Chemical Constituents and Pharmacological Activities of Garlic (Allium sativum L.): A Review

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Allicin is the most biologically active sulfur-containing compound of garlic and is responsible for its smell and taste.

“Allicin [S-(2-propenyl)-2-propene-1-sulfinothioate], the most biologically active sulfur-containing compound of garlic, is responsible for its smell and taste [23,24].”

• cites [23] Slusarenko, 2008, Control of plant diseases by natural products: Allicin from garlic as a case study, Eur. J. Plant Pathol. sourceNot checked yet

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• cites [24] Rahman, 2007, Allicin and other functional active components in garlic: Health benefits and bioavailability, Int. J. Food Prop. sourceNot checked yet

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In allicin biosynthesis, cysteine is transformed to alliin, which is hydrolyzed by the allinase enzyme.

“In the allicin biosynthesis, cysteine is transformed to alliin that is hydrolyzed by the allinase enzyme [38].”

• cites [38] Borlinghaus, 2014, Allicin: Chemistry and biological properties, Molecules sourceNot checked yet

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Garlic (Allium sativum L.) is an aromatic herbaceous plant consumed worldwide as food and traditional remedy for various diseases.

“Garlic (Allium sativum L.) is an aromatic herbaceous plant that is consumed worldwide as food and traditional remedy for various diseases.”

• Also stated in: § 1. Introduction · plain

  “Garlic (Allium sativum L.; Family: Amaryllidaceae) is an aromatic herbaceous annual spice and one of the oldest authenticated and most important herbs that have been used from ancient times as traditional medicine [16,17].”

• cites [16] Ayaz, 2007, Garlic (Allium sativum) and traditional medicine, Turkiye Parazitolojii Derg.Not checked yet

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• cites [17] Badal, 2019, Effect of organic manures and inorganic fertilizers on growth, yield and its attributing traits in garlic (Allium sativum L.), J. Pharmacogn. Phytochem.Not checked yet

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N-acetyl-S-allyl cysteine (NASAC) exists in human urine after garlic ingestion and is created by converting SAC into the N-acetylated metabolite by N-acetyl transferase enzyme.

“De Rooij et al. [40] reported the existence of N-acetyl-S-allyl cysteine (NASAC) in human urine after garlic ingestion that is created by converting SAC into the N-acetylated metabolite by N-acetyl transferase enzyme.”

• cites [40] Boogaard, 1996, Urinary excretion of N-acetyl-S-allyl-L-cysteine upon garlic consumption by human volunteers, Arch. Toxicol. sourceNot checked yet

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Allicin is a lipid-soluble sulfur compound that can be easily damaged by cooking and can provoke intolerance, allergic reactions, and gastrointestinal disorders.

“Allicin is a lipid-soluble sulfur compound, which can be easily damaged by cooking and has the ability to provoke intolerance, allergic reactions, and gastrointestinal disorders [27,28,29].”

• cites [27] Rishton, 2008, Natural products as a robust source of new drugs and drug leads: Past successes and present day issues, Am. J. Cardiol. sourceNot checked yet

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• cites [28] Batiha, 2018, Inhibitory effects of Uncaria tomentosa bark, Myrtus communis roots, Origanum vulgare leaves and Cuminum cyminum seeds extracts against the growth of Babesia and Theileria in vitro, Jpn. J. Vet. Parasitol.Not checked yet

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• cites [29] Sobolewska, 2015, Allium ursinum: Botanical, phytochemical and pharmacological overview, Phytochem. Rev. sourceNot checked yet

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Allicin degraded at room temperature and was more stable in methanol than in ethyl acetate.

“These results suggest that allicin degraded at room temperature and was more stable in methanol than in ethyl acetate.”

• cites [41] Freeman, 1995, Garlic chemistry: Stability of S-(2-propenyl)-2-propene-1-sulfinothioate (Allicin) in blood, solvents, and simulated physiological fluids, J. Agric. Food Chem. sourceNot checked yet

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Allicin can easily degrade under the influence of temperature to form ajoenes and vinyldithiins, which are more stable than allicin.

“Previous studies reported that allicin can easily degrade under the influence of temperature to form ajoenes ((E)- and (Z)-4, 5, 9-trithiadodeca-1, 6, 11-triene-9-oxides) and vinyldithiins which are more stable than allicin [43].”

• cites [43] Thomson, 2003, Garlic [Allium sativum]: A review of its potential use as an anti-cancer agent, Curr. Cancer Drug Targets sourceNot checked yet

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Allinase enzyme, composed of pyridoxal phosphate (PLP), splits alliin and produces ammonium, pyruvate, and allyl sulfenic acid, which are highly reactive and unstable at room temperature, and two molecules combine to form allicin.

“This enzyme composed of pyridoxal phosphate (PLP) which splits alliin and produces ammonium, pyruvate, and allyl sulfenic acid that are highly reactive and unstable at room temperature, where two molecules were combined to form allicin [37,39].”

• cites [37] Miron, 2000, The mode of action of allicin: Its ready permeability through phospholipid membranes may contribute to its biological activity, Biochim. Biophys. Acta sourceNot checked yet

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• cites [39] Shimon, 2007, Two structures of alliinase from Allium sativum L.: Apo form and ternary complex with aminoacrylate reaction intermediate covalently bound to the PLP cofactor, J. Mol. Biol. sourceNot checked yet

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In rats, alliin peak time (Tmax) was lower than 10 min and alliin was eliminated after 6 h from the blood, whereas allicin Tmax was 30-60 min and mean total fecal and urinary excretion was 85.5% after 72 h.

“The pharmacokinetic examination in rats using 35 S-labeled alliin, vinyl dithiins, and allicin, revealed that the alliin peak time (Tmax) was lower than 10 min and was eliminated after 6 h from the blood, whereas the allicin peak time (Tmax) was 30–60 min and the mean total fecal and urinary excretion was 85.5% after 72 h.”

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Allicin is a bright yellow oily liquid with a distinctive garlic odor and is very unstable, easily decomposed even at room temperature.

“Allicin, a bright yellow oily liquid that possesses a distinctive garlic odor and it is very unstable, therefore it can be easily decomposed even at room temperature [42].”

• cites [42] Najman, 2015, Biological evaluation of synthesized allicin and its transformation products obtained by microwaves in methanol: Antioxidant activity and effect on cell growth, Biotechnol. Biotechnol. Equip. sourceNot checked yet

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About 62% and 80% of allicin remained one day after Allium administration without increasing the concentration of allicin decomposition products such as DADS.

“About 62% and 80% of allicin remained one day after Allium administration without increasing the concentration of allicin decomposition products such as DADS [40].”

• cites [40] Boogaard, 1996, Urinary excretion of N-acetyl-S-allyl-L-cysteine upon garlic consumption by human volunteers, Arch. Toxicol. sourceNot checked yet

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Allyl mercaptan is the odorant molecule responsible for garlic breath and results from the interaction of allicin or diallyl disulfide with cysteine in the presence of S-ally-mercapto cysteine.

“Allyl mercaptan is the odorant molecule responsible for the garlic breath and results from the interaction of allicin or diallyl disulfide with cysteine in the presence of S-ally-mercapto cysteine [25,26].”

