A comprehensive review on antiepileptic properties of medicinal plants

Medicinal plants for epileptic seizures: Phytoconstituents, pharmacology and mechanisms revisited

ETHNOPHARMACOLOGICAL RELEVANCE

Epilepsy is a neurological disorder that presents with recurring and spontaneous seizures. It is prevalent worldwide, affecting up to 65 million people, with 80% of cases found in lower-income countries. Medicinal plants are commonly employed for managing and treating epilepsy and convulsions due to their unique therapeutic properties. With increasing research and clinical application, medicinal plants are gaining attention globally due to their potent therapeutic effects and fewer side effects. The development of new plant-based antiepileptic/anticonvulsant agents has become a major focus in the pharmaceutical industry.

AIM OF THE REVIEW

This article summarizes recent research on medicinal plants with reported antiepileptic/anticonvulsant effects. It provides pharmacological and molecular mechanism of action information for the crude extracts and related active constituents evaluated in preclinical research for the treatment of epilepsy and convulsions, and offers a reference for the development of future related studies in this area.

MATERIALS AND METHODS

Articles related to ethnopharmacological and antiepileptic studies on plants or natural products from 2018 to 2023 were collected from PubMed, Web of Science and Scopus, etc. using keywords related to epilepsy, medicinal plants, and natural products, etc. RESULTS: Eighty plant species are commonly used to treat epilepsy and convulsions in African and Asian countries. Sixty natural products showing potential for antiepileptic/anticonvulsant effects have been identified from these medicinal plants. These products can be broadly classified as alkaloids, coumarins, flavonoids, saponins, terpenoids and other compounds. The antiepileptic action of plant extracts and their active ingredients can be classified according to their abilities to modulate the GABAergic and glutamatergic systems, act as antioxidants, exhibit anti-neuroinflammatory effects, and provide neuroprotection. In addition, we highlight that some medicinal plants capable of pharmacologically relieving epilepsy and cognition may be therapeutically useful in the treatment of refractory epilepsy.

CONCLUSIONS

The review highlights the fact that herbal medicinal products used in traditional medicine are a valuable source of potential candidates for antiepileptic drugs. This confirms and encourages the antiepileptic/anticonvulsant activity of certain medicinal plants, which could serve as inspiration for further development. However, the aspects of structural modification and optimization, metabolism, toxicology, mechanisms, and clinical trials are not fully understood and need to be further explored.

Zebrafish as a robust preclinical platform for screening plant-derived drugs with anticonvulsant properties-a review

Traditionally, selected plant sources have been explored for medicines to treat convulsions. This continues today, especially in countries with low-income rates and poor medical systems. However, in the low-income countries, plant extracts and isolated drugs are in high demand due to their good safety profiles. Preclinical studies on animal models of seizures/epilepsy have revealed the anticonvulsant and/or antiepileptogenic properties of, at least some, herb preparations or plant metabolites. Still, there is a significant number of plants known in traditional medicine that exert anticonvulsant activity but have not been evaluated on animal models. Zebrafish is recognized as a suitable in vivo model of epilepsy research and is increasingly used as a screening platform. In this review, the results of selected preclinical studies are summarized to provide credible information for the future development of effective screening methods for plant-derived antiseizure/antiepileptic therapeutics using zebrafish models. We compared zebrafish vs. rodent data to show the translational value of the former in epilepsy research. We also surveyed caveats in methodology. Finally, we proposed a pipeline for screening new anticonvulsant plant-derived drugs in zebrafish ("from tank to bedside and back again").

Role of Acorus calamus in preventing depression, anxiety, and oxidative stress in long-term socially isolated rats

Background and Aim

Social isolation stress (SIS) and individual housing have been shown to cause abnormal cognitive insufficiencies, altered anxiety levels, and signs of psychiatric diseases. Acorus calamus (AC), commonly known as Sweet Flag, has been widely used in India to treat neurological, metabolic, and respiratory disorders, indicating its potential therapeutic value. This study aimed to determine the antidepressant and antioxidative effects of AC on rats subjected to long-term, social isolation-induced stress.

