Therapeutic Effects of Garlic: A Review

Garlic (Allium sativum) is a perennial bulb that belongs to thegenus, Allium and is closely related to onion, shallot, leek, chive,[1]. Natural products of animals, plants and microbial sources havebeen used by many cultures in ancient times including Babylonians,Chinese, Egyptians, Greeks, Hindus, Phoenicians, Romans, andVikings, either in the pure forms or crude extracts to treat manydiseases such as flatulence, intestinal disorders, respiratoryinfections, skin diseases, wounds, and many other ailments [2].

Garlic was in use at the beginning of recorded history andwas found in Egyptian pyramids and ancient Greek temples. Itsusefulness was known to ancient Egyptians, both as food flavoringand traditional medicine. In addition, garlic is one of the earliestdocumented examples of plants employed for treatment of diseaseand maintenance of health. Medical applications of garlic have beendocumented in ancient medical texts from Egypt, Greece, Rome,China and India. Almost 25 centuries ago, Hippocrates, the Fatherof Medicine, stated “let food be thy medicine and let medicine be thyfood”. Supporting this statement, Hippocrates prescribed garlic fora variety of conditions. Garlic was administered to provide strengthand increase work capacity for labourers in many cultures. It wasgiven as perhaps one of the earliest “performance enhancing”agents to the original Olympic athletes in Greece.

The therapeutic and preventive roles of garlic have beendemonstrated through appreciable epidemiologic evidence. Severalexperimental and clinical investigations suggest many favorableeffects of garlic and its preparations. These effects have been largelyattributed to

• reduction of risk factors for cardiovascular diseases,

• reduction of cancer risk,

• antioxidant effect,

• antimicrobial effect, and

• enhancement of detoxification foreign compound andhepatoprotection [3,4].

Today, the discovery of effective natural products andalternative medicines which is able to detoxify environmentaltoxicants is an important scientific issue that is popular amongstpeople concerned about potential adverse effects of conventionalmedicines. Garlic (Allium sativum L) is one of those plants thatwere seriously investigated over several years and used as aprophylactic as well as a therapeutic medicinal plant [5], known forits anticancer, anti-diabetic, antioxidant and immune modulationactivities. In this review, a survey on current experimental as wellas clinical state of knowledge about the preventive and therapeuticeffects of garlic in different diseases is given.

Antimicrobial effects

Pasteur (1958), first described the anti- microbial propertiesof garlic and since then, many researches have demonstrated theeffectiveness and broad-spectrum antimicrobial activity of garlic against many species of bacteria, viruses, parasites, protozoan andfungi [6]. According to [7,8] garlic, amongst many other medicinalplants, has an antimicrobial property which protects the host fromother pathogens highlighting the importance of search for naturalantimicrobial drugs. Previously conducted researches by Tsao andYin [9], confirmed that garlic is not only effective against Grampositive and Gram-negative bacteria but also possess antiviral andantifungal activities.

Antibacterial effects

According to Nervi [10] more recent studies have shown garlicto be effective against a group of gram-positive, gram-negative,and acid-fast bacteria. Garlic extract inhibits the growth of Grampositive and gram- negative bacteria, such as Staphylococcus,Streptococcus, Micrococcus, Enterobacter, Escherichia, Klebsiella,Lactobacillus, Pseudomonas, Shigella, Salmonella, Proteus, andHelicobacter pylori [9].

Nervi [10] also documented that garlic exerts a differentialinhibition between beneficial intestinal microflora and potentiallyharmful enterobacteria [11]. Its antibacterial activity is mainlydue to the presence of allicin produced by the enzymatic activityof allinase on alliin. Allicin is considered to be the most potentantibacterial agent in crushed garlic extracts, but it can be unstable,breaking down within 16 h at 23°C [12]. Cysteine and glutathionecounteract the thiolation activity of allicin. It is thought that allicinmodifies the sulfhydryl groups on the enzymes of the TN1546transposon, which encodes vancomycin resistance, enhancingsusceptibility to vancomycin [13].