• cites [25] Kaye, 2000, Analysis of responses of garlic derivatives in the pulmonary vascular bed of the rat, J. Appl. Physiol. sourceNot checked yet

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• cites [26] Lawson, 2005, Composition, stability, and bioavailability of garlic products used in a clinical trial, J. Agric. Food Chem. sourceNot checked yet

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Garlic has been used in traditional medicine to treat indigestion, respiratory and urinary tract infections and cardiac disorders, and it showed carminative, antipyretic, sedative, aphrodisiac, and diuretic effects.

“Moreover, garlic has been used in traditional medicine to treat indigestion, respiratory and urinary tract infections and cardiac disorders and it showed carminative, antipyretic, sedative, aphrodisiac, and diuretic effects [32].”

• cites [32] Souza, 2011, N-acetylcysteine an Allium plant compound improves high-sucrose diet-induced obesity and related effects, Evid. Based Complement. Altern. Med. sourceNot checked yet

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Allicin degradation products are commonly isolated from oil, aqueous and chloroform garlic extracts and are present as (E) and (Z) isomers, where (E)-ajoene is usually found in double amounts.

“These degradation products are commonly isolated from oil, aqueous and chloroform garlic extracts and are present as (E) and (Z) isomers, where (E)-ajoene is usually found in double amounts [44].”

• cites [44] Kuda, 2004, Effect of red pepper Capsicum annuum var. conoides and garlic Allium sativum on plasma lipid levels and cecal microflora in mice fed beef tallow, Food Chem. Toxicol. sourceNot checked yet

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Organosulfur compounds like allicin and DADS are the main compounds responsible for garlic's pungency effects and spicy aroma.

“The organosulfur compounds like allicin and DADS are the main compounds responsible for its pungency effects and spicy aroma.”

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Alliin is the main precursor of allicin, representing about 70% of total thiosulfinates in crushed garlic cloves.

“Alliin (S-allyl-L-cysteine sulfoxide) is the main precursor of allicin, which represents about 70% of total thiosulfinates existing in the crushed cloves [25].”

• cites [25] Kaye, 2000, Analysis of responses of garlic derivatives in the pulmonary vascular bed of the rat, J. Appl. Physiol. sourceNot checked yet

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Allicin is a sulfenic acid thioester and its pharmacological effect is attributed to its antioxidant activity and its interaction with thiol-containing proteins.

“Allicin (allyl thiosulfinate), is a sulfenic acid thioester and its pharmacological effect is attributed to its antioxidant activity as well as its interaction with thiol-containing proteins [37].”

• cites [37] Miron, 2000, The mode of action of allicin: Its ready permeability through phospholipid membranes may contribute to its biological activity, Biochim. Biophys. Acta sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Traditionally, garlic and its related compounds have been stated to have several biological activities including anticarcinogenic, antioxidant, antidiabetic, renoprotective, anti-atherosclerotic, antibacterial, antifungal, and antihypertensive activities.

“Traditionally, garlic and its related compounds have been stated to have several biological activities including anticarcinogenic, antioxidant [46], antidiabetic, renoprotective, anti-atherosclerotic, antibacterial, antifungal [47], and antihypertensive activities [17].”

• cites [46] Rahman, 2006, Garlic and cardiovascular disease: A critical review, J. Nutr. sourceNot checked yet

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• cites [47] Davis, 2005, An overview of the antifungal properties of allicin and its breakdown products-the possibility of a safe and effective antifungal prophylactic, Mycoses sourceNot checked yet

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• cites [17] Badal, 2019, Effect of organic manures and inorganic fertilizers on growth, yield and its attributing traits in garlic (Allium sativum L.), J. Pharmacogn. Phytochem.Not checked yet

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Garlic formulations consist of several organosulfur compounds, N-acetylcysteine (NAC), S-allyl-cysteine (SAC), and S-ally-mercapto cysteine (SAMC), which are derived from alliin.

“Garlic formulations consist of several organosulfur compounds, N-acetylcysteine (NAC), S-allyl-cysteine (SAC) [33], and S-ally-mercapto cysteine (SAMC), which are derived from alliin [34].”

• cites [33] Asdaq, 2011, Pharmacodynamic and pharmacokinetic interactions of propranolol with garlic (Allium sativum) in rats, Evid. Based Complement. Altern. Med. sourceNot checked yet

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• cites [34] Tran, 2018, Amelioration of single clove black garlic aqueous extract on dyslipidemia and hepatitis in chronic carbon tetrachloride intoxicated Swiss Albino mice, Int. J. Hepatol. sourceNot checked yet

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Ethanolic garlic extract showed a higher inhibitory effect against E. coli and Sal. typhi than the aqueous extract, which showed little or no inhibition effect.

“For instance, a study revealed that ethanolic garlic extract showed higher inhibitory effect against E. coli and Sal. typhi than the aqueous extract that showed little or no inhibition effect [51].”

• cites [51] Mikaili, 2013, Therapeutic uses and pharmacological properties of garlic, shallot, and their biologically active compounds, Iran. J. Basic Med. Sci.Not checked yet

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PCSO can produce more than fifty metabolites depending on water content and temperature, and allinase enzyme can act on a mixture of MCSO, PCSO, and alliin to produce other molecules such as allyl methane thiosulfinates, methyl methanethiosulfonate, and further corresponding thiosulfinates.

“PCSO can produce more than fifty metabolites depend on water content and temperature as well as allinase enzyme that can act on the mixture of MCSO, PCSO, and alliin to produce other molecules, such as allyl methane thiosulfinates, methyl methanethiosulfonate, and further corresponding thiosulfinates (R-S-S-R′), by which R and R′ are allyl, propyl, and methyls groups [31].”

• cites [31] Zeng, 2017, Therapeutic role of functional components in Alliums for preventive chronic disease in human being, Evid. Based Complement. Altern. Med. sourceNot checked yet

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About 90% of allicin stayed in SIF (pH 7.5) and SGF (pH 1.2) after incubation at 37 °C for 5 h, while only a small amount could be detected after 5 min in blood.

“Furthermore, about 90% of the allicin stayed in the SIF (pH 7.5) and SGF (pH 1.2) after incubation at 37 °C for 5 h, while only a small amount could be detected after 5 min in the blood.”

• cites [41] Freeman, 1995, Garlic chemistry: Stability of S-(2-propenyl)-2-propene-1-sulfinothioate (Allicin) in blood, solvents, and simulated physiological fluids, J. Agric. Food Chem. sourceNot checked yet

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Allicin demonstrates a defensive mechanism against pathogens by its ability to enhance the activity of immune cells and influence signaling pathways associated with these immune cells.

“Allicin demonstrated a defensive mechanism against pathogens by its ability to enhance the activity of immune cells and influence signaling pathways associated with these immune cells.”

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Allicin works on T-cell lymphocytes by inhibiting the SDF1α chemokine associated with weakness of the dynamic structure of the actin cytoskeleton, and it leads to inhibition of transendothelial migration of neutrophils.

“Moreover, allicin works on T-cell lymphocytes by inhibiting the SDF1α chemokine which is associated with the weakness of the dynamic structure of the actin cytoskeleton [75], in addition to this, it leads to inhibit the Transendothelial migration of neutrophils.”

• cites [75] Sela, 2004, Allicin inhibits SDF-1α-induced T cell interactions with fibronectin and endothelial cells by down-regulating cytoskeleton rearrangement, Pyk-2 phosphorylation and VLA-4 expression, Immunology sourceNot checked yet

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In vivo experiment showed garlic extract has antiviral activity and garlic showed protective activity against influenza viruses by improving the production of neutralizing antibodies when given to mice, based on the presence of ajoene, allicin, allyl methyl thiosulfinate, and methyl allyl thiosulfinate.

