Annona muricata (Soursop) and Hematopoiesis: Ethnomedicinal Insights, Immunomodulatory Mechanisms, and Translational Challenges

Annona muricata (soursop) is a tropical medicinal plant widely used in traditional medicine across Africa, the Caribbean, and parts of South America. While its ethnomedicinal applications span a range of conditions, including infections, inflammation, and anemia-related symptoms, its potential relevance to hematopoiesis has not been systematically examined. This narrative review synthesizes ethnomedicinal knowledge, phytochemical composition, and experimental evidence to explore the biological plausibility by which A. muricata may indirectly influence hematopoietic processes. Bioactive constituents of A. muricata, including flavonoids, polyphenols, and acetogenins, have demonstrated antioxidant, anti-inflammatory, and immunomodulatory properties in preclinical models. These effects are particularly relevant given the established roles of oxidative stress and chronic inflammation in disrupting hematopoietic stem and progenitor cell function and bone marrow homeostasis. Rather than proposing direct erythropoietic activity, this review emphasizes indirect, marrow-supportive mechanisms through which A. muricata may contribute to the preservation of hematopoietic function under conditions of physiological or inflammatory stress. The limitations of the current evidence base, including the predominance of in vitro and animal studies and the absence of direct hematopoietic endpoints in humans, are critically discussed. Overall, this review provides a cautious, integrative framework linking A. muricata bioactivity to hematopoietic regulation and highlights key gaps that must be addressed before any translational or clinical relevance can be established.