Leishmaniosis phytotherapy: Review of plants used in Iranian traditional medicine on leishmaniasis

Botanical description, phytochemical constituents, ethnobotany, traditional medicinal use, and pharmacological activities of Stachys lavandulifolia Vahl

Stachys lavandulifolia Vahl known as "mountain tea", is a perennial flowering plant belonging to the Lamiaceae family and is widespread in Iran, Armenia, Azerbaijan, Iraq, Turkey and Turkmenistan. S. lavandulifolia is widely used in traditional medicine for its analgesic, anti-inflammatory and anxiolytic properties. This plant has different chemical compounds classes including terpenoids, iridoids, flavonoids and phenylethanoids that have been isolated from the aerial parts of it. This review covers the plant botany, traditional medicinal uses and chemical composition of S. lavandulifolia, along with its biological and pharmacological activities including clinical trial data. The information of this review article was obtained from different scientific databases such as Google scholar, Science Direct, Hindawi, SID, Scopus, PubMed, and ACS as well as traditional Persian books. Pharmacological and clinical studies, especially Anxiolytic activity and anti-inflammatory on the plant are relatively low, so these studies are suggested in the future. Also, phytochemical investigation on root of the plant is necessary.

The effects of medicinal herbs and marine natural products on wound healing of cutaneous leishmaniasis: A systematic review

This study aimed to investigate the effects of medicinal herbs and marine natural products on wound healing of cutaneous leishmaniasis. To carry out this literature review, the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) instructions were used. Articles on the potential of medicinal plants and natural substances of marine origin against wound healing of cutaneous leishmaniasis were explored. The scientific databases considered were PubMed, Science Direct, Google Scholar, Web of Science, Scopus, and SpringerLink. The scientific documents collected were mainly scientific articles, books, book chapters, and doctoral thesis. The research considered 73 manuscripts published in the period from 1990 to 2020. From all the data collected, it appears that the scientific literature is rich in medicinal herbs and marine products to be valorized in the wound healing of cutaneous leishmaniasis. We have identified 15 medicinal plants traditionally used in the management of healing or ulcer of cutaneous leishmaniasis, 32 medicinal plants whose efficacy has been demonstrated in vitro or in vivo against cutaneous leishmaniasis, 5 marine products active against cutaneous leishmaniasis. It is also clear that the option of medicinal herbs/marine products in the management of cutaneous leishmaniasis is less expensive and allows to avoid the side effects of conventional products. It is necessary to encourage the development of dermatological topicals for the management of cutaneous leishmaniasis based on the data collected. In vivo research should be intensified on medicinal herbs traditionally used in wound healing of cutaneous leishmaniasis.

In vitro evaluation of hydroalcoholic extracts of Capparis Spinosa L., Ricinus communis, and Solanum luteum on Leishmania major (MRHO/IR/75/ER) promastigotes

Background: Plant extracts or compounds derived from plants are a valuable source for finding new anti-leishmaniasis drugs. Objective: In this study, Capparis spinosa L., Ricinus communis, and Solanum luteum were used as lethal agents for the promastigotes of Leishmania major parasites in the culture medium. Methods: Diluted extracts of 12.5, 100, and 500 mg/mL were prepared from medicinal plant dried extracts. Glucantime at a concentration of 500 mg/mL was used as a positive control. Results: For all three extracts, concentrations of 100 and 500 mg/mL could kill promastigotes at higher rates and speeds compared to other concentrations. The high concentrations of extracts (500 mg/mL) presented similar effects. According to the findings, hydroalcoholic extract of C. Spinosa L. presented considerably lower antiparasitic effects, and S. luteum and R. communis extracts were could kill most of the parasitic promastigotes at higher doses. The ANOVA test did not show any significant viability percentage difference of Leishmania extracts between different extract types. Conclusions: In this study, the lethal effects of R. communis and S. luteum hydroalcoholic extracts on L. major promastigotes were found to be stronger than the C. Spinosa L. extract.