“Interestingly, in vivo experiment exhibited the antiviral activity of garlic extract and they reported that garlic showed protective activity against influenza viruses by improving the production of neutralizing antibodies when given to mice and this activity was based on the presence of several phytochemicals namely, ajoene, allicin, allyl methyl thiosulfinate, and methyl allyl thiosulfinate [64]”

• cites [64] Sawai, 2008, Induction of cytotoxic T-lymphocyte and antibody responses against highly pathogenic avian influenza virus infection in mice by inoculation of a pathogenic H5N1 influenza virus particles inactivated with formalin, Immunology sourceNot checked yet

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Thiacremonone prevents neuroinflammation and amyloidogenesis by blocking NF-κB activity, and therefore can be used to treat neurodegenerative disorders (e.g., Alzheimer's disease) related to inflammation.

“Another report indicated that thiacremonone (a sulfur compound isolated from garlic) prevents neuroinflammation and amyloidogenesis by blocking the NF-κB activity, and therefore can be used to treat neurodegenerative disorders (e.g., Alzheimer’s disease) related to inflammation [77].”

• cites [77] Jin, 2013, Anti-inflammatory and anti-amyloidogenic effects of a small molecule, 2,4-bis(p-hydroxyphenyl)-2-butenal in Tg2576 Alzheimer’s disease mice model, J. Neuroinflamm. sourceNot checked yet

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AGE rich in flavonoid, phenol, and different sulfur compounds e.g., SAC shows high radical scavenging activity.

“Notably, several reports indicated that AGE rich in flavonoid, phenol, and different sulfur compounds e.g., SAC shows high radical scavenging activity [65].”

• cites [65] Jang, 2017, Antioxidant and antimicrobial activities of fresh garlic and aged garlic by-products extracted with different solvents, Food Sci. Biotechnol. sourceNot checked yet

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Aqueous garlic extract showed antibacterial activity toward Gram-negative (Kl. pneumoniae and E. coli) and Gram-positive (Bacillus subtilis and S. aureus) strains, whereas methanolic garlic extract showed antimicrobial activity against all tested strains except S. aureus.

“Meriga et al. [52] reported that aqueous garlic extract showed antibacterial activity toward Gram-negative (Kl. pneumoniae and E. coli) as well as Gram-positive (e.g., Bacillus subtilis and S. aureus) strains, whereas methanolic garlic extract showed antimicrobial activity against all tested strains except S. aureus.”

• cites [52] Meriga, 2012, Insecticidal, antimicrobial and antioxidant activities of bulb extracts of Allium sativum, Asian Pac. J. Trop. Med. sourceNot checked yet

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Alliin prevents ROS production by inhibiting NADPH oxidase 1, and thus inhibiting osteoclast fusion caused by receptor activator of nuclear factor-kappa B ligand (RANKL).

“Moreover, it was reported to prevent ROS production by inhibiting NADPH oxidase 1, and thus, inhibiting the osteoclast fusion caused by receptor activator of nuclear factor-kappa B ligand (RANKL) [67].”

• cites [67] Chen, Y., Sun, J., Dou, C., Li, N., Kang, F., Wang, Y., Cao, Z., Yang, X., and Dong, S. (2016). Alliin attenuated RANKL-induced osteoclastogenesis by scavenging reactive oxygen species through inhibiting Nox1. Int. J. Mol. Sci., 17. sourceNot checked yet

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ABG exhibited potent antioxidant activities and these activities may be responsible for its anti-inflammatory activity.

“Aged black garlic (ABG) exhibited potent antioxidant activities and these activities may be responsible for its anti-inflammatory activity.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

DAS exhibited potent antioxidant and cytoprotective activities, and these activities may be due to suppressing the enzymatic activity of cytochrome P450-2E1 and thereby reducing the generation of reactive oxygen and nitrogen species or by inducing the mRNA expression of Nrf2 and heme-oxygenase 1 enzyme.

“Interestingly, Abdel-Daim et al. [69] reported that DAS exhibited potent antioxidant and cytoprotective activities and these activities may be due to suppressing the enzymatic activity of cytochrome P450-2E1 and thereby reducing the generation of reactive oxygen and nitrogen species or by inducing the mRNA expression of Nrf2 and heme-oxygenase 1 enzyme.”

• cites [69] Shaheen, 2018, Thymoquinone and diallyl sulfide protect against fipronil-induced oxidative injury in rats, Environ. Sci. Pollut. Res Int. sourceNot checked yet

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Alliin shows wide-spectrum antioxidant activities by controlling ROS generation and preventing mitogen-activated protein kinase (MAPK).

“Alliin, the major compound isolated from AGE, showing wide-spectrum antioxidant activities by controlling ROS generation and preventing mitogen-activated protein kinase (MAPK).”

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Aqueous, ethanolic, and dichloromethane A. sativum extracts exhibited anthelmintic activity against Haemonchus contortus, with the ethanolic extract being the most effective, while aqueous garlic extract showed potent activity against Trichuris muris and Angiostrongylus cantonensis.

“For instance, an in vitro study revealed that the aqueous, ethanolic, and dichloromethane A. sativum extracts exhibited anthelmintic activity against Haemonchus contortus and the ethanolic extract was the most effective one, while aqueous garlic extract showed potent activity against Trichuris muris and Angiostrongylus cantonensis [58].”

• cites [58] Zhen, 2006, Experimental study on the action of allitridin against human cytomegalovirus in vitro: Inhibitory effects on immediate-early genes, Antiviral Res. sourceNot checked yet

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Frequent garlic intake promotes internal antioxidant activities and reduces oxidative adverse effects either by increasing endogenous antioxidant synthesis or reducing the production of oxidizers such as oxygen-free radical species (ORS).

“Asdaq and Inamdar [33] reported that the frequent garlic intake promotes internal antioxidant activities and reduces oxidative adverse effects either by increasing the endogenous antioxidant synthesis or reducing the production of oxidizers such as oxygen-free radical species (ORS).”

• cites [33] Asdaq, 2011, Pharmacodynamic and pharmacokinetic interactions of propranolol with garlic (Allium sativum) in rats, Evid. Based Complement. Altern. Med. sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

The anti-inflammatory effect of ABG may be attributed to direct suppression of toll-like receptor 4 (TLR4) signaling cascade activation in macrophages, reducing nuclear NF-κB level and improving NF-κB and IκB cytosolic levels in LPS-activated RAW264.7 cells.

“You et al. [74] investigated the anti-inflammatory effect of ABG and they reported that this activity may be attributed to the direct suppression of toll-like receptor 4 (TLR4) signaling cascade activation in macrophages, reducing nuclear NF-κB level and improving the NF-κB and IκB cytosolic levels in LPS-activated RAW264.7 cells.”

• cites [74] You, 2019, Anti-inflammatory effect of aged black garlic on 12-O-tetradecanoylphorbol-13-acetate-induced dermatitis in mice, Nutr. Res. Pract. sourceNot checked yet

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Saponins extracted from garlic scavenge intracellular ROS and protect mouse-derived C2C12 myoblasts towards growth inhibition and H2O2-induced DNA damage.