Materials and Methods

This study involved 2-month-old male rats (24) weighing approximately 180-200 g bred in-house. The rats were divided into four groups (n = 6): Group 1 received saline, Group 2 received SIS, Group 3 received only 50 mg/kg AC, and Group 4 received 50 mg/kg AC and SIS for 6 weeks. After this, behavioral, biochemical, and neuronal assays were conducted.

Results

Behavioral experiments showed significantly higher activity levels (p < 0.001) in AC-treated rats than in the SIS group. In addition, rats subjected to SIS with AC treatment exhibited enhanced total antioxidants, superoxide dismutase, and neuronal assays compared to rats subjected to SIS alone.

Conclusion

Acorus calamus treatment improved the antidepressant and antioxidant potential against SIS in rat brain tissue. Moreover, we proved that AC can effectively reverse the neurotoxicity induced by SIS in animal models. As we battle against the coronavirus disease 2019 pandemic and social isolation, AC could be considered a supplementary treatment to alleviate depressive-like symptoms in our present-day lifestyle.

Plant-Based Antioxidants for Prevention and Treatment of Neurodegenerative Diseases: Phytotherapeutic Potential of Laurus nobilis, Aronia melanocarpa, and Celastrol

With the progress of medicine, especially in the last century, life expectancy increased considerably. As a result, age-related diseases also increased, especially malignancies and degenerative diseases of the central nervous system. The incidence and prevalence of neurodegenerative diseases steadily increased over the years, but despite efforts to uncover the pathophysiological processes behind these conditions, they remain elusive. Among the many theories, oxidative stress was proposed to be involved in neurodegenerative processes and to play an important role in the morbidity and progression of various neurodegenerative disorders. Accordingly, a number of studies discovered the potential of natural plant constituents to have significant antioxidant activity. This review focused on several plant-based antioxidants that showed promising results in the prevention and treatment of neurodegenerative diseases. Laurus nobilis, Aronia melanocarpa, and celastrol, a chemical compound isolated from the root extracts of Tripterygium wilfordii and T. regelii, are all known to be rich in antioxidant polyphenols.

Senna singueana (Delile) lock: Ethnomedicinal uses and medicinal properties

Senna singueana (Delile) Lock is a potential medicinal plant commonly used to mitigate various infectious and non-infectious diseases including malaria, typhoid, gonorrhoea, bilharzia, cancer, epilepsy and ulcer. The phytochemical profile of S. singueana indicates the presence of different phytoconstituents corresponding to the pharmacological properties. The pharmacological potentials such as antibacterial, antifungal, antioxidant, antimalarial and antidiabetics are possessed by S. singueana. This review comprehensively discusses the potential of S. singueana for the mitigation of medical conditions. The information is collected from various online databases such as Google scholar, ScienceDirect, Springer, Web of Science and PubMed. Among other information, ethnomedicinal uses, phytochemistry, pharmacology and mechanisms of action are extensively presented. A review concluded by highlighting the challenges and potential future outlooks.

Evaluation of antibacterial, antioxidant, and anti-inflammatory properties of GC/MS characterized methanol leaf extract of Terminalia superba (Combretaceae, Engl. & Diels)

Background

Terminalia superba is a well-known medicinal plant used in folk medicine for the management of various diseases and swelling. Validation of its efficacy in standardized scientific models is lacking. This gap needs to be filled as a way of enhancing modern drug discovery. The aim is to evaluate the antibacterial, antioxidant, and anti-inflammatory properties of T. superba in known and established models. Also, to establish and possibly correlate the established activity with the phytochemicals identified using GC/MS and qualitative methods.

Results

The result showed a dose-dependent percentage inhibition of DPPH, HO•, and Fe3+ reducing activity. The antibacterial activity showed dose-dependent significant (p < 0.05) inhibition against all the organisms used. The anti-inflammatory activity of METS was confirmed in the carrageenan model with significant (p < 0.05) inhibition of paw volume when compared to control while significantly decreasing (p < 0.05) weight of xylene-induced ear. For instance, after 6 h, there was  a reduction of 42%, 33%, and 22% for diclofenac, 200 mg, and 100 mg, respectively, as against 4% in control. The significant (p < 0.05) increase in MDA was attenuated by the treatment with METS dose dependently. Phytochemical assay and GC/MS characterization showed that alkaloids, saponins, phenols, quinone, tannins, coumarins, proteins, flavonoids, and amino acids were dominant with fatty acids accounting for 53%. Others are esters (23%), organic compounds (12%), alkanes (9%), and carboxylic acids (3%).