Antifungi effects

Ajoene is an active compound found in garlic which plays agreat role as topical antifungal agent [14,15]. According to ShamsGhahfarokhi, et al. [16], garlic has been shown to inhibit growth offungal diseases as equally as the drug ketoconazole, when testedon the fungi Malassezia furfur, Candida albicans, Aspergillus,Cryptococcus and other Candida species.

A report from a Chinese medical journal by Lemar, et al. [17],delineates the use of intravenous garlic to treat a potentiallyfatal and rare fungal infection of the brain called Cryptococcusmeningitis. In the report, the Chinese compared the effectivenessof the garlic with standard medical treatment which involved avery toxic antibiotic called Amphotericin-B. The study revealedthat, intravenous garlic was more effective than the drug and wasnot toxic regardless of its dosage. Lanzotti, et al. [18] also reportedthat garlic exhibited antifungal effects on two species, the air-bornepathogen Botrytis cinerea and Trichoderma harzianum. Greatersatisfaction with the use of garlic rather than nystatin was reportedby the patients with denture stomatitis [19].

Antiviral effects

Very little work has been done to investigate the antiviralproperties of garlic. There are insufficient clinical trials regardingthe effects of garlic in preventing or treating the common cold. Asingle trial suggested that garlic may prevent occurrences of thecommon cold, but more studies are needed to validate this finding.This trial randomly assigned 146 participants to either a dailygarlic supplement (with 180 mg of allicin content) or a placebo for12 weeks.

An investigation by Lissiman, et al. [20] revealed 24 occurrencesof the common cold in the garlic group compared with 65 in theplacebo group, resulting in fewer days of illness in the garlic groupcompared with the placebo group. However, claims of effectivenessof garlic on common cold appear to rely largely on poor qualityevidence.

Anti-protozoal properties

Several studies have shown that the extract was effective againsta host of protozoa including Candida albicans [21], Scedosporiumprolificans [15], tinea pedis [14], Opalina ranarum, Balantidiumentozoon, Entamoeba histolytica, Trypanosomes, Leishmania,Leptomonas, and Crithidia [10].

Due to the occurrence of unpleasant side effects andincreasing resistance to the synthetic pharmaceuticals, garlic wasrecommended for the treatment of giardiasis. Inhibitory activityof garlic on giardia was noted with crude extract at 25 pg/mlLand the lethal dosage was established as approximately 50 pg/mL. Encouraged by these results, a clinical trial was carried outon patients that had giardiasis [22]. Garlic was established as anantigiardial, removing the symptoms from all patients within 24h and completely removing any indication of giardiasis from thestool within 72 h at a dosage of 1 mg/mL twice daily aqueousextract or 0.6 mg/mL commercially prepared garlic capsules. No invitro calculations were possible, as the workers could not culturethe protozoa in vitro. It was suggested that allicin, ajoene, andorganosulfides from garlic are effective antiprotozoal compounds[21].

Effect of garlic on hypertension

Garlic has probably been most popularized as a complementarytherapy for blood pressure control. A recent study conducted invitro by Benavides has confirmed that, the vasoactive ability ofgarlic sulfur compounds whereby red blood cells convert garlicorganic polysulfides into hydrogen sulfide, a known endogenouscardio-protective vascular cell signaling molecule. Although, as of2015, clinical research conducted by Rohner, et al. [23] to determinethe possible effects of consuming garlic on hypertension has foundno clear effect [24]. A 2016 meta-analysis by Sahebkar, et al. [25]indicated there was no effect of garlic consumption on blood levelsof lipoprotein(a), a biomarker of atherosclerosis. Because garlicmight reduce platelet aggregation, people taking anticoagulantmedication are cautioned about consuming garlic [26,27].