“Saponins extracted from garlic were reported to scavenge intracellular ROS and protect mouse-derived C2C12 myoblasts towards growth inhibition and H2O2-induced DNA damage [68].”

• cites [68] Shang, A., Cao, S.Y., Xu, X.Y., Gan, R.Y., Tang, G.Y., Corke, H., Mavumengwana, V., and Li, H.B. (2019). Bioactive compounds and biological functions of garlic (Allium sativum L.). Foods, 8. sourceNot checked yet

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Allicin is a dose-related biocide that can influence essential metabolism of cysteine proteinase, and thus kill all eukaryotic cells due to the presence of thiol groups in all living cells.

“Allicin is a dose-related biocide that can influence essential metabolism of cysteine proteinase, and thus, kill all eukaryotic cells due to the presence of thiol groups in all living cells.”

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DATS was effective against HCMV replication and viral immediate-early gene expression and acts by enhancing natural killer-cell (NK-cell) activity that destroys virus-infected cells.

“Moreover, DATS was effective against the HCMV replication and viral immediate-early gene expression and it acts by enhancing natural killer-cell (NK-cell) activity that destroys virus-infected cells [58].”

• cites [58] Zhen, 2006, Experimental study on the action of allitridin against human cytomegalovirus in vitro: Inhibitory effects on immediate-early genes, Antiviral Res. sourceNot checked yet

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Garlic extract inhibited the growth of Blastocystis spp. in vivo, and this activity is attributed to garlic extracts containing several phytochemicals, e.g., thiosulfinates, which possess antibacterial activity related to thiol enzyme inhibition present in several microorganisms.

“Abdel-Hafeez et al. [60] showed that garlic extract inhibited the growth of Blastocystis spp. in vivo and this activity attributed to that garlic extracts contains several phytochemicals e.g., thiosulfinates are one of the bioactive compounds that possess antibacterial activity that is related to thiol enzymes inhibition which presents in several microorganisms.”

• cites [60] Ahmad, 2015, In vivo antiprotozoan effects of garlic (Allium sativum) and ginger (Zingiber officinale) extracts on experimentally infected mice with Blastocystis spp., Parasitol. Res. sourceNot checked yet

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The anti-inflammatory activity of DAS is induced by diminishing the expression of inflammatory cytokines (e.g., NF-κB, IL-1β, and TNF-α) and ROS generation by suppressing CYP-2E1 hepatic enzyme.

“Notably, Abdel-Daim et al. [76] reported that the anti-inflammatory activity of DAS induced by diminishing the expression of the inflammatory cytokines (e.g., NF- κB, IL-1β, and TNF-α), and the ROS generation by suppressing CYP-2E1 hepatic enzyme.”

• cites [76] Abdel-Daim, M.M., Abushouk, A.I., Bungău, S.G., Bin-Jumah, M., El-Kott, A.F., Shati, A.A., Aleya, L., and Alkahtani, S. (2020). Protective effects of thymoquinone and diallyl sulphide against malathion-induced toxicity in rats. Environ. Sci. Pollut. Res., 1–8. sourceNot checked yet

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Allicin and garlic oil showed potent antifungal effects against Candida albicans, Ascosphaera apisin, and A. niger and acted by penetrating the cellular membrane and organelle membranes like mitochondria, leading to organelle destruction and cell death.

“Moreover, allicin and garlic oil showed potent antifungal effects against Candida albicans, Ascosphaera apisin, and A. niger [44] and they acted by penetrating the cellular membrane as well as organelles membranes like the mitochondria and leading to organelles destruction and cell death [57].”

• cites [44] Kuda, 2004, Effect of red pepper Capsicum annuum var. conoides and garlic Allium sativum on plasma lipid levels and cecal microflora in mice fed beef tallow, Food Chem. Toxicol. sourceNot checked yet

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• cites [57] Pai, 1995, Antifungal effects of Allium sativum (garlic) extract against the Aspergillus species involved in otomycosis, Lett. Appl. Microbiol. sourceNot checked yet

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Garlic extract increases the activities of some antioxidant enzymes (e.g., superoxide dismutase (SOD)) and decreases glutathione peroxidase (GSH-Px) in hepatic tissues of rats.

“Moreover, garlic extract was found to increase the activities of some antioxidant enzymes (e.g., superoxide dismutase (SOD)) and decrease glutathione peroxidase (GSH-Px) in hepatic tissues of rats.”

May combine two claims.

Garlic extract acts by affecting the fungal cell wall and causing irreversible ultrastructural changes in fungal cells, leading to loss of structural integrity and affected germination ability; these changes in cytoplasmic content lead to nucleus and cell organelle damage that ultimately leads to cell death.

“The garlic extract acted by affecting the fungal cell wall and causing irreversible ultrastructural changes in the fungal cells, which lead to loss of structural integrity and affected the germination ability. These changes in the cytoplasmic content lead to nucleus and cell organelles damage that ultimately leads to cell death.”

May combine two claims.

Allicin acts by preventing the parasite's RNA as well as DNA and protein synthesis.

“Allicin also acts by preventing the parasite’s RNA as well as DNA and protein synthesis.”

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Allicin acts by preventing several thiol enzymes, while ajoene's antiviral activity is due to the prevention of adhesive interaction and fusion of leukocytes.

“Allicin acts by preventing several thiol enzymes, while ajoene’s antiviral activity was due to the prevention of adhesive interaction and fusion of leukocytes.”

May combine two claims.

ABG extract may act by inhibiting iNOS and COX-2 expression, and thus prevented NO, interleukin-6 (IL-6) and TNF-α formation in LPS-activated RAW264.7 cells and TPA-mediated dermatitis in mice.

“Additionally, they revealed that ABG extract may act by another mechanism of action by inhibiting the iNOS and COX-2 expression, and thus, prevented the NO, interleukin-6 (IL-6) and TNF-α formation of in LPS-activated RAW264.7 cells and TPA-mediated dermatitis in mice.”

• cites [74] You, 2019, Anti-inflammatory effect of aged black garlic on 12-O-tetradecanoylphorbol-13-acetate-induced dermatitis in mice, Nutr. Res. Pract. sourceNot checked yet

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Different cholinesterase inhibitors such as donepezil, rivastigmine, and tacrine are used to treat Alzheimer's disease, and their side effects are becoming increasingly remarkable.

“different cholinesterase inhibitors such as donepezil, rivastigmine, and tacrine are used to treat AD, and their side effects are becoming increasingly remarkable [103,104].”

• cites [103] Inglis, 2002, The tolerability and safety of cholinesterase inhibitors in the treatment of dementia, Int. J. Clin. Pract. Suppl.Not checked yet

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• cites [104] Jann, 2002, Clinical pharmacokinetics and pharmacodynamics of cholinesterase inhibitors, Clin. Pharmacokinet. sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Alzheimer's disease is the main cause of dementia in the elderly with neurodegenerative and cerebrovascular disorders.

“Alzheimer’s disease (AD) is the main cause of dementia in the elderly with neurodegenerative and cerebrovascular disorders [88].”

• cites [88] VinayKumar, D.K. (2003). Robbins Basic Pathology/[Edited by] Vinay Kumar, Ramzi S. Cotran, Stanley L. Robbins; with Illustrations by James A. Perkins, Saunders.Not checked yet

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In vivo consumption of A. sativum extracts improves memory by eliminating free radicals that cause oxidative damage and inhibit acetylcholinesterase enzyme.

