antidiabetic and glucose-lowering effects. These findings are reported in streptozotocin-induced diabetic animal models. Different leaf preparations have been used, including aqueous extracts, ethanol extracts, n-butanol fractions, and hot infusions (Toma et al., 2015; Woldekidan et al., 2021). The antidiabetic activity of Moringa stenopetala is suggested to involve several mechanisms. These include enhanced peripheral glucose uptake, possible stimulation of insulin secretion, and protection or preservation of pancreatic β-cells. In addition, strong antioxidant activity helps reduce oxidative stress and lipid peroxidation associated with diabetic complications (Mthiyane et al., 2022). These effects are further supported by its rich phytochemical composition. It contains phenolic compounds, flavonoids, alkaloids, and saponins (Yalew, Mekonnen, and Retta, 2019). These constituents contribute to its antioxidant properties and blood glucose–lowering effects.

Toma et al. (2015) carried out an in vivo experimental study in diabetic rats using aqueous ethanol and n-butanol fractions of Moringa stenopetala leaves at a dose of 500 mg/kg. Metformin (150 mg/kg) was used as a reference drug. The treatment lasted 14 days. The study assessed fasting blood glucose, lipid profile, liver and kidney function tests, and pancreatic histology. An oral sucrose tolerance test was also performed. The results showed a marked reduction in blood glucose. It also improved metabolic markers and pancreatic structure. This indicated strong antidiabetic activity. The use of a validated diabetic model and a standard drug improves reliability. However, the short duration and lack of mechanistic studies limit long-term interpretation. Habtemariam (2015) conducted an in vitro experimental study on leaf extracts and isolated compounds of Moringa stenopetala. The study evaluated α-glucosidase inhibition, antioxidant activity, and β-cell protection. The extract showed no α-glucosidase inhibition. However, it showed strong antioxidant activity. Rutin was identified as the main active compound responsible for β-cell protection. The study provides strong phytochemical and mechanistic insights. However, the in vitro design limits clinical relevance and physiological interpretation.

Woldekidan et al. (2021) performed an in vivo study in alloxan-induced diabetic rats. The animals received aqueous leaf extract at 250 and 500 mg/kg. Glibenclamide (5 mg/kg) was used as a standard control. The treatment lasted 28 days. The study evaluated biochemical and histological parameters. The extract significantly reduced blood glucose levels. It also improved liver, kidney, and pancreatic tissue structure. The study used dose-dependent treatment and a positive control, which strengthens validity. However, limited molecular analysis and variability in diabetes induction reduce mechanistic clarity. Yalew et al. (2019) conducted an in vivo study in streptozotocin-induced diabetic mice. The animals received methanol–water extract and ethyl acetate fraction at 300 mg/kg. The treatment lasted 14 to 21 days. The study measured fasting blood glucose and antioxidant activity. The ethyl acetate fraction showed strong antioxidant effects and significant glucose reduction. Fractionation helped identify active components. However, the small sample size and lack of toxicity data reduce generalizability.

Toma et al. (2012) performed an in vivo study in diabetic mice using a butanol fraction for 28 days. The study assessed blood glucose, lipid profile, and body weight. Toxicity was also evaluated. The extract improved metabolic parameters and showed high safety, with LD₅₀ above 5000 mg/kg. The inclusion of toxicity data is a major strength. However, the lack of mechanistic biomarkers limits interpretation. Toma (2022) conducted an in vivo study in male Wistar rats using hot tea infusion of Moringa stenopetala leaves. Blood glucose was measured at different time points. A sucrose challenge test was also performed. The infusion significantly reduced fasting and postprandial glucose levels. The study reflects real-life traditional use, improving relevance. However, the absence of biochemical and histological analysis limits full pharmacological understanding.

5.2. Antioxidant Activity

Moringa stenopetala has shown strong free radical–scavenging activity in several experimental studies (Dessalegn and Rupasinghe, 2021). This highlights its role in reducing oxidative damage and preventing diseases linked to oxidative stress. The effect is mainly due to its high content of bioactive phytochemicals. These include phenolic compounds, flavonoids, and other secondary metabolites. In vitro studies have confirmed this activity. Tests such as DPPH radical scavenging assays show that M. stenopetala leaf extracts can effectively neutralize free radicals (Ntshambiwa, Seifu, and Mokhawa, 2023). This reflects strong electron donation and reducing ability. In addition, its antioxidant effect is not only due to direct radical scavenging. It also works by inhibiting lipid peroxidation and enhancing the body’s natural antioxidant defense systems (Tebeka and Libsu, 2014). This protective effect is particularly important in diseases such as diabetes mellitus, where oxidative stress contributes significantly to disease progression and complications.