An appraisal of the scientific current situation and new perspectives in the treatment of cutaneous leishmaniasis

Leishmaniasis is a Neglected Tropical Diseases caused by protozoan parasites of the genus Leishmania. It is a major health problem in many tropical and subtropical regions of the world and can produce three different clinical manifestations, among which cutaneous leishmaniasis has a higher incidence in the world than the other clinical forms. There are no recognized and reliable means of chemoprophylaxis or vaccination against infections with different forms of leishmaniasis. In addition, chemotherapy, unfortunately, remains, in many respects, unsatisfactory. Therefore, there is a continuing and urgent need for new therapies against leishmaniasis that are safe and effective in inducing a long-term cure. This review summarizes the latest advances in currently available treatments and improvements in the development of drug administration. In addition, an analysis of the in vivo assays was performed and the challenges facing promising strategies to treat CL are discussed. The treatment of leishmaniasis will most likely evolve into an approach that uses multiple therapies simultaneously to reduce the possibility of developing drug resistance. There is a continuous effort to discover new drugs to improve the treatment of leishmaniasis, but this is mainly at the level of individual researchers. Undoubtedly, more funding is needed in this area, as well as greater participation of the pharmaceutical industry to focus efforts on the development of chemotherapeutic agents and vaccines for this and other neglected tropical diseases.

Antileishmanial Potential of Berberine Alkaloids From Berberis glaucocarpa Roots: Molecular Docking Suggests Relevant Leishmania Protein Targets

Leishmaniases are a spectrum of poverty-linked neglected parasitic diseases that are endemic in 88 countries around the globe and affect millions of people every year. Currently available chemotherapeutic options are inadequate due to side effects, high cost, prolonged treatment, and parasite resistance. Thus, there is an existing need to develop new potent and safer leishmanicidal drugs. Considering the folkloric antiulcer and leishmanicidal use of the genus Berberis and its alkaloids, 5 reported alkaloids, namely berberine (1), palmatine (2), columbamine (3), 8-trichloromethyldihydroberberine (4), and jatrorrhizine (5), were isolated from the roots of Berberis glaucocarpa using classical (column and preparative chromatography) and modern isolation techniques (Sephadex LH-20). Their structures were elucidated and established from 1D and 2D spectroscopic data. The isolated alkaloids displayed excellent antileishmanial potential with IC50 values ranging from 1.50 to 2.56 µM: 1 (1.50 ± 0.53 µM), 2 (2.31 ± 0.37 µM), 3 (2.56 ± 0.48 µM), 4 (1.40 ± 0.90 µM), 5 (2.44 ± 1.34 µM). While the IC50 value for the standard drug (Amphotericin-B) was found to be 1.08 ± 0.95 µM. All of the isolated alkaloids displayed excellent antileishmanial potential as well as minimal cytotoxicity against THP-1 monocytic cells. Molecular docking analysis has revealed Leishmania N-myristoyl transferase, methionyl-tRNA synthetase, pteridine reductase 1, oligopeptidase B, tyrosyl-tRNA synthetase, and/or glycerol-3-phosphate dehydrogenase to be potential protein targets for the alkaloids.

Household knowledge, practice and treatment seeking behaviors towards cutaneous leishmaniasis in the endemic rural communities of Ganta- afeshum district, Tigrai, northern Ethiopia, 2019: a cross-sectional study

BACKGROUND

Cutaneous leishmaniasis is endemic to Ethiopia. However, the prevention and control efforts of leishmaniasis remain unfocused with clear knowledge and practice gaps within the country. Thus, a house to house survey has been carried out to assess the knowledge, practice and treatment-seeking behavior of households towards cutaneous leishmaniasis in the rural communities of Tigrai region, northern Ethiopia.

METHODS

A community-based cross-sectional house-to-house survey was conducted in two selected rural villages of Ganta-afeshum district, Tigrai, northern Ethiopia in 2019. A simple random sampling technique was employed to select the participants. Household heads were interviewed using a pre-tested semi-structured questionnaire. Epi info version 7.0 was used for data entry and the data were imported to SPSS version 23 for analysis. Chi-square test (χ2) was used to test the association between the independent variables and the knowledge and practice status of the study participants. P-value < 0.05 was used to declare a statistically significant association among the variables.

RESULTS

In our study, most of the participants (78%) stated that cutaneous leishmaniasis is a health problem in the area. Three hundred eighty (99.5%) participants responded that the most common clinical presentation of cutaneous leishmaniasis is a lesion on the face. All of the study participants did not know the mode of cutaneous leishmaniasis transmission, and had never heard of the sand fly. A majority of the participants were unaware of the main prevention methods for cutaneous leishmaniasis. Lastly, traditional medicine was used in 90% of the study households with a previous history for cutaneous leishmaniasis.