Anticancer

Garlic preparations and their respective constituents havesuggested possible cancer-preventive effects in many in vitro and invivo studies conducted by Kyo, et al. [28]. One of the most prominent actions of garlic is the prevention of the growth of cancer, due toa large number of potent bioactive compounds with anti-tumorproperties, largely allylsulfide derivatives. The action of differentgarlic derivatives has been reported by Capasso, [29] to modulateimmune response through a series of molecular mechanisms incarcinogenesis, such as DNA adduct formation, mutagenesis, cellproliferation and differentiation, scavenging of free radicals aswell as angiogenesis. Garlic exhibits a variety of anti-tumor effects,including inhibition of tumor cell growth and chemo preventiveeffects. In both rodents and humans, garlic and its constituentshave been found to inhibit the development of chemically inducedtumors in the liver [30], colon [31], prostate etc. [32].

Garlic reduces the growth rate of cancer cells, with cellcycle blockade that occurs in the G2/M phase [29] and also theantioxidant effect of allicin in reducing the formation of carcinogeniccompounds in the gastro-intestinal tract [33]. The risk of patientswith prostate cancer is reduced by garlic and was found to beindependent of body size, intake of other foods and total calorieintake and was more pronounced for men with localized prostatecancer than with advanced prostate cancer. Men in the higher oftwo intake categories of total Allium vegetables (>10.0 g/day) hada statistically significant lower risk of prostate cancer than those inthe lowest category (<2.2 g/day) [32].

Borkowska, et al. [34] investigations on the anticancer activityof garlic both in in vitro and in vivo has been shown to be dueto the presence of Diallyl trisulfide (DATS), an organosulfurcompound isolated from garlic. The cytotoxicity of DATS towardprostate epithelial cells is reduced as opposed to PC-3 cancer cell.DATS reduces mitosis in tumors by decreased histone deacetylaseactivity, increased acetylation of H3 and H4, inhibition of cellcycle progression, and decreased activity of pro-tumor markers(survivin, Bcl-2, c-Myc, mTOR, EGFR, VEGF) [35].

Certain components of garlic have been found to block covalentbond formation of carcinogens to DNA, stimulate degradationof carcinogens, have anti-oxidative and free radical scavengingproperties, and modulate immune responses, cell proliferation, andapoptosis. Ajoene, a garlic stable oil soluble sulfur rich compoundand garlic-derived natural compound has been shown to induceapoptosis in human leukemic cells via stimulation of peroxideproduction, activation of caspase-3-like and caspase-8 activity.Garlic promotes the effect of eicosapentaenoic acid, a breast cancersuppressor, and opposes the effect of linoleic acid, a breast cancerenhancer [36]. Furthermore, allicin is also responsible for the antiproliferativeeffect of garlic derivatives on human colon cancer cells.

Anti-diabetes

Studies conducted by Ohaeri [37], have shown the effectivenessof garlic in reducing blood glucose level in diabetic animals suchas alloxan-induced diabetes mellitus in rats and mice. Garlicsignificantly reduced serum total cholesterol and LDL cholesteroland moderately raised HDL cholesterol as compared with placeboin diabetic patients [38]. S-allyl cysteine, a bioactive componentderived from garlic, restored erectile function in diabetic rats bypreventing reactive oxygen species formation through modulationof NADPH oxidase subunit expression [39].

Garlic extract was administered orally for 14 days in a studyconducted by Eidi, et al. [40] to evaluate the level of serum glucose,total cholesterol, triglycerides, urea and uric acid, in normal andstreptozotocin-induced diabetic mice. The result of the studyshowed a significant decrease (p<0.05) in serum glucose, totalcholesterol, triglycerides, urea, uric acid, while serum insulin levelincreased in diabetic mice, but not in normal mice. The anti-diabeticeffect of garlic is mainly attributed to the presence of volatile sulfurcompounds, such as alliin, allicin, diallyl disulfide, diallyl trisulfide,diallyl sulfide, S-allyl cysteine, ajoene, and allyl mercaptan. Thereduction in insulin resistance has been reported by Padiya andBanerjee [41], to be due to the presence of garlic extract. However,although experimental studies demonstrated a clear hypoglycemiceffect of garlic, the effect of garlic on human blood glucose is stillcontroversial.