“The in vivo consumption of A. sativum extracts have shown that it improves memory by eliminating free radicals that cause oxidative damage and inhibit AChE enzyme [97].”

• cites [97] Mukherjee, 2013, Learning and memory promoting effects of crude garlic extract, Indian J. Exp. Biol.Not checked yet

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May combine two claims.

Allicin-derived polysulfanes target microtubules, leading to interruption of the cell-cycle and finally to apoptosis.

“Allicin-derived polysulfanes have been reported to target microtubules, which lead to interruption of the cell-cycle and finally to apoptosis.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Garlic reduced the plasma concentrations of saquinavir by about 50% in healthy participants after 3-week garlic supplement uptake.

“Piscitelli et al. [86] reported that garlic reduced the plasma concentrations of saquinavir by about 50% in healthy participants, after 3-week of a garlic supplement uptake, in addition to this, many researchers evaluated the antitumor and cytotoxic actions of garlic and its related constituents in vitro and in vivo.”

• cites [86] Piscitelli, 2002, The effect of garlic supplements on the pharmacokinetics of saquinavir, Clin. Infect. Dis. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

AGE or SAC inhibits the brain's frontal lobe degeneration, promotes memory and learning retention, and prolongs the lifespan.

“Mbyirukira and Gwebu [95] reported that AGE or SAC inhibits the brain’s frontal lobe degeneration, promotes memory and learning retention, and prolongs the lifespan.”

• cites [95] Mbyirukira, 2003, Aged garlic extract protects serum-deprived PC12 cells from apoptosis, J. Ala. Acad. Sci.Not checked yet

  Not checked in the free run.

May combine two claims.

Allicin inhibits acetylcholinesterase and butyrylcholinesterase enzymes, which successively increases acetylcholine concentration in the brain.

“allicin inhibits AChE and butyrylcholinesterase (BuChE) enzymes (enzymes that break down neurotransmitter choline) which successively increased ACh concentration in the brain.”

• cites [98] Kumar, 2015, Dual inhibition of acetylcholinesterase and butyrylcholinesterase enzymes by allicin, Indian J. Pharmacol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Allicin can prevent gastrointestinal cancer cells MGC 803 proliferation and induce apoptosis, which can be accomplished through enhancing p38 expression and cleaved caspase 3.

“Furthermore, Zhang et al. [80] revealed that allicin can prevent gastrointestinal cancer cells MGC 803 proliferation and induce apoptosis, which can be accomplished through enhancing p38 expression and cleaved caspase 3.”

• cites [80] Zhang, 2015, Allicin induces apoptosis of the MGC-803 human gastric carcinoma cell line through the p38 mitogen-activated protein kinase/caspase-3 signaling pathway, Mol. Med. Rep. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Allicin is a small lipophilic molecule that can suppress butyrylcholinesterase and acetylcholinesterase, and therefore enhances acetylcholine concentration, which is decreased remarkably in Alzheimer's disease patients' brains.

“Allicin is a small lipophilic molecule that can suppress BuChE and AChE, and therefore, enhances ACh concentration, which is decreased remarkably in AD patient’s brains [103].”

• cites [103] Inglis, 2002, The tolerability and safety of cholinesterase inhibitors in the treatment of dementia, Int. J. Clin. Pract. Suppl.Not checked yet

  Not checked in the free run.

May combine two claims.

AGE protected the brain from neurodegenerative diseases in an animal model by preventing brain injury following ischemia, saving neurons toward apoptosis, and inhibiting oxidative death caused by β-amyloid.

“Borek [93] evaluated the neuroprotective effect of AGE using an animal model and they showed that AGE protected the brain from neurodegenerative diseases by preventing brain injury following ischemia, saving neurons toward apoptosis, and inhibiting oxidative death caused by β-amyloid [94].”

• cites [93] Borek, 2006, Garlic reduces dementia and heart-disease risk, J. Nutr. sourceNot checked yet

  Not checked in the free run.

• cites [94] Jackson, 2003, Effect of aged garlic extract on human recombinant caspace-3 activity, J. Ala. Acad. Sci.Not checked yet

  Not checked in the free run.

May combine two claims.

Garlic powders inhibited DNA damage caused by N-nitrosodimethylamine in the liver when administered to rats by 35%, and this effect was due to the high concentration of alliin up to 60% in the samples.

“In addition, garlic powders inhibited the DNA damage caused by N-nitrosodimethylamine in the liver when administered to rats by 35% and this effect was due to the high concentration of alliin up to 60% in the samples [84].”

• cites [84] Singh, 2006, Inhibition of carcinogen-induced DNA damage in rat liver and colon by garlic powders with varying alliin content, Nutr. Cancer sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Allicin can enhance the treatment of pancreatic cancer thereby inverting gene silencing and restraining cancer cell proliferation.

“It also can enhance the treatment of pancreatic cancer thereby invert gene silencing and restrain cancer cell proliferation [79].”

• cites [79] Chhabria, 2015, In situ allicin generation using targeted alliinase delivery for inhibition of MIA PaCa-2 cells via epigenetic changes, oxidative stress and cyclin-dependent kinase inhibitor (CDKI) expression, Apoptosis sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The anticancer mechanisms of garlic extracts are attributed to inhibition of cell growth and proliferation, regulation of carcinogen metabolism, stimulation of apoptosis, prevention of angiogenesis, invasion, and migration, and thus reducing anticancer agent's negative effects.

“Shang et al. [68] reported that the anticancer mechanisms of garlic extracts were attributed to the inhibition of cell growth and proliferation, regulation of carcinogen metabolism, stimulation of apoptosis, prevention of angiogenesis, invasion, and migration and thus reducing the anticancer agent’s negative effects.”

• cites [68] Shang, A., Cao, S.Y., Xu, X.Y., Gan, R.Y., Tang, G.Y., Corke, H., Mavumengwana, V., and Li, H.B. (2019). Bioactive compounds and biological functions of garlic (Allium sativum L.). Foods, 8. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Combination therapy of allicin with cholinesterase inhibitors including rivastigmine, galantamine, and donepezil are now the most commonly used for the treatment of Alzheimer's disease as they correct the cholinergic deficiency seen with Alzheimer's disease.

“Combination therapy of allicin with cholinesterase inhibitors (ChEIs) including; rivastigmine, galantamine, and donepezil are now the most commonly used for the treatment of AD [99] as they have the ability to correct the cholinergic deficiency seen with AD.”

• cites [99] Hogan, 2007, Progress update: Pharmacological treatment of Alzheimer’s disease, Neuropsychiatr. Dis. Treat.Not checked yet

  Not checked in the free run.

May combine two claims.

Oil from garlic bulbs suppressed acetylcholinesterase activity of cerebral cortex synaptosome and exhibits antioxidant properties, inhibiting acetylcholinesterase activity in vitro.

“oil from garlic bulbs suppressed AChE activity of cerebral cortex synaptosome and exhibits antioxidant properties, thus, inhibiting AChE activity in vitro [91]”

• cites [91] Akinyemi, A.J., Lekan Faboya, A.P., Awonegan, I.O., Anadozie, S., and Oluwasola, T.A. (2018). Antioxidant and anti-Acetylcholinesterase activities of essential oils from garlic (Allium sativum) Bulbs. Int. J. Plant Res., 31.Not checked yet

  Not checked in the free run.

May combine two claims.

