Suppr
超能文献

乌干达具有抗疟疗效和安全性的植物评估：应用 RITAM 评分。

A review of efficacy and safety of Ugandan anti-malarial plants with application of RITAM score.

机构信息

Department of Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda.

Pharm-Biotechnology and Traditional Medicine Centre, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda.

出版信息

Malar J. 2023 Mar 17;22(1):97. doi: 10.1186/s12936-023-04486-6.

DOI:10.1186/s12936-023-04486-6

PMID:36932389

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10021060/

Abstract

BACKGROUND

Malaria, a treatable disease mainly caused by Plasmodium falciparum has remained a health challenge in Africa, a continent that accounted for 96% of total global cases and deaths in 2021. Uganda, a malaria endemic country is experiencing malaria parasite resistance to some of the drugs used in the artemisinin-based combination therapy (ACT). In an effort to prioritize herbal medicines for new product development, this review synthesized the available safety and efficacy literature on the Ugandan anti-malarial plants to suggest most effective herbal plants.

METHODS

Literature was exhaustively searched using engines and databases, such as Google scholar, Pubmed, and Scopus-indexed journals during the period of June 2020-December 2021. In the first phase, information on ethnobotanical uses of anti-malarial plants in Uganda was gathered and synthetized to generate a list of plants, followed by data on anti-malarial efficacy (both in vitro and in vivo) on each listed plant. Minimum inhibitory concentrations (µg/ml), and % parasite suppression for every plant were scored using The Research Initiative on Traditional and Antimalarial Methods (RITAM) scoring system. The best twenty (20) plants were evaluated for acute safety (LD) data in rat model, plant parts used, ease of cultivation, presence of clinical studies and other relevant factors for suggesting the best three (3) plants for future anti-malarial product development.

RESULTS

Over one hundred twenty-six (126) plant species are used in Uganda for treatment of malaria in local communities. Out of these, about 33% (41) have been studied for efficacy and safety, with Artemisia annua and Vernonia amygdalina being the most extensively studied and among the best twenty (20) anti-malarial plants in Uganda. Both are limited by parasite recrudescence in clinical studies. Microglossa pyrifolia, a very potent plant (IC50 = 0.03 - 0.05 µg/ml has potential to penetrate the liver and could ameliorate the challenge of recrudescence if combined with A. annua and V. amygdalina in a polyherbal formulation.

CONCLUSION

There are many plants with promising potential for malaria treatment in Uganda and a herbal combination of A. annua, V. amydalina and M. pyrifolia could offer the next herbal ACT if carefully studied and developed.

摘要

背景

疟疾是一种可治愈的疾病，主要由恶性疟原虫引起，但它仍是非洲的一个健康挑战，该大陆在 2021 年占全球总病例和死亡人数的 96%。乌干达是一个疟疾流行的国家，正在经历抗疟药物的寄生虫耐药性，这些药物用于青蒿素为基础的联合治疗（ACT）。为了优先开发草药产品，本综述综合了乌干达抗疟植物的现有安全性和疗效文献，以提出最有效的草药植物。

方法

使用引擎和数据库（如 Google Scholar、Pubmed 和 Scopus 索引期刊）在 2020 年 6 月至 2021 年 12 月期间进行了全面的文献搜索。在第一阶段，收集了乌干达抗疟植物的民族植物学用途信息，并进行了综合，以生成一份植物清单，然后收集了关于每个列出的植物的抗疟疗效（体外和体内）的数据。使用传统和抗疟方法研究倡议（RITAM）评分系统对每种植物的最低抑制浓度（µg/ml）和寄生虫抑制率（%）进行评分。对最好的二十（20）种植物进行了急性安全性（LD）在大鼠模型中的数据评估，植物部位、栽培难易度、临床研究的存在以及其他用于建议三种（3）植物用于未来抗疟产品开发的相关因素。

结果

乌干达有超过 126 种植物物种用于当地社区治疗疟疾。其中，约 33%（41 种）已进行了疗效和安全性研究，青蒿和苦艾是研究最广泛的两种植物，也是乌干达最好的二十（20）种抗疟植物之一。两者在临床研究中都受到寄生虫复燃的限制。Microglossa pyrifolia 是一种非常有效的植物（IC50=0.03-0.05µg/ml），如果与青蒿和苦艾联合制成草药配方，可能具有穿透肝脏的潜力，并能改善复燃的挑战。