Much has been written about the mangosteen fruit in the past few years. In fact, one could argue that much has been written over the past few hundred years, both from a traditional medicine and scientific perspective. Recently, a sincere, yet, I believe, possibly inaccurate article was published discussing the mangosteen fruit. The author stated that mangosteen had limited medicinal qualities, and he generally criticized commercial mangosteen products. The following commentary attempts to address some of the opinions expressed in the article, “Beyond the Mangosteen: A Future Full of Color.”

The author incorrectly stated that there are, “limited medicinal qualities” in the mangosteen fruit. Medicinal benefits of mangosteen date back hundreds of years with the oldest recorded documentation derived from the Ming Dynasty in China (1368-1644 A.D).[1] Over succeeding centuries, the medicinal uses of the mangosteen rind are chronicled in traditional texts all over South East Asia. For example:
• Thailand. Treat diarrhea, dysentery, skin infections and eczema.[2]
• India. Treat chronic dysentery, diarrhea, other gastrointestinal problems, gout, fevers and urinary infections.[3]
• Philippines. Treat fevers, thrush, diarrhea, dysentery and urinary disorders.[4]
• Malaysia. Treat stomach ache and diarrhea.[5]
• China. Treat bowel complaints.[6]

As recent as 1932 the use of a mangosteen preparation was used to treat dysentery in hospitals in Singapore.[7] The mangosteen has been used the same way (rind or whole fruit), for the same purposes (inflammatory and infectious conditions) by traditional healers all across South East Asia. The mangosteen is not a new medicinal botanical; it is simply new to us.

The author of the aforementioned article stated that, “the rind possess a great diversity of complex organic chemicals, amongst which are tannic acid and xanthones.”  In addition to the tannic acid and xanthones the mangosteen fruit and rind includes proanthocyanidins, anthocyanins, catechins, and polysaccharides. The author argues that, “xanthones comprise much of the promotional claims pertaining to the alleged historical medicinal uses but it may be the tannic acid which explains why it has been used almost exclusively as an astringent and aid in controlling dysentery.” Mangosteen possesses tannins and the tannins most likely contribute to its effective treatment of dysentery. However, if tannins are the only biologically active mangosteen constituent, why are scientists focused on studying xanthones and their effects on disease instead of tannins? For example, there are over 20 papers published on the anti-microbial effect of mangosteen xanthones and no papers published on mangosteen tannins. It seems that scientists from Thailand, India and Japan studying mangosteen understand that there is more to the medicinal benefits of the mangosteen than its “tannins”.  It should be noted that the mangosteen rind possesses a higher concentration of xanthones than the white, inner fruit. One researcher stated that the mangosteen and its xanthones merits consideration for its, “therapeutic and chronic disease prevention potential and mechanism.”[8]

Currently, there are over 100 papers published on the medicinal benefits of the mangosteen fruit. The majority of these papers are in-vitro or in-vivo animal models. The research is sound but relatively recent given that the majority of these papers were published in the last few decades. Therefore, there is still much work to be done. Some of the research being conducted on the mangosteen fruit and its derivatives include:
• Inflammation. Scientists have used a variety of models to study the anti-inflammatory properties of mangosteen such as induced arthritis[9], acne[10], histamine[11] and prostaglandin inhibition[12]. There are over a dozen published scientific articles on the anti-inflammatory properties of the mangosteen.
• Antioxidant. Over 15 journal articles published on the antioxidant properties of mangosteen and its constituents.[13]
• Antimicrobial. Over 20 papers published on antimicrobial properties.[14]
• Anti-tumor. Over a dozen papers published on antitumor properties.[15]
• Protective effects of the skin properties[17]

In addition, the author criticized commercial nutritional product companies, which market mangosteen beverages containing the entire mangosteen fruit (rind and pulp). One commercial mangosteen company, XanGo LLC, recently reported the results of a randomized, double-blind, placebo controlled study which they commissioned. The study, conducted by Medicus Research, a respected third-party research organization located in Northridge, Calif., examined inflammatory and antioxidant markers in obese patients during an 8-week period. The results demonstrated high levels of antioxidant derivatives in the blood and lowering of blood inflammatory markers (such as C-reactive protein). This study demonstrates that commercial mangosteen companies are adding to the “body of knowledge” and further validates the continued use and study of the whole mangosteen fruit.