Conclusions

T. superba possesses antioxidant, antibacterial, and anti-inflammatory properties which are believed to arise from the secondary metabolites observed in the GC–MS characterization.

Graphical Abstract

Medicinal plants utilized in the management of epilepsy in Ethiopia: ethnobotany, pharmacology and phytochemistry

Epilepsy is a common central nervous system (CNS) disorder that affects 50 million people worldwide. Patients with status epilepticus (SE) suffer from devastating comorbidities and a high incidence of mortalities. Antiepileptic drugs (AEDs) are the mainstream treatment options for the symptomatic relief of epilepsy. The incidence of refractory epilepsy and the dose-dependent neurotoxicity of AEDs such as fatigue, cognitive impairment, dizziness, attention-deficit behavior, and other side effects are the major bottlenecks in epilepsy treatment. In low- and middle-income countries (LMICs), epilepsy patients failed to adhere to the AEDs regimens and consider other options such as complementary and alternative medicines (CAMs) to relieve pain due to status epilepticus (SE). Plant-based CAMs are widely employed for the treatment of epilepsy across the globe including Ethiopia. The current review documented around 96 plant species (PS) that are often used for the treatment of epilepsy in Ethiopia. It also described the in vivo anticonvulsant activities and toxicity profiles of the antiepileptic medicinal plants (MPs). Moreover, the phytochemical constituents of MPs with profound anticonvulsant effects were also assessed. The result reiterated that a lot has to be done to show the association between herbal-based epilepsy treatment and in vivo pharmacological activities of MPs regarding their mechanism of action (MOA), toxicity profiles, and bioactive constituents so that they can advance into the clinics and serve as a treatment option for epilepsy.

Investigation of Natural Compounds for Therapeutic Potential in Streptozotocin-induced Diabetic Neuroinflammation and Neuropathic Pain

Diabetic neuropathy (DN) is a serious microvascular complication of diabetes mellitus (DM) that impacts the nervous system. Several risk factors are involved in the progression and maintenance of DN-associated pain, such as higher expression of various inflammatory mediators, e.g., tumor necrotic factor-alpha (TNF-α), nuclear factor-kappa B (NF-κB), and cyclo-oxygenase-2 (COX-2). The present research explores the neuroprotective potential of natural isolates, including berbamine, bergapten, and carveol, on the DM-induced neuroinflammation and neurodegeneration that cause neuropathic pain. The study utilized computerized techniques, including computational analysis (a docking assay and a molecular dynamic simulation) before moving to in vivo protocols. Diabetic neuropathy was induced by intraperitonial injection (IP) of streptozotocin (65 mg/kg), and the animal subjects (rats) were kept for 4 weeks for the development of DN. Once diabetic neuropathy was confirmed, the subjects were treated with berbamine, bergapten, and carveol until the sixth week (i.e., 2 weeks of treatment). At the sixth week, the rats were sacrificed, and the sciatic nerve and spinal cord of each was collected for further molecular investigation. Docking and a molecular dynamic simulation (MDS) delivered the information that the natural compounds (berbamine, bergapten, and carveol) were interacting with the selected target protein (i.e., mitogen-activated protein kinase). After IP, it was found that berbamine, bergapten, and carveol had ameliorated mechanical allodynia and thermal hyperalgesia by the 28th day of the study (2 weeks after treatment) without affecting blood glucose levels. Berbamine, bergapten, and carveol markedly elevated the levels of glutathione (GSH) and glutathione s-transferase (GST), in both the sciatic nerve and spinal cord, and also reduced lipid peroxidase (LPO) and nitric oxide (NO). The abovementioned natural isolates reduced pathologic alterations provoked through DN, a finding confirmed through histopathological assays (hematoxylin and eosin staining and immuno-histochemical analysis). Treatment down regulated higher expressions of the inflammatory mediatorcyclooxygenase-2 (COX-2), tumor necrosis factor-α (TNF-α), and nuclear factor kappa B (NF-κB), as confirmed by ELISA and polymerase chain reaction (PCR). The outcomes of berbamine, bergapten, and carveol are compared with those of pregabalin as a positive control group. Compared to pregabalin, treatment with the aforementioned three natural compounds improved nociception and reduced hyperalgesic effects, and consequently reduced pain perception and inflammation. Our results suggest the mechanism for the neuro-protective impact of berbamine, bergapten, and carveol might possibly be arbitrated via COX-2, TNF-α, and NF-κB, and regulated by mitogen-activated protein kinase, ultimately ameliorating STZ-provoked, DM-induced neuroinflammation and neurodegeneration, and associated neuropathic pain.

