Health Care Professional Information

Scientific Name
Garcinia mangostana L.
Common Name

Numerous brand names. XanGo is a dietary supplement that contains Garcinia mangostana and other fruit juices. But it is not synonymous with the mangosteen fruit.

Clinical Summary

Mangosteen is a plant native to Southeast Asia. The fruits are used in traditional medicine to treat skin infections, wounds, and diarrhea.
Recent studies have revealed that xanthones from the fruit hulls exhibit antibacterial (3), antifungal (4), and anti-inflammatory (5), cytototoxic (12) , aromatase-inhibitory (14) and anticancer (17) (18) properties and afford protection against doxorubicin-induced neurotoxicity (19).
Alpha-mangostin, a xanthone, inhibited growth of leukemia HL60 cells (1) (6), reduced the synthesis of prostaglandins (5), and prevented oxidative damage of LDL (7) in vitro. It was also shown to have renoprotective effects against cisplatin-induced nephrotoxicity (16). There is preliminary evidence that alpha- and gamma-mangostins act as histamine and serotonin receptor blockers (8), and inhibit HIV-1 protease (9). Garcinone E, another xanthone, exerts cytotoxic effects against hepatocellular carcinoma cells (10). Extract from the pericarp of mangosteen has antioxidant (13), antiproliferative and apoptotic effects (11).

Small studies in humans suggest its benefits as an adjunct for periodontal treatment (20) and for control of halitosis (21).

Mangosteen products may interfere with certain chemotherapeutic drugs.
Diabetic patients should use mangosteen juice with caution due to the sugar content.

Purported Uses
  • Bacterial Infections
  • Diarrhea
  • Fungal infections
  • Inflammation
  • Skin infections
  • Wound healing
Constituents
  • Xanthones: alpha-mangostin, beta-mangostin, gamma-mangostin, garcinone B, garcinone E
  • Mangostinone
  • Tannins
  • Flavonoid: epicatechin
    (1) (2)
Mechanism of Action

The xanthones, alpha- and beta-mangostins, and garcinone B exhibit strong inhibitory effect against Mycobacterium tuberculosis (3), and aromatase inhibitory activity (14). Alpha- and gamma-mangostins also antagonize the activities of histamine and serotonin by acting as receptor blockers (8).

Alpha-mangostin was shown to inhibit fatty acid synthase (FAS) believed to be via stronger action on the ketoacyl synthase domain and weaker effects on the acetyl/malonyl transferase domain (22). It also reduced the synthesis of prostaglandins by inhibiting the activities of COX-1 and COX-2 enzymes (5), and prevented oxidative damage of LDL by functioning as a free-radical scavenger (7).

In other studies, alpha-mangostin inhibited growth of leukemia HL60 cells by inducing caspase-3-dependent apoptosis (1) (6). Its preventive effect on cisplatin-induced apoptotic death is associated with the inhibition of p53 expression and generation of reactive oxygen species (23).  A recent study implicates the antitumor activity of alpha-mangostin to activation of autophagy and not ER stress induction (24).
Garcinone E also has cytotoxic effects against hepatocellular carcinoma cells (10). In vitro studies have demonstrated that a crude methanolic extract from the pericarp of mangosteen has antiproliferative, antioxidative, and apoptotic effects against SKBR3 breast cancer cells (11).

Adverse Reactions

Case Report: Severe lactic acidosis was reported following consumption of mangosteen juice daily for twelve months (15).

Herb-Drug Interactions

Chemotherapy: Mangosteen products have antioxidant effects (7) and may interfere with the action of anthracyclines, platinum compounds, and alkylating agents.
Cytochrome P450 substrates: Mangosteen inhibits CYP1A1, CYP1A2, CYP2E1 and CYP3A11 and can affect the intracellular concentration of drugs metabolized by these enzymes (25).

Literature Summary and Critique

There are no clinical data available to support the beneficial effects of mangosteen in humans.