Immune modulation

With the arrival of frightening viral diseases like HIV/AIDS,boosting immunity system is receiving a new attention. Due tothe absence of an effective cure to these types of diseases have,strengthening the body’s ability to fight off infection has becomeeven more important.

Garlic contains certain that promote an immune responseto germs/antigen [28,42]. When garlic is chewed or crushed, thecompound alliin turns into allicin the main active ingredient ingarlic [43]. The distinctive smell and taste of garlic is because of thepresence of sulphur in allicin. However, due to its unstability, it isquickly converted to other sulphur-containing compounds believedto give garlic its therapeutic properties [42].

According to Nantz, et al. [44], garlic has abundant sulfurcontaining amino acids and other compounds that have beenshown to boost the activity of the immune system against virusessuch as the viruses that cause common cold. Furthermore, studiesconducted by Josling [45], have shown that garlic can reduce therisk of becoming sick, as well as the duration of the illness. It canalso reduce the severity of symptoms.

Effect of garlic on hepatotoxicity

Detoxification of substances is facilitated by the liver in thepresence of glutathione. It has been hypothesized that garlicorgano-sulfur compounds may protect the liver cells from sometoxic agents by preventing glutathione depletion. For this reason, ithas been demonstrated that garlic protects against acetaminopheninducedhepatotoxicity. An elevated damage of the liver’s markerenzymes (aspartate transaminase and alanine aminotransferase)and reduction in plasma albumin level is revealed to have beenassociated to gentamycin. Studies conducted by Ademiluyi, et al. [46]have shown that the dietary inclusion of garlic powder protects ratsagainst gentamycin-induced hepatotoxicity, improves antioxidantstatus, and modulates oxidative stress. In addition, Garlic extract may reduce lipid peroxidation and enhance antioxidant defensesystem [47].

Antioxidant

The antioxidant property exhibited by whole garlic and agedgarlic extract also enhances the serum levels of two antioxidantenzymes, catalase and glutathione peroxidase [48]. S-allyl cysteine,a component of garlic also confirmed significant antioxidanteffects. The sulfur compounds found in fresh garlic appear to benearly 1000 times more potent as antioxidants than crude, agedgarlic extract. Garlic (both the homogenate of 10% in physiologicalsaline solution and its supernatant) was able to reduce the radicalspresent in cigarette smoke [49]. Furthermore, allicin being anothercomponent that is abundant in dried garlic and is formed whengarlic is crushed. According to recent studies, allicin decomposes toform sulfenic acid, a potent antioxidant [50-56].

Adverse effect of garlic

The most common side effect of garlic is bad breath (halitosis)and body odor especially when raw form of the herbs are taken, thisis because allyl methyl sulfide (AMS) absorbed into the blood duringthe metabolism of garlic-derived sulfur compounds; it travels fromthe blood to the lungs [1] (and from there to the mouth, causingbad breath) and skin, where it is released through pores. As such itis considered safe to ingest one to two cloves of raw garlic per dayis in adults. Rare garlic allergy has been attributed to the proteinallinase, which has induced immunoglobulin E (IgE) mediatedhypersensitivity responses from skin prick testing.

The consumption of garlic for its therapeutic potential in curingand preventing/reducing the symptoms of disease has proven tobe of clinical importance throughout the world. However, due tothe ever-growing resistance of microbes, intake of garlic is ableto provide some level of anti-fungal, ant- anti-microbial activities.As such, more studies need to be conducted to refine the use andefficacy of garlic.

None.

No conflict of interest.