As the mangosteen continues to find a greater place in the scientific laboratory and our daily diets, there will be more debate about its health benefits. As an advocate for mangosteen and other natural products I welcome that debate, inasmuch as the free exchange of ideas leads to greater discovery and is based upon reliable facts. Good science stands the test of time. The mangosteen has stood this test of time through traditional medicine and is continuing to be validated through scientific investigation. 

Endnotes
1. Benemerito, A.N., The Garcinia of South China (Guttiferae). Lingnan Sci. Journ., 1936. 15: p. 57-66.
2. Saralamp, P., et al., Medicinal Plants in Thailand. 1996, Bangkok: Siambooks and Publications.
3. Waring, E.J., Pharmacopeia of India. 1868, London: W. H. Allen & Co., 13, WaterlooPlace,
   Publishers to the India Office. 503.
4. Pardo De Tavera, T., The Medicinal Plants of the Phillipines. 1901, Philadelphia: Blakiston's Son & Co.
5. Krishnapilly, B., M. Marzalina, and M. Hairs, Seeds and fruits of some common tropical species used as medicine by folk healers. Bulletin FRIM, 1993. 3(2): p. 9-11.
6. Murrah, et al., Historical and Descriptive Account of China. 1836, London: Oliver & Boyd, Tweeddale Court and Simpkin, Marshall & Co.
7. Garnett, M. and S. Sturton, G. mangostana in the treatment of amoebic dysentery. Chiness Med J 1932. 46(10): p. 969-973
8. Fu, C., et al., Oligomeric proanthocyanidins from mangosteen pericarps. J Agric Food Chem, 2007. 55(19): p. 7689-94.
9. Nakatani, K., et al., gamma-Mangostin inhibits inhibitor-kappaB kinase activity and decreases lipopolysaccharide-induced cyclooxygenase-2 gene expression in C6 rat glioma cells. Mol Pharmacol, 2004. 66(3): p. 667-74.
10. Chomnawang, M., et al., Effect of Garcinia mangostana on inflammation caused by Propionibacterium acnes. Fitoterapia, 2007. 78(6): p. 401-8.
11. Nakatani, K., et al., Inhibitions of histamine release and prostaglandin E2 synthesis by mangosteen, a Thai medicinal plant. Biol Pharm Bull, 2002. 25(9): p. 1137-1141.
12. Nakatani, K., et al., Inhibition of cyclooxygenase and prostaglandin E2 synthesis by gamma-mangostin, a xanthone derivative in mangosteen, in C6 rat glioma cells. Biochem Pharmacol, 2002. 63(1): p. 73-79.
13. Jung HA, et al., Antioxidant xanthones from the pericarp of Garcinia mangostana (Mangosteen). J Agric Food Chem, 2006. 54(6): p. 2077-82.
14. Sakagami, Y., et al., Antibacterial activity of alpha-mangostin against vancomycin resistant Enterococci (VRE) and synergism with antibiotics. Phytomedicine, 2005. 12(3): p. 203-8.
15. Ho, C., Y. Huang, and C. Chen, Garcinone E, a xanthone derivative, has potent cytotoxic effect against hepatocellular carcinoma cell lines. Planta Med, 2002. 68(11): p. 975-979.
16. Gopalakrishnan, G., B. Banumathi, and G. Suresh, Evaluation of the antifungal activity of natural xanthones from Garcinia mangostana and their synthetic derivatives. J Nat Prod, 1997. 60(5): p. 519-524.
17. Hsu, J., G. Skover, and M. Goldman, Evaluating the efficacy in improving facial photodamage with a mixture of topical antioxidants. J Drugs Dermatol, 2007. 6(11): p. 1141-8.

Dr. Morton is an advocate for natural products and an internationally recognized author and lecturer on the history and scientific investigation of the mangosteen fruit.