The Therapeutic Potential of Agarwood as an Antimicrobial and Anti-inflammatory Agent: A Scoping Review

Microorganisms such as bacteria, viruses and fungi are frequently the cause of infections. Antimicrobial agents, such as antibiotics, antivirals, and antifungals, are used to target and eliminate these infectious agents. Treating infections is crucial to prevent them from spreading, causing complications, or becoming chronic. On the other hand, inflammation is a natural response of the immune system to injury, infection, or irritation. While acute inflammation is a natural and protective process, chronic inflammation can contribute to various health issues, including autoimmune diseases, allergies, and chronic conditions like arthritis. Although herbal remedies have been used for centuries and can be effective in certain situations, it is crucial to use them with caution. Not all herbal remedies are supported by scientific evidence, and their safety and efficacy can vary. Thus, we conducted this review to determine the potential health benefits of agarwood as an antimicrobial and anti-inflammatory agent. Original articles were searched in three databases (PubMed, Scopus and Google Scholar) from the year 2013 to 2023 using the Medical subject heading (MeSH) terms “antimicrobial” and/or “anti-inflammatory”, crossed with the term “agarwood”. Synonyms and relevant search terms were also searched.  The most studied agarwood for antimicrobial and anti-inflammatory agents is Aquilaria sinensis. Some studies have shown its potential application as a biopesticide for mosquito control and as a potent inhibitor for fungi, including Lasiodiplodia theobromae, Fusarium oxysporum, and Candida albicans. Moreover, it is capable of inhibiting Bacillus subtilis and Staphylococcus aureus activities. In conclusion, agarwood and its isolates are worthy of further biomedical investigation and could be developed as potential candidates for the treatment or prevention of various microbial and inflammatory diseases. This review reveals that despite the absence of clinical trials, agarwood exhibits antimicrobial and anti-inflammatory properties.