Dessalegn and Rupasinghe (2021) performed a laboratory-based chemical profiling study of Moringa stenopetala leaves. They investigated secondary metabolites and antioxidant potential in aqueous and methanolic extracts using HPLC-DAD analysis. Several major phenolic compounds were identified, including hydroxycinnamic acid (538 ± 6 µg/g), 3-hydroxybenzoic acid (31 ± 6 µg/g), quercetin-3-O-rutinoside (1155 ± 65 µg/g), syringic acid (84 ± 13 µg/g), chlorogenic acid (165 ± 19 µg/g), succinic acid (1811 ± 105 µg/g), and fumaric acid (1582 ± 65 µg/g). The methanol extract showed higher total flavonoid content (11 ± 2 mg catechin equivalent/g) and total phenolic content (39 ± 3 mg gallic acid equivalent/g). It also demonstrated stronger antioxidant activity in the DPPH assay (EC50 = 78 ± 6 μg/mL) and better metal ion chelating activity (EC50 = 239 ± 12 μg/mL). The authors concluded that the leaves are a promising source of nutraceutical compounds. The study provides strong chemical profiling using HPLC-DAD; however, it lacks in vivo or clinical validation.

Dadi et al. (2019) conducted an experimental study using ultrasound-assisted extraction to evaluate the effect of temperature and extraction time on bioactive compounds and antioxidant activity in Moringa stenopetala leaves. The study measured total phenolic content (46.6 mg gallic acid equivalents/g dry mass) and total flavonoid content (20.4 mg catechin equivalents/g dry mass). Antioxidant activity was assessed using DPPH (336.5 mg Trolox equivalents/g), ABTS (581.8 mg Trolox equivalents/g), FRAP (133.3 mg Trolox equivalents/g), and metal chelating activity (28.4 mg EDTA equivalents/g). The results showed that optimized extraction conditions significantly increased the recovery of antioxidant compounds. The study is strong in optimizing extraction efficiency; however, it is limited to in vitro assays and lacks in vivo validation.

Tebeka and Libsu (2014) conducted a laboratory-based comparative antioxidant study of Moringa stenopetala leaf powder obtained from a home garden and a commercial source. Antioxidant activity was evaluated using FRAP, DPPH, peroxide value, and conjugated diene hydroperoxide methods. The garden samples showed higher total phenolic content (92.8 ± 1.01 mg GAE/100 g) than the commercial samples (75.5 ± 2.28 mg GAE/100 g). They also showed higher FRAP values (442.0 ± 10.58 vs 291.3 ± 15.52 mg AAE/100 g). The study concluded that Moringa stenopetala has strong antioxidant activity, supporting its traditional use. The study is limited by its in vitro design and the lack of standardized cultivation and processing methods, which may affect reproducibility.

5.3. Antimicrobial Activity

Moringa stenopetala has shown strong antibacterial and antifungal activities in several experimental studies (Seleshe and Kang, 2019). Leaf extracts prepared using solvents such as water, ethanol, methanol, and other fractions have been reported to inhibit a wide range of pathogenic microorganisms (Miller et al., 2024). This includes both Gram-positive and Gram-negative bacteria, as well as some fungal species (Miller et al., 2024). This antimicrobial effect is mainly due to its bioactive phytochemicals. These include flavonoids, phenolic acids, alkaloids, tannins, and saponins (Manilal et al., 2020). These compounds may act by damaging microbial cell membranes. They can also inhibit key enzymes and disrupt microbial metabolic processes (Manilal et al., 2020).

The findings suggest that Moringa stenopetala may be useful in managing infectious diseases (Miller et al., 2024). This supports its traditional use for treating infections. However, the antimicrobial activity varies depending on the extraction method, concentration, and microorganism type (Seleshe and Kang, 2019). Most of the evidence is based on in vitro studies. Therefore, further in vivo studies and clinical trials are needed (Hadis, Gebreyohannes, and Gemeda, 2020). These are important to confirm the safety and effectiveness in humans.

Basha et al. (2012) conducted an in vitro study using disk diffusion and agar dilution methods to evaluate the antibacterial activity of Moringa stenopetala against human pathogenic bacteria. The extracts demonstrated significant antibacterial effects. Staphylococcus aureus was the most susceptible organism, whereas Pseudomonas aeruginosa showed the highest resistance. The chloroform fraction exhibited the strongest antibacterial activity, with an inhibition zone of 28.00 ± 0.57 mm and an MIC value of 0.31 mg/mL. Methanol and ethyl acetate extracts showed moderate activity, with inhibition zones of 18.66 ± 0.88 mm and 16.00 ± 1.15 mm and MIC values of 1.25 mg/mL and 2.5 mg/mL, respectively. The study suggested that Moringa stenopetala has potential for antibacterial drug development. The study provides robust in vitro antibacterial evidence; however, it lacks in vivo validation and compound isolation.

Metsopkeng et al. (2020) evaluated the antimicrobial activity of Moringa stenopetala extracts in an aquatic system. Leaf extracts reduced bacterial counts from 9.27 log(CFU/100 mL) to between 4.74 and zero, depending on experimental conditions. Root extracts also showed strong inhibitory effects, including complete suppression in some cases. The activity was influenced by concentration (0.5–2 g/L) and temperature (7°C–44°C). The study demonstrates dose-dependent antimicrobial effects under environmental conditions; however, its clinical relevance is limited, and toxicity assessment was not performed.

Seleshe and Kang (2019) assessed the antimicrobial activity of different solvent extracts of Moringa stenopetala leaves against multiple pathogenic microorganisms. Methanol and chloroform extracts showed strong antimicrobial activity, with MIC values as low as 62.5 μg/mL against Candida albicans and Streptococcus pneumoniae. Chloroform extract showed MIC values of 125 μg/mL against several bacterial strains, while aqueous extracts were less effective, with MIC values of 250 μg/mL. The study has a strong methodological design with broad microbial coverage; however, it lacks a mechanistic explanation and toxicity evaluation.

Gebino et al. (2021) investigated the antimicrobial activity of Moringa stenopetala seed oil applied to textile materials. The treated fabrics showed bacterial reduction of 77.6%–100% before washing and 45.8%–85.2% after 15 washing cycles. The study presents an innovative application; however, reduced activity after repeated washing indicates limited durability, and clinical relevance remains indirect. Kekuda et al. (2016) evaluated the antifungal and antioxidant activities of Moringa stenopetala leaf extracts. The extracts showed dose-dependent antifungal activity, with Aspergillus species being the most sensitive. They also exhibited strong antioxidant activity, with higher performance in the ABTS assay compared to DPPH. The study confirms antifungal and antioxidant potential; however, it lacks compound isolation and in vivo validation.

5.4. Antiparasitic Activity

Management of trypanosomiasis remains a major therapeutic challenge. This is because the currently available trypanocidal drugs are highly toxic. In addition, parasite resistance is increasing (Kifleyohannes et al., 2014). These factors significantly reduce treatment effectiveness. They also highlight the urgent need for safer and more effective alternatives, especially from medicinal plants. To address this problem, Kifleyohannes et al. (2014) evaluated the antitrypanosomal activity of Moringa stenopetala. The study was conducted in mice infected with Trypanosoma congolense. The aim was to determine whether these plant extracts could provide protective and therapeutic effects against the infection. The results showed that both extracts had significant antitrypanosomal activity (Kifleyohannes et al., 2014). This was demonstrated by a marked reduction in parasitaemia compared to the untreated control group. Treated animals also showed improved hematological and clinical outcomes. These included maintenance of packed cell volume (PCV), reduced body weight loss, and overall better health status during infection. In addition, the treated groups showed significantly longer survival time (Kifleyohannes et al., 2014). This indicates a protective effect against disease progression.

