Proconvulsant effect of khat (Catha edulis) in Sprague dawley rats

Status analysis of herbal drug therapies in epilepsy: advancements in the use of medicinal plants with anti-inflammatory properties

BACKGROUND

Use of plants and plant products in health care has shown exponential increase in past two decades.

INTRODUCTION

In-spite of the availability of well-established pharmacotherapy for epilepsy, a large no of population still explores alternative treatments due to refractory seizures, adverse effects of drugs, chronic treatment, inaccessibility of standard therapies in rural areas and the social stigma attached to the disease. Various studies on medicinal plants showed the protective effect of herbals in animal models of epilepsy.

METHOD

In the present review, a status analysis of the traditional use of various medicinal plants in epilepsy with a special focus on plats having anti-inflammatory potential is recorded.

RESULT AND CONCLUSION

The shortcomings of research on medicinal plants which needs to be explored further in order to tackle the growing need of safer and effective drugs for epilepsy are discussed. Overall, there is a huge scope of herbal drugs in CNS disorders especially epilepsy, either as an adjunct by reducing the dose and thus side effects of standard anti-epileptic drugs or as standalone agent . Although, there is still an urgent need of well planned randomized controlled clinical trials to validate their efficacy and safety.

Evaluation of neurotoxicity and hepatotoxicity effects of acute and sub-acute oral administration of unripe ackee (Blighia sapida) fruit extract

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Acute oral dose of 2000 mg/kg of unripe B. sapida fruit extract (BSE) was toxic to mice.

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Repeated treatment with BSE impaired locomotor function, memory performance and shortened seizure latency in mice.

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Repeated treatment with BSE significantly up-regulate acetylcholinesterase enzyme activity in mice.

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Repeated treatment with BSE elevates oxidative stress in the brain and liver of mice.

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Repeated treatment with BSE showed histopathological evidences of toxicity in mice brain and liver.

Ackee (Blighia sapida) is a commonly eaten fruit that is indigenous to West Africa and Jamaica. Ackee poisoning in young children have been reported in parts of Nigeria due to consumption of the unripe fruits. This study was designed to identify potential mechanisms of acute and sub-acute toxicity of unripe B. sapida fruit extract (BSE).

Acute toxic effect was investigated in mice of either sex administered BSE 2000 mg/kg. The sub-acute toxicity effects were investigated in mice of either sex that received 28 days repeated administration of BSE (100 and 500 mg/kg, p.o.). Locomotor activity and memory performance were measured as well as seizure vulnerability in PTZ-induced model. Liver enzymes were assessed in the serum. Acetylcholinesterase, oxidative stress parameters and histopathological changes were assessed in the brain and liver tissues.

Signs and symptoms of toxicity such as urination, tremor, depressed locomotion and death were observed in acute toxicity test. Sub-acute dosing caused significant impairment in locomotor activity and memory performance in mice. Seizure threshold was shortened in BSE-treated compared to control mice. Brain acetylcholinesterase activity was significantly increased. