Aloe vera polysaccharides (AVPs), particularly acemannan and related O-acetylated mannan/glucomannan fractions, are bioactive macromolecules that contribute substantially to the health-promoting properties of A. vera. In recent years, research on AVPs has advanced from conventional extraction and activity screening toward structure-preserving preparation, detailed structural characterization, mechanism-oriented pharmacological evaluation, and application-driven development. This review systematically summarizes recent progress in extraction, purification, structural characterization, pharmacological activities, structure-activity relationships (SARs), toxicological evaluation, clinical evidence, and potential applications of AVPs. Particular emphasis is placed on how preparation methods influence structural heterogeneity and how structural parameters, including molecular weight distribution, acetylation degree, and glycosidic linkage patterns, are associated with biological functions. In addition, this review distinguishes purified AVPs and acemannan-rich fractions from crude A. vera preparations and critically discusses dose-response evidence, long-term or high-dose safety concerns, clinical translation bottlenecks, and quality-control requirements. Overall, this review provides an updated preparation-structure-activity-translation framework for understanding AVPs and supports their rational development for functional food, biomaterial, therapeutic, and cosmeceutical applications.
Keywords: Acemannan; Aloe vera polysaccharides; Clinical translation; Structural characterization; Structure-activity relationships; Toxicological evaluation.
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