Dosage (Inside MSKCC Only)
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References
  1. Matsumoto K, et al.Induction of apoptosis by xanthones from mangosteen in human leukemia cell lines. J Nat Prod 2003; 66(8):1124-1127.
  2. Suksamrarn S, et al. Xanthones from the green fruit hulls of Garcinia mangostana. J Nat Prod 2002; 65(5):761-763.
  3. Suksamrarn S, et al. Antimycobacterial activity of prenylated xanthones from the fruits of Garcinia mangostana. Chem Pharm Bull (Tokyo) 2003; 51(7):857-859.
  4. Gopalakrishnan G, Banumathi B, Suresh G. Evaluation of the antifungal activity of natural xanthones from Garcinia mangostana and their synthetic derivatives. J Nat Prod 1997; 60(5):519-524.
  5. 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):73-79.
  6. Matsumoto K, et al. Preferential target is mitochondria in alpha-mangostin-induced apoptosis in human leukemia HL60 cells. Bioorg Med Chem 2004; 12(22):5799-5806.
  7. Williams P, et al. Mangostin inhibits the oxidative modification of human low density lipoprotein. Free Radic Res 1995; 23(2):175-184.
  8. Chairungsrilerd N, et al. Histaminergic and serotonergic receptor blocking substances from the medicinal plant Garcinia mangostana. Planta Med 1996; 62(5):471-472.
  9. Chen SX, Wan M, Loh BN. Active constituents against HIV-1 protease from Garcinia mangostana. Planta Med 1996; 62(4):381-382.
  10. Ho CK, Huang YL, Chen CC. Garcinone E, a xanthone derivative, has potent cytotoxic effect against hepatocellular carcinoma cell lines. Planta Med 2002; 68(11):975-979.
  11. Moongkarndi P, et al. Antiproliferation, antioxidation and induction of apoptosis by Garcinia mangostana (mangosteen) on SKBR3 human breast cancer cell line. J Ethnopharmacol 2004; 90(1):161-166.
  12. Suksamrarn S, et al. Cytotoxic prenylated xanthones from the young fruit of Garcinia mangostana. Chem Pharm Bull 2006: 54(3): 301-5.
  13. Jung HA, et al. Antioxidant xanthones from the pericarp of Garcinica mangostana (Mangosteen). J Agric Food Chem 2006; 54(6): 2077-82.
  14. Balunas MJ, Su B, Brueggemerier RW, Kinghorn AD. Xanthones from the Botanical Dietary Supplement Mangosteen (Garcinia mangostana) with Aromatase Inhibitory Activity. J Nat Prod. 2008 Jun 18.
  15. Wong LP, Klemmer PJ. Severe lactic acidosis associated with juice of the mangosteen fruit Garcinia mangostana. Am J Kidney Dis. 2008 May;51(5):829-33.
  16. Pérez-Rojas JM, Cruz C, García-López P, et al. Renoprotection by alpha-mangostin is related to the attenuation in renal oxidative/nitrosative stress induced by cisplatin nephrotoxicity. Free Radic Res. 2009 Nov;43(11):1122-32.
  17. Krajarng A, Nakamura Y, Suksamrarn S, Watanapokasin R. Alpha-Mangostin Induces Apoptosis in Human Chondrosarcoma Cells through Downregulation of ERK/JNK and Akt Signaling Pathway. J Agric Food Chem. 2011 May 25;59(10):5746-54.
  18. Shibata MA, Iinuma M, Morimoto J, et al. alpha-Mangostin extracted from the pericarp of the mangosteen (Garcinia mangostana Linn) reduces tumor growth and lymph node metastasis in an immunocompetent xenograft model of metastatic mammary cancer carrying a p53 mutation. BMC Med. 2011 Jun 3;9(1):69.
  19. Tangpong J, Miriyala S, Noel T, et al. Doxorubicin-induced central nervous system toxicity and protection by xanthone derivative of Garcinia mangostana. Neuroscience. 2011 Feb 23;175:292-9.
  20. Rassameemasmaung S, Sirikulsathean A, Amornchat C, et al. Topical application of Garcinia mangostana L. pericarp gel as an adjunct to periodontal treatment. Complement Ther Med. 2008 Oct;16(5):262-7.
  21. Rassameemasmaung S, Sirikulsathean A, Amornchat C, et al. Effects of herbal mouthwash containing the pericarp extract of Garcinia mangostana L on halitosis, plaque and papillary bleeding index. J Int Acad Periodontol. 2007 Jan;9(1):19-25.
  22. Quan X, Wang Y, Ma X, et al. α-Mangostin induces apoptosis and suppresses differentiation of 3T3-L1 cells via inhibiting fatty acid synthase. PLoS One. 2012;7(3):e33376.
  23. Sánchez-Pérez Y, Morales-Bárcenas R, García-Cuellar CM, et al. The alpha-mangostin prevention on cisplatin-induced apoptotic death in LLC-PK1 cells is associated to an inhibition of ROS production and p53 induction. Chem Biol Interact. 2010 Oct 6;188(1):144-50.
  24. Kim SJ, Hong EH, Lee BR, et al. α-Mangostin Reduced ER Stress-mediated Tumor Growth through Autophagy Activation. Immune Netw. 2012 Dec;12(6):253-60.
  25. Chatuphonprasert W, Jarukamjorn K. Impact of six fruits—banana, guava, mangosteen, pineapple, ripe mango and ripe papaya—on murine hepatic cytochrome P450 activities. J Appl Toxicol. 2012 Dec;32(12):994-1001.

Consumer Information

How It Works

Bottom Line: 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 the fruits of mangosteen are effective against bacterial and fungal infections and can reduce inflammation. Other studies have shown that mangosteen can inhibit the growth of leukemia and breast cancer cells. There is also evidence that some compounds in mangosteen act as free-radical scavengers to prevent LDL (low density lipoprotein) damage. 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.
  • 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.
Patient Warnings
  • Several Mangosteen products are sold via a network marketing approach. There is no conclusive regarding the safety and efficacy of mangosteen in treating cancer. Patients should consult their oncologists before using any supplements during cancer treatment.
Do Not Take If
  • You are taking drugs that are substrates of Cytochrome P450 1A1, 1A2, 2E1 and 3A11  (Mangosteen may increase the risk of side effects of these drugs).
Side Effects

Case Report: Severe lactic acidosis was reported following consumption of mangosteen juice daily for twelve months.

Special Point
  • Mangosteen products have antioxidant effects. They may interfere with the action of certain chemotherapeutic drugs and radiation therapy.
  • Due to the sugar content, diabetic patients should use mangosteen juice with caution.
E-mail your questions and comments to aboutherbs@mskcc.org.