CONCLUSION

There is a lack of awareness regarding the transmission of cutaneous leishmaniasis in Ganta-afeshum, Ethiopia, where the majority of individuals are unfamiliar with the sand fly vector. Prevention methods for cutaneous leishmaniasis were unavailable among the community. Therefore, health education programs concerning cutaneous leishmaniasis transmission, prevention, and treatment in the area should be rigorously implemented.

Effects of topical gel formulation of Ficus carica latex on cutaneous leishmaniasis induced by Leishmania major in BALB/c mice

Objectives

The current study aimed to evaluate the effects of Ficus carica latex on the treatment of cutaneous leishmaniasis (CL), induced by Leishmania major. A 5% topical gel with F. carica latex was prepared. BALB/c mice were infected by inoculation of amastigotes form of L. major. Thirty BALB/c mice were divided into five groups, where the first group was treated daily, the second group twice per day, and the third group every other day with the 5% topical gel, for 3 weeks. The sizes of the lesions were measured before and during the course of treatment.

Results

Although the mean size of lesions in the mice group treated with the 5% F. carica gel, especially in the group receiving daily treatment, was less than the mean size of the lesions in the control group, yet, the differences was not statistically significant (p > 0.05). The findings of the current study demonstrated that the 5% F. carica latex with a 3-week course of treatment had no considerable effect in recovery or control of CL induced by L. major in the murine model. Using higher concentration of F. carica latex and with longer treatment lengths may increase its efficacy in the treatment of CL.

The potential role and apoptotic profile of three medicinal plant extracts on Leishmania tropica by MTT assay, macrophage model and flow cytometry analysis

Introduction

Treatment of leishmaniasis with conventional synthetic drugs is a major global challenge. This study was designed to explore the leishmanicidal activity and apoptotic profile of three leaf extracts on Leishmania tropica stages.

Methods

The plants of Quercus velutina, Calotropis procera and Nicotiana tabacum were gathered from Anbarabbad county, in the southeastern part of Kerman province and extracted by maceration method using methanol alcohol. Various concentrations of the extracts (1, 10, 100 and 1000 μg/mL) were used against L. tropica stages to evaluate the inhibitory effect by colorimetric assay, macrophage model and flow cytometry. The MTT assay was conducted to determine the IC₅₀ and CC₅₀ values in promastigotes and J774-A1 macrophages, respectively. For intra-macrophage amastigotes, the leishmanicidal activity was evaluated by calculating the mean number of amastigotes in each macrophage and also IC₅₀ values. The promastigote or amastigote stages with no drug and complete medium without organisms were considered as positive and negative controls, respectively. Meglumine antimoniate (Glucantime) was also used as standard drug. Also, annexin V was used to assess the apoptotic profile. All treatment settings were incubated for a standard time of 72 h in triplicates. Data were analyzed by t-test and ANOVA.

Results

The findings showed that all plant extracts inhibited the proliferation rate of promastigotes and amastigotes (P ˂ 0.001); especially, Q. velutina represented the lowest IC₅₀ in both stages. Besides, Q. velutina showed the least number of amastigotes in each macrophage compared to the other groups (4.5 μg/mL). The percentage of parasitic apoptosis at 1000 μg/mL of Q. velutina, C. procera, N. tabacum and Glucantime® were 37.4, 18.6, 8.5 and 52.4, respectively. Amastigotes (clinical stage) were significantly more susceptible to extracts and also Glucantime® than promastigotes (P < 0.001).

Conclusions

This study revealed that all three extracts of Q. velutina, C. procera and N. tabacum exhibited an effective antileishmanial activity and induced apoptosis against the L. tropica promastigotes. Further investigations are essential to isolate and analyze the chemical compositions and their biological properties.

Pharmaceutical agents for treatment of leishmaniasis: a patent landscape

INTRODUCTION

Leishmaniasis is a neglected tropical disease caused by protozoa of the genus Leishmania. Worldwide, approximately 1.5-2 million new cases of leishmaniasis and 20,000-30,000 deaths occurs each year. Effective treatment for all forms of leishmaniasis have numerous adverse effects contributing to poor adherence and/or treatment interruption by the patient. Development of novel therapies, as multitarget drugs, for example, can contribute to accelerate discover safer, more active, and patient-compliant drugs for leishmaniasis treatment.