1. Block E (2010) Garlic and Other Alliums: The Lore and the Science, Royal Society of Chemistry 8(5): 4-9.
2. Parekh J, Chanda S (2007) In vitro antimicrobial activity of Trapa natans L, Fruit rind extracted in different solvents. African Journal of Biotechnology 6(6): 766-770.
3. Colín González AL, Santana RA, Silva Islas CA, Chánez Cárdenas ME, Santamaría A (2012) The antioxidant mechanisms underlying the aged garlic extract and S allylcysteine-induced protection, Oxidative Medicine and Cellular Longevity 10: 1155.
4. Aviello G, Abenavoli L, Borrelli F, Capasso R, Izzo AA, et al. (2009) Garlic: empiricism or science? Nat Prod Commun 4(12): 1785-1796.
5. Onyeagba R, Ugbogu OC, Okeke CU, Iroakasi O (2004) Studies on the antimicrobial effects of garlic (Allium sativum L) ginger (Zingiber officinale Roscoe) and lime (Citrus aurantifolia L,). African Journal of Biotechnology 3(10): 552-554.
6. Jaber MA, Al Mossawi A (2007) Susceptibility of some multiple resistant bacteria to garlic extracts. African Journal of Biotechnology 6(6): 771-776.
7. Bajpai M, Pande A, Tewari SK, Prakash D (2005) Phenolic contents and antioxidant activity of some food and medicinal plants. Int J Food Sci Nutr 56(4): 287-291.
8. Wojdylo A, Oszmianski J, Czemerys R (2007) Antioxidant activity and phenoli Chihara c compounds in 32 selected herbs. Food Chemistry 105(3): 940-949.
9. Tsao SM, Yin MC (2001) In vitro antimicrobial activity of four diallyl sulphides occurring naturally in garlic and Chinese leek oil. J Med Microbiol 50(7): 646-649.
10. Nervi C (2006) Garlic Biochemistry: Effect on human health, Università degli Studi di Torino. Nutrition and Food Research 51(11): 1386-1397.
11. Rees LP, Minney SF, Plummer NT (1993) Assessment of the anti-microbial activity of garlic (Allium sativum). World J Microbiol Biotechnol 9(3): 303-307.
12. Hahn G (1996) Garlic: the science and therapeutic application of Allium sativum L and related species (2^nd edn). Baltimore Williams and Wilkins, pp. 1-24.
13. Houshmand B, Mahjour F, Dianat O (2013) Antibacterial effect of different concentrations of garlic (Allium sativum) extract on dental plaque bacteria. Indian J Dent Res 24(1): 71-75.
14. Ledezma E, Marcano K, Jorquera A, De Sousa L, Padilla M, et al. (2000) Efficacy of ajoene in the treatment of tinea pedis: a double-blind and comparative study with terbinafine. J Am Acad Dermatol 43(5): 829-832.
15. Davis SR, Penie R, Apitz Castro R (2003) The in vitro susceptibility of Scedosporium prolificans to ajoene allitridium and a raw extract of garlic (Allium sativum). J Antimicrob Chemother 51(3): 593-597.
16. Shams Ghahfarokhi M, Shokoohamiri MR, Amirrajab N, Moghadasi B, Ghajari A, et al. (2006) In vitro antifungal activities of Allium cepa Allium sativum and ketoconazole against some pathogenic yeasts and dermatophyte. Fitoterapia 77(4): 321-323.
17. Lemar KM, Miguel AA, Sonia C, Brian O, Carsten TM, et al. (2007) Diallyl disulphide depletes glutathione in Candida albicans: oxidative stress mediated cell death studied by two-photon microscopy. Yeast 24 (8): 695-706.
18. Lanzotti V (2006) The analysis of onion and garlic. J Chromatogr A 1112(1-2): 3-22.