Kifleyohannes et al. (2014) conducted an in vivo experimental study using Swiss white male mice aged 8–12 weeks. The mice were randomly divided into six groups. They were infected with approximately 1 × 10⁵ Trypanosoma congolense. The animals were then treated orally with aqueous and methanol plant extracts at 400 mg/kg for seven days. Control groups received distilled water or diminazene aceturate. The study monitored parasitaemia, body weight, packed cell volume (PCV), and survival for 25 days. The results showed a significant reduction in parasitaemia and improvement in body weight, PCV, and survival compared with the untreated group. The effects were similar to the standard drug, although no significant difference was observed between extract-treated groups. The study provides strong in vivo evidence with appropriate controls and a reference drug. However, it is limited by a small sample size, short duration, and lack of mechanistic and toxicity evaluation.

Bekele et al. (2013) carried out an in vitro experimental study on the antileishmanial activity of compounds from the roots of Moringa stenopetala. Two compounds (MS-1 and MS-2) were isolated using column chromatography. Their structures were confirmed as triglycerides using ¹H-NMR, ¹³C-NMR, DEPT-135, and IR spectroscopy. The compounds were tested against promastigote and amastigote forms of Leishmania aethiopica. MS-1 showed strong activity similar to amphotericin B and miltefosine. MS-2 showed weaker activity. The study is strong in compound isolation and structural identification, with the use of standard drugs for comparison. However, it is limited by a lack of in vivo validation and the absence of toxicity studies.

5.5. Antihypertensive Activity

Moringa stenopetala has been documented in multiple experimental studies to show blood pressure–lowering effects, supporting its traditional use in cardiovascular disease management (Hadis, Gebreyohannes, and Gemeda, 2020). In several Ethiopian communities, the plant is commonly consumed. It is traditionally believed to help maintain normal blood pressure levels (Agedew et al., 2026). Preclinical studies also show that leaf extracts can reduce elevated arterial pressure through different physiological mechanisms (Geleta et al., 2016). The antihypertensive effect is mainly associated with its bioactive phytochemicals (Nureye et al., 2025). These include flavonoids, phenolic compounds, alkaloids, and saponins. These compounds may promote vasodilation by improving endothelial function. They also increase nitric oxide availability and reduce peripheral vascular resistance. In addition, the antioxidant activity of the plant helps protect blood vessels from oxidative damage (Geleta et al., 2016). This is important because oxidative stress contributes to the development of hypertension.

Geleta et al. (2016) carried out an in vivo experimental study to evaluate the antihypertensive and lipid-lowering effects of crude aqueous and 70% ethanol leaf extracts of Moringa stenopetala in rats with fructose-induced hypertension. The animals were randomly divided into control and treatment groups (n = 6 per group). The treatment groups received oral doses of 250, 500, and 1000 mg/kg daily alongside fructose administration. The positive control group received captopril (20 mg/kg/day with fructose), while the negative control group received only fructose solution (66% w/v ad libitum). The normal control group received distilled water ad libitum for 15 days. The results showed that both extracts significantly prevented the increase in blood pressure in a dose-dependent manner. The effect was comparable to captopril. The extracts also reduced serum cholesterol, glucose, and triglyceride levels. Liver enzyme levels increased, while kidney function parameters remained unchanged compared with the normal control. The study is strong due to appropriate controls and a dose-dependent design. However, it has limitations, including a short study duration, a small sample size, and the use of an animal model, which limits direct application to humans.

Mengistu et al. (2012) conducted combined in vivo and in vitro experiments to evaluate the hypotensive effects of aqueous leaf extract of Moringa stenopetala. In the in vivo study, blood pressure was recorded from anesthetized male guinea pigs using a pressure transducer connected to the carotid artery. The extract was administered at doses of 10, 20, 30, and 40 mg/kg (n = 12). In the in vitro study, isolated thoracic aorta tissues were placed in an organ bath containing Krebs-Henseleit solution. The bath was maintained at 37°C with continuous oxygenation (95% oxygen and 5% carbon dioxide). The extract produced a significant, dose-dependent reduction in systolic, diastolic, and mean arterial blood pressure. The hypotensive effect was not affected by atropine or propranolol, suggesting it does not act through cholinergic or adrenergic pathways. It also inhibited potassium-induced aortic contraction in a dose- and time-dependent manner. The study concluded that Moringa stenopetala has a strong blood pressure–lowering effect, supporting its traditional use. The study is strong because it combines in vivo and in vitro methods and provides mechanistic insight into vascular effects. However, limitations include the use of anesthetized animals, small sample size, and lack of compound isolation, which reduce mechanistic and clinical translation.