AREAS COVERED

In this review, authors summarize pharmaceutical agents for treatment of leishmaniasis developed between 2014 and 2019, which includes synthetic and natural drugs for specific treatments, as well as considering new approaches and strategies using drug delivery system.

EXPERT OPINION

Universities or public research institutes produced most of the patents related to pharmaceutical agents for treatment of leishmaniasis in this review, and the majority of the inventions disclosed did not conduct clinical trials. In other words, there is still a lot of investment to be done for the identification of new drugs.

Therapeutic Interventions for Countering Leishmaniasis and Chagas's Disease: From Traditional Sources to Nanotechnological Systems

The incidence of neglected diseases in tropical countries, such as Leishmaniasis and Chagas's disease, is attributed to a set of biological and ecological factors associated with the socioeconomic context of developing countries and with a significant burden to health care systems. Both Leishmaniasis and Chagas's disease are caused by different protozoa and develop diverse symptoms, which depend on the specific species infecting man. Currently available drugs to treat these disorders have limited therapeutic outcomes, frequently due to microorganisms' drug resistance. In recent years, significant efforts have been made towards the development of innovative drug delivery systems aiming to improve bioavailability and pharmacokinetic profiles of classical drug therapy. This paper discusses the key facts of Leishmaniasis and Chagas's disease, the currently available pharmacological therapies and the new drug delivery systems for conventional drugs.

A systematic literature review and classification of knowledge discovery in traditional medicine

INTRODUCTION AND OBJECTIVE

Despite the importance of machine learning methods application in traditional medicine there is a no systematic literature review and a classification for this field. This is the first comprehensive literature review of the application of data mining methods in traditional medicine.

METHOD

We reviewed 5 database between 2000 to 2017 based on the Kitchenham systematic review methodology. 502 articles were identified and reviewed for their relevance to application of machine learning methods in traditional medicine, 42 selected papers were classified and categorized on four dimension; 1) application domain of data mining techniques in traditional medicine; 2) the data mining methods most frequently used in traditional medicine; 3) main strength and limitation of data mining techniques in traditional medicine; 4) the performance evaluation methods in data mining methods in traditional medicine.

RESULT

The result obtained showed that main application domain of data mining techniques in traditional medicine was related to syndrome differentiation. Bayesian Networks (BNs), Artificial Neural Networks (ANNs) and Support Vector Machines (SVMs) were recognized as being the methods most frequently applied in traditional medicine. Furthermore, each data mining techniques has its own strength and limitations when applied in traditional medicine. Single scaler methods were frequently used for performance evaluation of data mining methods.

CONCLUSION

Machine learning methods have become an important research field in traditional medicine. Our research provides information about this methods by examining the related articles.

Medicinal plants with promising antileishmanial activity in Iran: a systematic review and meta-analysis

BACKGROUND

Leishmaniasis is a major public health problem worldwide. The aim of the present study was to investigate medicinal plants with anti-Leishmania activity which used in Iran.

METHODS

Data were systematically gathered from five English databases including Ebsco, Science Direct, PubMed, Google Scholar and Scopus, four Persian databases including Magiran, Iran doc, Iran medex and the Scientific Information Database (SID) from 1999 to April 2015. Information obtained included plant family, extraction method, concentrations of extracts, animal models and parasite strains.

RESULTS

A total of 68 articles including 188 experiments (140 in vitro and 48 in vivo) between 1999 and 2015, met our eligibility criteria. Thoroughly, 98 types of plants were examined against three genera of Leishmania spp. For the heterogeneity study conducted, it was showed that there was a great deal of variation among studies. Based on random effect, meta-analysis pooled mean of IC50 was obtained 456.64 (95% CI: 396.15, 517.12).

CONCLUSION

The most Iranian plants used as anti-leishmanial activity were Artemisia species, Allium sativum, Achilleamille folium, Peganum harmala and Thymus vulgaris. The present systematic and meta-analysis review provide valuable information about natural products with anti-Leishmania activity, which would be examined in the future experimental and clinical trials and herbal combination therapy.