19. Bakhshi M, Taheri JB, Shabestari SB, Tanik A, Pahlevan R (2012) Comparison of therapeutic effect of aqueous extract of garlic and nystatin mouthwash in denture stomatitis. Gerodontology 29(2): 680-684.
20. Lissiman E, Bhasale AL, Cohen M (2012) Garlic for the common cold. Cochrane Database of Systematic Review 51(11): 1335-1344.
21. Lemar KM, Turner MP, Lloyd D (2002) Garlic (Allium sativum) as an anti-Candida agent: a comparison of the efficacy of fresh garlic and freeze-dried extracts. J Appl Microbiol 93(3): 398-405.
22. Soffar SA, Mokhtar GM (1991) Evaluation of the antiparasitic effect of aqueous garlic (Allium sativum) extract in hymenolepiasis nana and giardiasis. J Egypt Soc Parasitol 21(2): 497-502.
23. Rohner A, Ried K, Sobenin IA, Bucher HC, Nordmann AJ (2015) A systematic review and meta-analysis on the effects of garlic preparations on blood pressure in individuals with hypertension. Am J Hypertens 28(3): 414-423.
24. Stabler SN, Tejani AM, Huynh F Fowkes C (2012) Garlic for the prevention of cardiovascular morbidity and mortality in hypertensive patients. Cochrane Database Syst Rev 8(8): CD007653.
25. Sahebkar A, Serban C, Ursoniu S, Banach M (2016) Effect of garlic on plasma lipoprotein(a) concentrations: A systematic review and meta-analysis of randomized controlled clinical trials. Nutrition 32(1): 33-40.
26. Rahman K (2007) Effects of garlic on platelet biochemistry and physiology. Mol Nutr Food Res 51(11): 1335-1344.
27. Borrelli F Capasso, A Raffaele, Angelo A (2013) Antioxidant action and therapeutic efficacy of Allium sativum L. Molecules 18(1): 690-700.
28. Kyo E, Uda N, Kasuga S, Itakura Y (2001) Immunomodulatory effects of aged garlic extract. J Nutr 131(3): 1075S-1079S.
29. Capasso A (2013) Antioxidant action and therapeutic efficacy of Allium sativum L. Molecules 18(1): 690-700.
30. Kweon S, Park KA, Choi H (2003) Chemopreventive effect of garlic powder diet in diethyl nitrosamine induced rat hepato carcinogenesis. Life Sci 73(19): 2515-2526.
31. Knowles LM, Milner JA (2003) Diallyl disulfide induces ERK phosphorylation and alters gene expression profiles in human colon tumor cells. J Nutr 133(9): 2901-2906.
32. Hsing AW, Chokkalingam AP, Gao YT, Madigan MP, Deng J, et al. (2002) Allium vegetables and risk of prostate cancer:a population based study. J Natl Cancer Inst 94 (21): 1648-1651.
33. Galeone C, Pelucchi C, Levi F, Negri E, Franceschi S, et al. (2006) Onion and garlic use and human cancer. Am J Clin Nutr 84 (5): 1027-1032.
34. Borkowska A, Knap N, Antosiewicz J (2013) Diallyl Trisulfide Is More Cytotoxic to Prostate Cancer Cells PC-3 than to Noncancerous Epithelial Cell Line PNT1A: A Possible Role of p66Shc signaling Axis. Nutr Cancer 65(5): 711-717.
35. Wallace IV, Haar CP, Vandergrift WA, Giglio P, Dixon Mah YN, et al. (2013) Multi-targeted DATS prevents tumor progression and promotes apoptosis in ectopic glioblastoma xenografts in SCID mice via HDAC inhibition. J Neurooncol 114(1): 43-50.
36. Tsubura A, Lai YC, Kuwata M, Uehara N, Yoshizawa K (2011) Anticancer effects of garlic and garlic-derived compounds for breast cancer control. Anticancer Agents Med Chem 11(13): 249-253.