Raw garlic extract is the most effective and highly specific anticancer drug when compared with 33 raw vegetable extracts against different cancer cells without affecting non-cancerous cells.

“Raw garlic extract was found to be the most effective and highly specific anticancer drug when compared with 33 raw vegetable extracts against different cancer cells without affecting the non-cancerous cells [78].”

• cites [78] Li, 2018, A novel therapeutic anticancer property of raw garlic extract via injection but not ingestion, Cell Death Discov. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Allicin isolated from garlic suppresses colorectal cancer metastasis through enhancing immune function and preventing the formation of tumor vessels as well as survivin gene expression to enhance cancer cell apoptosis.

“Allicin isolated from garlic was reported to suppress colorectal cancer metastasis through enhancing the immune function and preventing the formation of tumor vessels as well as survivin gene expression to enhance the cancer cell’s apoptosis.”

• cites [79] Chhabria, 2015, In situ allicin generation using targeted alliinase delivery for inhibition of MIA PaCa-2 cells via epigenetic changes, oxidative stress and cyclin-dependent kinase inhibitor (CDKI) expression, Apoptosis sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

Acetylcholinesterase is the main enzyme that converts acetylcholine in the nervous system to acetate and choline.

“Acetylcholinesterase (AChE) is the main enzyme that converts the acetylcholine (ACh) in the nervous system to acetate and choline [89].”

• cites [89] Maggi, 2010, Identification of non-alkaloid acetylcholinesterase inhibitors from Ferulago campestris (Besser) Grecescu (Apiaceae), Fitoterapia sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Z-ajoene has anti-proliferative activities against different types of cancers and inhibits the growth of human breast cancer cells and glioblastoma multiforme cancer stem cells (GBM CSC).

“Moreover, Z-ajoene has shown anti-proliferative activities against different types of cancers and it inhibits the growth of human breast cancer cells and glioblastoma multiforme cancer stem cells (GBM CSC) [68].”

• cites [68] Shang, A., Cao, S.Y., Xu, X.Y., Gan, R.Y., Tang, G.Y., Corke, H., Mavumengwana, V., and Li, H.B. (2019). Bioactive compounds and biological functions of garlic (Allium sativum L.). Foods, 8. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The antiobesity effect of garlic extracts is attributed to stimulation of AMP-activated protein kinase, increased thermogenesis, and decreased multiple genes expression involved in adipogenesis.

“Lee et al. [116] revealed that the antiobesity effect of garlic extracts attributed to stimulation of AMP-activated protein kinase (AMPK) as well as increased thermogenesis and decreased multiple genes expression that is included in adipogenesis.”

• cites [116] Lee, 2011, Reduction of body weight by dietary garlic is associated with an increase in uncoupling protein mRNA expression and activation of AMP-activated protein kinase in diet-induced obese mice, J. Nutr. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Ajoene isolated from garlic extracts stimulates apoptosis, decreases fat accumulation in 3T3-L1 adipocytes, and dramatically decreases body weight gain in mice without affecting the amount of food intake.

“Ajoene isolated from garlic extracts was found to stimulate apoptosis, decrease the fat accumulation in 3T3-L1 adipocytes and dramatically decrease the body weight gain in mice without affecting the amount of food intake [117].”

• cites [117] Han, 2011, Ajoene, a stable garlic by-product, inhibits high fat diet-induced hepatic steatosis and oxidative injury through LKB1-dependent AMPK activation, Antioxid. Redox Signal. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Garlic pills administration at 900 mg/day in patients with type II diabetes and hyperlipidemia decrease cholesterol, serum lipids, and fasting blood sugar.

“Another clinical study examined the antidiabetic effect of garlic pills administration at 900 mg/day in patients with type II diabetes and hyperlipidemia and they reported that garlic pills decrease the cholesterol, serum lipids, and fasting blood sugar [114].”

• cites [114] Faroughi, 2018, Effects of garlic pill on blood glucose level in borderline gestational diabetes mellitus: A triple blind, randomized clinical trial, Iran. Red. Crescent Med. J. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Oral or intraperitoneal administration of 50 mg/kg garlic to rats did not show any effect on liver and lung tissue, while intake of garlic at 250, 500, and 1000 mg/kg per day led to acute deformities in the rat's liver and lung tissue, suggesting dose-related toxicity.

“Rana et al. [82] revealed that oral or intraperitoneal administration 50 mg/kg of garlic to rats did not show any effect on liver and lung tissue, while intake garlic at 250, 500, and 1000 mg/kg per day led to acute deformities in the rat’s liver and lung tissue, suggesting the dose-related toxicity.”

• cites [82] Rana, 2011, Garlic in health and disease, Nutr. Res. Rev. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Garlic extracts reduce body weight, adipose tissue mass and improve plasma lipid profiles in mice with high-fat diet-induced obesity, mediated by downregulation of multiple genes involved in adipogenesis and upregulation of mitochondrial inner membrane proteins.

“Garlic extracts have been reported for their activity in reducing body weight, adipose tissue mass and improved plasma lipid profiles in mice with high-fat diet-induced obesity and these effects mediated by the downregulation of multiple genes expression that is included in adipogenesis along with upregulation of the mitochondrial inner membrane proteins expression [116].”

• cites [116] Lee, 2011, Reduction of body weight by dietary garlic is associated with an increase in uncoupling protein mRNA expression and activation of AMP-activated protein kinase in diet-induced obese mice, J. Nutr. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Variable results were attributed to differences in garlic preparation composition, amount of active sulfur compounds in each preparation, and the mechanism by which they act.

“They claimed that these variable results were attributed to the differences in garlic preparation composition, amount of active sulfur compounds exist in each preparation and the mechanism by which they act.”

May combine two claims.

Garlic reduces cholesterol level either by stimulating acidic and neutral steroids excretion or by reducing the cholesterogenic and lipogenic effects of fatty acid synthase, 3-hydroxy-3-methyl-glutaryl-CoA reductase, malic, and glucose-6 phosphate dehydrogenase in hepatocytes.

“garlic reduces the cholesterol level either by stimulating the acidic and neutral steroids excretion or by reducing the cholesterogenic and lipogenic effects of fatty acid synthase, 3-hydroxy-3-methyl-glutaryl-CoA reductase, malic, and glucose-6 phosphate dehydrogenase in hepatocytes [107].”

• cites [107] Qidwai, 2013, Role of garlic usage in cardiovascular disease prevention: An evidence-based approach, Evid. Based Complement. Altern. Med. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Garlic significantly decreased serum total cholesterol, triglyceride, and LDL levels and moderately elevated HDL cholesterol.

“Garlic was found to have an important effect on dyslipidemia by significantly decreased serum TC, TG, and LDL levels and moderately elevated HDL cholesterol [108].”

• cites [108] Iweala, 2005, Effect of ethanolic extracts of Allium sativum Linn. Liliaceae on serum cholesterol and blood sugar levels of alibino rabbits, Plant Prod. Res. J.Not checked yet

  Not checked in the free run.

May combine two claims.

Garlic significantly decreases systolic as well as diastolic blood pressure.

“Varshney and Budoff [119] reported the essential function of garlic in the control of cardiovascular risk factors as it is known to significantly decrease systolic as well as diastolic blood pressure.”

• cites [119] Varshney, 2016, Garlic and Heart Disease, J. Nutr. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

AGE prevents both ADP-activated platelets binding to immobilized fibrinogen and platelet aggregation by inhibiting GPIIb/IIIa receptor and increasing cAMP.