5.6. Diuretic Activity

Moringa stenopetala has been reported to show diuretic properties (Hadis, Gebreyohannes, and Gemeda, 2020). This supports its traditional use in managing conditions associated with fluid retention and urinary disorders. Experimental animal studies have shown that leaf extract administration increases urine output (Fekadu et al., 2017). It also enhances electrolyte excretion, indicating a clear diuretic effect. This effect may be related to its phytochemical constituents. These include flavonoids, saponins, and other bioactive compounds. These substances may influence kidney function by altering tubular reabsorption of water and electrolytes. In addition, the diuretic activity of Moringa stenopetala may support cardiovascular and metabolic health (Dadi et al., 2020). It may help regulate blood pressure and reduce fluid overload in the body. However, the evidence is still limited and mainly based on animal studies (Hadis, Gebreyohannes, and Gemeda, 2020). Therefore, further pharmacological and clinical studies are needed. These are required to confirm its efficacy, safety, and mechanisms of action in humans.

Geleta et al. (2015) conducted an in vivo experimental study using a murine diuresis model to evaluate the diuretic effect of hydro-ethanolic leaf extract of Moringa stenopetala. Furosemide (10 mg/kg) was used as a standard drug, normal saline (1 ml/100 g) as a control, and extract doses (150, 250, 350, 500, and 1000 mg/kg) as test treatments. Urine output and electrolyte levels (Na⁺, K⁺, and Cl⁻) were measured. The study showed significant diuretic and electrolyte-modulating effects in a dose-dependent manner. Moderate doses showed the strongest activity. This supports the traditional use of the plant for hypertension and heart failure. The study has strong controls and a standard comparator. However, it used an acute animal model. This limits long-term safety evaluation and human applicability.

Fekadu et al. (2017) conducted an in vivo experimental study using saline-loaded male Wistar rats to assess the diuretic activity of aqueous crude extract and hot tea infusion of Moringa stenopetala leaves. The study included distilled water (control), furosemide (standard), different extract doses, and tea infusion prepared using traditional methods. Urine volume and electrolytes (Na⁺, K⁺, and Cl⁻) were assessed. The results showed significant diuretic, natriuretic, and kaliuretic effects. This confirmed the traditional use of the plant. The study is strengthened by the inclusion of both crude extract and real-life tea preparation. However, dosing based on teaspoons reduces accuracy. The short duration also limits precise dose–response interpretation.

5.7. Anti-Inflammatory & Analgesic Activity

Moringa stenopetala has been shown in experimental studies to have significant anti-inflammatory and analgesic effects, supporting its traditional use in treating pain and inflammatory conditions (Geremew et al., 2015). Different solvent extracts of the leaves have reduced both acute and chronic inflammation in animal models (Tamrat et al., 2017). They have also decreased pain-related behaviors in experimental studies. These activities are commonly evaluated using standard experimental models. Examples include the carrageenan-induced paw edema model for inflammation. Pain is assessed using the writhing and hot plate tests. The anti-inflammatory and analgesic effects are mainly associated with its bioactive compounds (Assaye et al., 2025). These include flavonoids, phenolic acids, alkaloids, saponins, and tannins. These compounds act through several mechanisms. They reduce inflammatory mediators such as prostaglandins and cytokines. They also inhibit oxidative stress and regulate pain signaling pathways in both the central and peripheral nervous systems.

Tamrat et al. (2017) conducted an in vivo animal experimental study to evaluate the analgesic and anti-inflammatory effects of solvent fractions of Moringa stenopetala using established rodent models. The plant material was extracted using Soxhlet and maceration techniques, producing chloroform, methanol, and aqueous fractions. These were administered at different doses. Morphine and aspirin were used as reference drugs, while vehicle-treated groups served as controls. The results showed that the methanol and aqueous fractions significantly reduced both central and peripheral pain responses and also suppressed inflammation (Tamrat et al., 2017). These findings support the traditional use of the plant in managing pain and inflammatory conditions. The study is strong because it uses validated experimental models and appropriate controls. However, it is limited by its preclinical nature, lack of human studies, and absence of long-term safety assessment.