37. Ohaeri OC (2001) Effect of garlic oil on the levels of various enzymes in the serum and tissue of streptozotocin diabtic rats. Biosci Rep 21(1): 19-24.
38. Ashraf R, Aamir K, Shaikh AR, Ahmed T (2005) Effects of garlic on dyslipidemia in patients with type 2 diabetes mellitus. J Ayub Med Coll Abbottabad 17(3): 60-64.
39. Yang J, Wang T, Yang J, Rao K, Zhan Y, et al. (2013) S‐allyl cysteine restores erectile function through inhibition of reactive oxygen species generation in diabetic rats. Andrology 1(3): 487-494.
40. Eidi A, Eidi M, Esmaeili E (2006) Antidiabetic effect of garlic (Allium sativum L) in normal and streptozotocin-induced diabetic rats. Phytomedicine 13(9-10): 624-629.
41. Padiya R, Banerjee SK (2013) Garlic as an anti-diabetic agent: recent progress and patent reviews. Recent Pat Food Nutr Agric 5(2): 105-127.
42. Arreola R, Quintero Fabian S, Lopez Roa RI, Flores Gutierrez EO, Reyes Grajeda JP, et al. (2015) Immunomodulation and anti-inflammatory effects of garlic compounds. Journal of Immunological Research pp. 401-630.
43. Borlinghaus J, Albreght F, Gruhike MC, Nwachukwu ID, Slusarenko AJ (2014) Allicin: chemistry and biological properties. Molecules 19 (8): 12591-12618.
44. Nantz MP, Rowe CA, Muller CE, Creasy RA, Stanilka JM, et al. (2012) Supplementation with aged garlic extract improves both NK and γδ-T cell function and reduces the severity of cold and flu symptoms: a randomized double-blind placebo-controlled nutrition intervention. Clin Nutr 31 (3): 337-344.
45. Josling P (2001) Preventing the common cold with a garlic supplement: a double-blind placebo-controlled survey. Adv Ther 18(4): 189-193.
46. Ademiluyi AO, Oboh G, Owoloye TR, Agbebi OJ (2013) Modulatory effects of dietary inclusion of garlic (Allium sativum) on gentamycin-induced hepatotoxicity and oxidative stress in rats. Asian Pacific Journal of Tropical Biomedicine 3(6): 470-475.
47. El Kott AF (2012) Amelioration of Nitrate-induced Hepatotoxicity. Journal of Medical Sciences 12: 85-91.
48. Prasad G, Sharma VD, Kumar A (1995) Efficacy of garlic (Allium sativum L) therapy against experimental dermatophytosis in rabbits. Indian J Med Res 75: 465-467.
49. Torok B, Belagyi J, Rietz B, Jacob R, (1994), Effectiveness of garlic on the radical activity in radical generating systems, Arzneimittelforschung: 44:608-611.
50. Vaidya V, Ingold KU, Pratt DA (2009) Garlic: Source of the ultimate antioxidants-Sulfenic acids. Angew Chem Int Ed Engl 48 (1): 157-160.
51. Fenwick GR, Hanley AB (1985) Allium species poisoning. Vet Rec 116(1): 28.
52. Friedman T, Shalom A, Westreich M (2006) Self-inflicted garlic burns: our experience and literature review. Int J Dermatol 45(10): 1161-1163.
53. Jain RC (1998) Anti-tubercular activity of garlic oil. Indian J Pathol Microbiol 41(1): 131.
54. Jonkers D, Sluimer J, Stobberingh E (1999) Effect of garlic on vancomycin-resistant enterococci. Antimicrob Agents Chemother 43(12): 3045.
55. Yeh GY, Davis RB, Phillips RS (2006) Use of Complementary Therapies in Patients with Cardiovascular Disease. Am J Cardiol 98 (5): 673-680.
56. Yin J, Li H (2007) Anaphylaxis Caused by Younger Garlic. Journal Allergy and Clinical Immunology 119(1): S34.