“The AGE was reported to prevent both ADP-activated platelets binding to immobilized fibrinogen and platelet aggregation by inhibiting GPIIb/IIIa receptor and increasing cAMP [124].”

• cites [124] Rahman, 2016, Aged garlic extract inhibits human platelet aggregation by altering intracellular signaling and platelet shape change, J. Nutr. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Garlic administration at a dose of 300 and 60 mg/day for 12 months and 12 weeks, respectively, decreased total cholesterol, triglyceride, and LDL while increased HDL in patients.

“Sobenin et al. [110,111] revealed that garlic administration at a dose of 300 and 60 mg/day for 12 months and 12 weeks, respectively decreased TC, TG, and LDL while increased HDL.”

• cites [110] Sobenin, 2008, Metabolic effects of time-released garlic powder tablets in type 2 diabetes mellitus: The results of double-blinded placebo-controlled study, Acta Diabetol. sourceNot checked yet

  Not checked in the free run.

• cites [111] Sobenin, 2010, The effects of time-released garlic powder tablets on multifunctional cardiovascular risk in patients with coronary artery disease, Lipids Health Dis. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Garlic intake at a dose of 500 and 1000 mg/kg/day remarkably decreased auto-antioxidants without changing the lipid peroxidation level, whereas daily intake of 1000 mg/kg resulted in morphological deformities in the liver under light microscopy and ultrastructural levels.

“While garlic intake at a dose of 500 and 1000 mg/kg/day remarkably decreased the auto-antioxidants without changing the lipid peroxidation level, whereas the daily intake of 1000 mg/kg resulted in morphological deformities in the liver under light microscopy and ultrastructural levels.”

• cites [82] Rana, 2011, Garlic in health and disease, Nutr. Res. Rev. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

1,2-vinyldithiin prevents human preadipocytes differentiation and decreases lipid accumulation by decreasing C/EBPα, PPARγ2, and LPL expression and the PPARγ effect in human adipocytes.

“1,2-vinyldithiin also has been reported to prevent the human preadipocytes differentiation and decrease lipid accumulation by decreasing the C/EBPα, PPARγ2, and LPL expression and the PPARγ effect in human adipocytes [118].”

• cites [118] Keophiphath, 2009, 1,2-Vinyldithiin from garlic inhibits differentiation and inflammation of human preadipocytes, J. Nutr. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Allyl propyl disulfide, allicin, cysteine sulfoxide, and S-allyl cysteine sulfoxide decreased blood glucose level by preventing insulin activation caused by liver, enhancing secretion of insulin from pancreatic beta cells, isolation of insulin from bonded forms, and increasing cell sensitivity to insulin.

“allyl propyl disulfide, allicin, cysteine sulfoxide, and S-allyl cysteine sulfoxide decreased the blood glucose level by preventing the insulin activation caused by liver, enhancing the secretion of insulin from pancreatic beta cells, isolation of insulin from the bonded forms, and increasing the cell sensitivity to insulin [114].”

• cites [114] Faroughi, 2018, Effects of garlic pill on blood glucose level in borderline gestational diabetes mellitus: A triple blind, randomized clinical trial, Iran. Red. Crescent Med. J. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Garlic reduces the risk of plasma viscosity, unstable angina, and peripheral arterial occlusive disorders and increases the elasticity of the blood vessels and perfusion of capillaries.

“garlic has been reported to reduce the risk of plasma viscosity, unstable angina, and peripheral arterial occlusive disorders and increase the elasticity of the blood vessels and perfusion of capillaries [87].”

• cites [87] Bayan, 2014, Garlic: A review of potential therapeutic effects, Avicenna J. Phytomed.Not checked yet

  Not checked in the free run.

May combine two claims.

Garlic administration at a dose of 100 mg/kg for 5 days resulted in complete prevention of acute hypoxic pulmonary vasoconstriction caused by endothelin-1 in isolated rat pulmonary arteries, acting by reducing endothelin 1 and angiotensin II production.

“Garlic administration at a dose of 100 mg/kg for 5 days resulted in complete prevention of acute hypoxic pulmonary vasoconstriction caused by endothelin-1 in isolated rat pulmonary arteries and they found that garlic acts by reducing endothelin 1 and angiotensin II production [120].”

• cites [120] Drobiova, 2011, Garlic increases antioxidant levels in diabetic and hypertensive rats determined by a modified peroxidase method, Evid. Based Complement. Altern. Med. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Various evidence encourages the significant and crucial role of garlic preparations and their phytochemicals in treating hypercholesterolemia by preventing cholesterol biosynthesis in the liver and inhibiting LDL and HDL oxidation.

“various evidence encourages the significant and crucial role of garlic preparations and its phytochemicals in treating hypercholesterolemia by preventing the cholesterol biosynthesis in the liver as well as inhibiting low-density lipoproteins (LDL and HDL) oxidation.”

• cites [107] Qidwai, 2013, Role of garlic usage in cardiovascular disease prevention: An evidence-based approach, Evid. Based Complement. Altern. Med. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Allicin shows remarkable activity in reversing systolic blood pressure caused by dexamethasone and enhances body weight and food intake in hypertension caused by dexamethasone in rats.

“Dubey et al. [122] revealed that allicin shows remarkable activity in reversing systolic blood pressure caused by dexamethasone and enhances body weight and food intake in hypertension caused by dexamethasone in rats.”

• cites [122] Dubey, 2017, Antihypertensive effect of allicin in dexamethasone-induced hypertensive rats, Integr. Med. Res. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Previous reports have reported the cardiovascular effects of garlic including potentially irreversible antiplatelet activity, anticoagulant, fibrinolytic activity, a remarkable decrease in platelet accumulation and mixed activity on fibrinolytic effectiveness.

“Previous reports have reported the cardiovascular effects of garlic including potentially irreversible antiplatelet activity, anticoagulant, fibrinolytic activity, a remarkable decrease in platelet accumulation and mixed activity on fibrinolytic effectiveness [130].”

• cites [130] Borrelli, 2007, Garlic (Allium sativum L.): Adverse effects and drug interactions in humans, Mol. Nutr. Food Res. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Garlic and ezetimibe combined treatment reduces plasma LDL-C and total cholesterol, and thus inhibits the absorption of intestinal cholesterol and reduces cardiovascular disorder risk factors.

“Mohammadi et al. [134] revealed the potent activity of garlic and ezetimibe combined treatment in reducing plasma LDL-C and TC, and thus, inhibiting the absorption of intestinal cholesterol and reducing the cardiovascular disorders risk factors.”

• cites [134] Mohammadi, 2015, Combination of ezetimibe and garlic reduces serum lipids and intestinal niemann-pick C1-like 1 expression more effectively in hypercholesterolemic mice, Avicenna J. Med. Biochem. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Extracts and isolated compounds from A. sativum possess several biological properties including anticarcinogenic, antioxidant, antidiabetic, renoprotective, anti-atherosclerotic, antibacterial, antifungal, antiprotozoal, and antihypertensive activities.

“Extracts and isolated compounds from A. sativum reported to possess several biological properties including anticarcinogenic, antioxidant, antidiabetic, renoprotective, anti-atherosclerotic, antibacterial, antifungal, antiprotozoal, and antihypertensive activities.”

May combine two claims.