Hussein et al. (2022) conducted an in vivo laboratory-based study to investigate the analgesic effects of Moringa stenopetala leaf methanol extract and its mechanisms of action in mice. The extract produced significant inhibition of pain responses in different experimental models. Mechanistic studies using receptor antagonists showed involvement of opioid receptors, serotonergic (5-HT2A/5-HT2C), and α2-adrenergic pathways. The study concluded that Moringa stenopetala has strong analgesic potential and may be useful for future drug development in pain management (Hussein et al., 2022). The study is strengthened by its mechanistic approach using receptor blockade experiments. However, it is limited by the use of acute animal models only, a lack of clinical evidence, and insufficient standardization of the plant extract.

5.8. Antidiarrheal Activity

Moringa stenopetala has shown antidiarrheal activity in experimental studies (Woldeyohannes et al., 2022). This supports its long-standing traditional use for treating gastrointestinal problems such as diarrhea. Different leaf extract preparations have been tested in animal models of induced diarrhea (Woldeyohannes et al., 2022). These extracts significantly reduced the frequency and severity of diarrheal episodes. The effect is believed to be related to its bioactive phytochemicals (Woldeyohannes et al., 2022). These include tannins, flavonoids, saponins, alkaloids, and other phenolic compounds. These constituents may work by reducing intestinal motility, decreasing fluid secretion, and improving water and electrolyte absorption in the intestine. Therefore, further clinical studies are needed to confirm its safety and effectiveness in humans (Woldeyohannes et al., 2022).

Woldeyohannes et al. (2022) conducted an in vivo experimental study in Swiss albino mice to assess the antidiarrheal and antisecretory effects of 80% methanolic leaf extract of Moringa stenopetala. The study used castor oil-induced diarrhea, charcoal meal intestinal transit, and castor oil-induced enteropooling models. Mice were randomly divided into five groups (n = 6 per group), including a negative control (0.5 ml of 2% Tween-80), a positive control (loperamide 3 mg/kg), and three treatment groups (150, 300, and 450 mg/kg). The extract showed dose-dependent effects. Diarrhea inhibition was 48.5%, 58.6%, and 60%. Gastrointestinal motility was reduced by 36.8%, 54.4%, and 55.9%. Intestinal fluid secretion was reduced by 11.5%, 54.54%, and 61.82%. The study used appropriate animal models and a standard control drug, which strengthens its reliability. However, it was limited by a small sample size, short duration, and lack of detailed mechanistic and safety evaluations.

5.9. Anticancer/Antiproliferative Activity

Moringa stenopetala has been reported in several experimental studies to have anticancer and anti-proliferative effects (Tiloke et al., 2018). This suggests its potential role in cancer prevention and treatment strategies. In vitro studies using different cancer cell lines have shown that leaf extracts of Moringa stenopetala can inhibit tumor cell growth. They also reduce cell viability in a dose-dependent manner (Assaye et al., 2025). These effects are mainly associated with its high content of secondary metabolites. These include flavonoids, phenolic compounds, alkaloids, and glucosinolate derivatives. These compounds are known to interfere with abnormal cell growth pathways. The anti-proliferative activity is believed to occur through multiple mechanisms. These include induction of apoptosis (programmed cell death). It also involves cell cycle arrest and reduction of oxidative stress linked to tumor development (Assaye et al., 2025). In addition, the strong antioxidant activity of the plant may help prevent DNA damage. It may also inhibit early stages of cancer formation (El-Mekkawy et al., 2021). However, most of the evidence comes from preclinical in vitro and animal studies. Therefore, more in vivo studies and clinical trials are needed (Hadis et al., 2020). These are required to confirm its safety, efficacy, and possible use in cancer management.