Cytotoxic Effect of Rosmarinus officinalis Extract on Glioblastoma and Rhabdomyosarcoma Cell Lines

Rosmarinus officinalis is a well-studied plant, known for its therapeutic properties. However, its biological activity against several diseases is not known in detail. The aim of this study is to present new data regarding the cytotoxic activity of a hydroethanolic extract of Rosmarinus officinalis on glioblastoma (A172) and rhabdomyosarcoma (TE671) cancer cell lines. The chemical composition of the extract is evaluated using liquid chromatography combined with time-of-flight mass spectrometry, alongside its total phenolic content and antioxidant activity. The extract showed a promising time- and dose-dependent cytotoxic activity against both cell lines. The lowest IC50 values for both cell lines were calculated at 72 h after treatment and correspond to 0.249 ± 1.09 mg/mL for TE671 cell line and 0.577 ± 0.98 mg/mL for A172 cell line. The extract presented high phenolic content, equal to 35.65 ± 0.03 mg GAE/g of dry material as well as a strong antioxidant activity. The IC50 values for the antioxidant assays were estimated at 12.8 ± 2.7 μg/mL (DPPH assay) and 6.98 ± 1.9 μg/mL (ABTS assay). The compound detected in abundance was carnosol, a phenolic diterpene, followed by the polyphenol rosmarinic acid, while the presence of phenolic compounds such as rhamnetin glucoside, hesperidin, cirsimaritin was notable. These preliminary results suggest that R. officinalis is a potential, alternative source of bioactive compounds to further examine for abilities against glioblastoma and rhabdomyosarcoma.

Folecitin Isolated from Hypericum oblongifolium Exerts Neuroprotection against Lipopolysaccharide-Induced Neuronal Synapse and Memory Dysfunction via p-AKT/Nrf-2/HO-1 Signalling Pathway

Neurodegenerative diseases, especially Alzheimer's disease (AD), are characterised with neuronal synapse and memory dysfunction, and thus, there is an urgent need to find novel therapeutic medicines that can target different pathways to restore the deficits. In this investigation, we assessed the medicinal potency of folecitin (a flavonoid isolated from Hypericum oblongifolium Wall.) against lipopolysaccharide (LPS)-induced amyloidogenic amyloid beta (Aβ) production pathway-mediated memory impairment in mice. The LPS was administered intraperitonially (i.p.) 250 μg/kg/day for 3 consecutive weeks, followed by the coadministration of folecitin (30 mg/kg/day) with LPS for the last two weeks (2^nd and 3^rd week). The expression of various proteins involved in synapse, neuronal death, and Aβ generation was evaluated using the Western blot approach. Results indicated that folecitin significantly decreased LPS-induced apoptotic proteins; expressed BAX, PARP-1, and caspase-3 proteins; and inhibited BACE1 that cleaves transmembrane amyloid precursor protein and the amyloidogenic Aβ production pathway. Folecitin restored both preneural and postneuronal synapse, accompanied by the improvement in memory impairment. Moreover, folecitin significantly activated endogenous antioxidant proteins Nrf-2 and HO-1 by stimulating the phosphorylation of Akt proteins. These findings indicate that folecitin might be a promising target for developing novel medication to treat neurodegenerative disorders caused by neurotoxins.