Oxidative hemolysis is the main toxicological mechanism of Allium-derived sulfur compounds and is distinguished by methemoglobinemia development and Heinz body formation in the red blood cells.

“Oxidative hemolysis is the main toxicological mechanism of Allium-derived sulfur compounds and it is distinguished by methemoglobinemia development and Heinz body formation in the RBCs [128].”

• cites [128] Salgado, 2011, Allium species poisoning in dogs and cats, J. Venom. Anim. Toxins Incl. Trop. Dis. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Clinical studies reported that low doses of garlic are safe, whereas therapeutic doses might cause mild gastrointestinal disorders, while high doses have been reported to cause liver damage.

“Clinical studies reported that low doses of garlic are safe, whereas therapeutic doses might cause mild gastrointestinal disorders, while high doses have been reported to cause liver damage [82,123,133].”

• cites [82] Rana, 2011, Garlic in health and disease, Nutr. Res. Rev. sourceNot checked yet

  Not checked in the free run.

• cites [123] Ried, 2014, Potential of garlic (Allium sativum) in lowering high blood pressure: Mechanisms of action and clinical relevance, Integr. Blood Press. Control sourceNot checked yet

  Not checked in the free run.

• cites [133] Almogren, 2013, Garlic and onion sensitization among Saudi patients screened for food allergy: A hospital-based study, Afr. Health Sci.Not checked yet

  Not checked in the free run.

May combine two claims.

Chronic administration of 50 mg garlic powder per day led to anti-androgenic effects by inhibiting spermatogenesis in rats, leading to decreased sialic acid concentration in the seminal vesicles, testes, and epididymis with reduced Leydig cell function.

“Additionally, the chronic administration of 50 mg garlic powder per day led to anti-androgenic effects by inhibiting spermatogenesis in rats, leading to decrease sialic acid concentration in the seminal vesicles, testes, and epididymis with reduced Leydig cell function [82].”

• cites [82] Rana, 2011, Garlic in health and disease, Nutr. Res. Rev. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Garlic-artemether combination treatment has a potent immunomodulatory and anti-plasmodial effect.

“Vathsala and Murthy [138] revealed the potent immunomodulatory and anti-plasmodial effect of garlic–artemether combination treatment.”

• cites [138] Vathsala, P.G., and Murthy, P.K. (2019). Immunomodulatory and antiparasitic effects of garlic–arteether combination via nitric oxide pathway in Plasmodium berghei-infected mice. J. Parasit. Dis., 49–61. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Dehydrated raw garlic powder when administered orally resulted in acute injury to the gastric mucosa, whilst AGE protects the intestinal mucosa of experimental animals.

“Chen et al. [131] revealed that dehydrated raw garlic powder when administered orally resulted in acute injury to the gastric mucosa, whilst Yuncu et al. [132] reported that AGE, the sulfur-free compound, protects the intestinal mucosa of experimental animals.”

• cites [131] Chen, K., Xie, K., Liu, Z., Nakasone, Y., Sakao, K., Hossain, A., and Hou, D.X. (2019). Preventive effects and mechanisms of garlic on dyslipidemia and gut microbiome dysbiosis. Nutrients, 11. sourceNot checked yet

  Not checked in the free run.

• cites [132] Yuncu, 2006, Effect of aged garlic extract against methotrexate-induced damage to the small intestine in rats, Phytother. Res. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Garlic is well-known to have immunomodulatory and anti-inflammatory activities.

“Garlic is also well-known to have immunomodulatory and anti-inflammatory activities.”

May combine two claims.

Allicin is a membrane-permeable compound that can enter cells easily and interact with cellular thiols such as glutathione or cysteine residues in proteins as well as enzymes containing reactive cysteine, and this may be the potential interpretation of allicin's toxicity.

“Allicin is a membrane-permeable compound that can enter cells easily and interact with cellular thiols such as glutathione or cysteine residues in proteins [37,89,90] as well as enzymes containing reactive cysteine and this may be the potential interpretation of allicin’s toxicity [63].”

• cites [37] Miron, 2000, The mode of action of allicin: Its ready permeability through phospholipid membranes may contribute to its biological activity, Biochim. Biophys. Acta sourceNot checked yet

  Not checked in the free run.

• cites [89] Maggi, 2010, Identification of non-alkaloid acetylcholinesterase inhibitors from Ferulago campestris (Besser) Grecescu (Apiaceae), Fitoterapia sourceNot checked yet

  Not checked in the free run.

• cites [90] Lu, 2011, The discovery of potential acetylcholinesterase inhibitors: A combination of pharmacophore modeling, virtual screening, and molecular docking studies, J. Biomed. Sci. sourceNot checked yet

  Not checked in the free run.

• cites [63] Gruhlke, M.C., Nicco, C., Batteux, F., and Slusarenko, A.J. (2016). The effects of allicin, a reactive sulfur species from garlic, on a selection of mammalian cell lines. Antioxidants, 6. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Garlic homogenate is a good combination therapy as it reduces the dose and toxic side effects of propanol, which may assist in decreasing repeated higher doses of propanol.

“They indicated that garlic homogenate is a good combination therapy as it reduces the dose and toxic side effects of propanol, which may assist in decreasing repeated higher doses of propanol.”

• cites [33] Asdaq, 2011, Pharmacodynamic and pharmacokinetic interactions of propranolol with garlic (Allium sativum) in rats, Evid. Based Complement. Altern. Med. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Many surgeons recommended stopping garlic administration in high doses up to 7 to 10 days prior to operation due to its effect to prolong the bleeding time that was observed in one patient with epidural spontaneous hematoma.

“Many surgeons recommended stopping garlic administration in high doses up to 7 to 10 days prior to operation due to its effect to prolong the bleeding time that was observed in one patient with epidural spontaneous hematoma [46].”

• cites [46] Rahman, 2006, Garlic and cardiovascular disease: A critical review, J. Nutr. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Garlic does not seem to affect drug metabolism, although recent reports on healthy participants show inconsistent results regarding the garlic effect in the pharmacokinetics of protease inhibitors, as well as anticoagulants due to its antithrombotic properties.

“Garlic does not seem to affect the drug metabolism, although recent reports on healthy participants show inconsistent results regarding the garlic effect in the pharmacokinetics of protease inhibitors, as well as anticoagulants due to its antithrombotic properties [46].”

• cites [46] Rahman, 2006, Garlic and cardiovascular disease: A critical review, J. Nutr. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

Allicin, the active substance of garlic, can induce gastric agitation especially if administered in high doses.

“Allicin, the active substance of the garlic, can induce gastric agitation especially if administered in high doses.”

May combine two claims.

Prolonged feeding of raw garlic in high doses led to weight loss and anemia due to red blood cell lysis, while administration of 5 mL/kg of raw garlic juice resulted in stomach injury that led finally to death.

“Previous in vivo experiments revealed that prolonged feeding of raw garlic in high doses led to weight loss and anemia due to red blood cells (RBCs) lysis, while administration of 5 mL/kg of raw garlic juice resulted in stomach injury that led finally to death [20].”

• cites [20] Mathew, 2008, Neuroprotective effects of garlic a review, Libyan J. Med.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

A. sativum has been reported to affect the pharmacokinetics of antiretroviral drugs, as well as anticoagulants.

“In addition to that, A. sativum has been reported to affect the pharmacokinetics of antiretroviral drugs, as well as anticoagulants.”