Habtemariam et al. (2017) conducted an in vitro cytotoxicity study on Moringa stenopetala seed extracts and reported strong anticancer activity. The water extract, obtained after hexane defatting, showed potent effects against HepG2 liver cancer cells and SH-SY5Y neuroblastoma cells. Methanol extracts showed weak activity, while hexane extracts were non-cytotoxic. The study isolated glucomoringin isothiocyanate (moringin) as the main active compound. This compound showed much higher potency than etoposide, indicating strong anticancer potential. However, the study is limited by its in vitro design, lack of in vivo validation, and absence of toxicity testing in normal cells, which limit clinical relevance. Assaye et al. (2025) conducted an in vitro antiproliferative study of Moringa stenopetala leaf extract using anaplastic thyroid carcinoma and lung adenocarcinoma cell lines. The extract significantly inhibited cancer cell proliferation in a dose-dependent manner, suggesting potential anticancer activity. However, the study relied solely on cell culture models. It also lacked mechanistic pathway analysis and standardized extract characterization, which may limit reproducibility and clinical applicability.

El-Mekkawy et al. (2021) carried out an in vitro cytotoxicity, genotoxicity, and molecular study using methanolic leaf extract fractions of Moringa stenopetala. The study tested multiple cancer cell lines. Fractions Fr-4 and Fr-6 showed strong cytotoxic effects against breast, liver, and colon cancer cells. These fractions also induced DNA damage and altered cancer-related gene expression patterns similar to chemotherapeutic agents. This suggests possible anticancer mechanisms linked to bioactive compounds. However, the study is limited by the lack of in vivo validation, possible variation in fraction composition, and insufficient toxicity assessment on normal cells, limiting therapeutic translation.

5.10. Neuroprotective Activity

Moringa stenopetala has been reported in several experimental studies to have anticancer and anti-proliferative effects (Tiloke et al., 2018). This suggests a possible role in cancer prevention and treatment strategies. In vitro studies on different cancer cell lines show that leaf extracts of Moringa stenopetala inhibit tumor cell growth. They also reduce cell viability in a dose-dependent manner (Assaye et al., 2025). These effects are mainly due to its rich secondary metabolites. These include flavonoids, phenolic compounds, alkaloids, and glucosinolate derivatives. These compounds can interfere with abnormal cell growth pathways. They also include cell cycle arrest and reduced oxidative stress linked to tumor development (Assaye et al., 2025). In addition, the plant has strong antioxidant activity (El-Mekkawy et al., 2021). This may help prevent DNA damage. It may also block early cancer development. However, most evidence is from preclinical studies. These include in vitro and animal models. Therefore, more in vivo and clinical studies are needed. These are necessary to confirm safety, efficacy, and clinical use in cancer management (Hadis et al., 2020).

Tsegay et al. (2021) conducted an in vivo study using a lithium–pilocarpine–induced temporal lobe epilepsy model in Sprague-Dawley rats to assess the anticonvulsant, anxiolytic, and antidepressant effects of Moringa stenopetala crude extract. Rats were divided into nine groups, including controls and treatment groups receiving 400, 600, and 800 mg/kg doses either before and after induction or after induction only. Seizures were induced using lithium (3 meq/kg) and pilocarpine (35 mg/kg). The extract delayed seizure onset (58.1 min and 80.4 min) compared to controls (13.3 and 35.4 min), reduced seizure severity, and improved behavior. Hippocampal protection was also observed. The study has a strong experimental design with proper controls and dose variation. However, results are limited by a lack of human data and incomplete identification of active compounds.

Adefegha et al. (2024) performed an in vitro study using BV-2 microglial cells to evaluate the antioxidant and neuroprotective effects of aqueous Moringa stenopetala leaf extract. The extract was prepared in 0.5% DMSO and tested at 0.1–100 µg/ml for cell viability and nitric oxide levels. A dose of 50 µg/ml was used for ROS and protein carbonyl assays. The extract maintained cell viability and reduced nitric oxide, ROS, and protein damage markers. Key compounds identified included chlorogenic acid, rutin, kaempferol, and quercetin derivatives. The study shows clear antioxidant mechanisms at the cellular level. However, the lack of in vivo confirmation limits its clinical relevance.

Salile and Abula. (2021) conducted both in vitro and in vivo experiments to study the anticonvulsant activity of 80% methanol root extract of Moringa stenopetala. The in vitro model used 0 Mg²⁺ mouse brain slices at 0.7 mg/kg with diazepam (3 μM) as a control. The in vivo model used PTZ-induced seizures at 85 mg/kg. The extract reduced seizure activity in both models and showed neuroprotective effects. Using both models strengthens the findings. However, the absence of detailed pharmacokinetics and active compound isolation limits interpretation.

5.11. Hepatoprotective & Nephroprotective Activity

Moringa stenopetala has shown significant protective effects on both the liver and kidneys in experimental studies (Tesfaye et al., 2022). This supports its traditional use in managing hepatic and renal disorders. These protective effects are mainly associated with its high content of bioactive compounds, including phenolic compounds, flavonoids, alkaloids, and other antioxidant substances (Adefegha et al., 2025). These constituents help reduce oxidative stress, which is a major cause of liver and kidney tissue damage. In hepatoprotective studies, Moringa stenopetala leaf extracts have been reported to reduce serum liver enzymes such as ALT and AST (Ghebreselassie et al., 2011). This indicates improved liver function and reduced hepatocellular injury. The extracts also inhibit lipid peroxidation and promote liver tissue regeneration (Geleta, Makonnen, and Debella, 2016). This suggests protection against toxin-induced liver damage. Similarly, in nephroprotective models, the plant extracts improve kidney function biomarkers. They also reduce oxidative damage in renal tissues and preserve normal kidney histology (Ghebreselassie et al., 2011; Geleta, Makonnen, and Debella, 2016). These effects are linked to reduced inflammation and enhanced antioxidant defense mechanisms.

Geleta, Makonnen, and Debella. (2016) conducted an in vivo study in female Wistar rats to assess the safety of Moringa stenopetala leaf extract on liver and kidney function. A single high dose (5000 mg/kg) was given for acute toxicity testing, and repeated doses (250, 500, 1000 mg/kg) were administered for 15 days. No mortality or visible toxic signs were observed, indicating LD50 > 5000 mg/kg. Liver enzymes increased in a dose-dependent manner, while kidney markers remained unchanged, suggesting possible liver toxicity. The study is strong due to its acute and subacute design; however, the short duration and limited histopathological evidence reduce the strength of its toxicity conclusion.

Ghebreselassie et al. (2011) conducted an in vivo study in Swiss albino mice using aqueous leaf extract of Moringa stenopetala. The animals received 600, 750, and 900 mg/kg daily for six weeks. No major changes were seen in liver or kidney tissue structure. However, blood glucose and cholesterol levels decreased, and body weight increased at higher doses. The study is strengthened by its longer duration and inclusion of biochemical and histological analysis, but it lacks a detailed mechanistic explanation and full statistical power reporting.

5.12. Reproductive Toxicity

Reproductive toxicity studies of Moringa stenopetala have been conducted to evaluate its safety, particularly regarding fertility and reproductive organ function (Abdu et al., 2023a). These studies are important because medicinal plants may have both beneficial and harmful effects on reproductive health, depending on dose and duration of exposure. In animal models, researchers have assessed reproductive parameters such as organ weight, hormone levels, sperm quality, estrous cycle, and histopathological changes in reproductive tissues after administration of leaf extracts (Abdu et al., 2023a). Some studies have also reported possible effects on reproductive hormones and sperm parameters, but these outcomes vary depending on extract type, dose, and treatment duration (Abdu et al., 2023c). Despite these findings, the evidence is still limited and mainly preclinical. Therefore, further long-term and well-designed studies are needed to confirm the reproductive safety of Moringa stenopetala in humans.

Abdu et al. (2023) conducted an in vivo animal study in male rats using a 70% ethanol extract of Moringa stenopetala leaves for ten weeks. The animals were divided into five groups. Three treatment groups received 250, 500, and 1000 mg/kg body weight. Two groups served as pair-fed and ad libitum controls. The study assessed reproductive organ parameters, serum testosterone, LH, FSH, and selected biochemical markers. Data were analyzed using one-way ANOVA followed by Tukey’s and Dunnett’s post hoc tests. The results showed that the highest dose (1000 mg/kg) significantly increased testosterone, LH, and FSH compared to the pair-fed control group. No significant changes were observed in reproductive organ weight or histology. However, ALT, AST, ALP, HDL, and creatinine levels were elevated in the high-dose group. The study has a strong experimental design with clear dose groups and appropriate controls, which improves the reliability of the findings. However, it is limited by its animal model, which reduces direct application to humans. In addition, long-term safety was not fully assessed. The biochemical changes at high doses suggest the need for further safety and clinical studies.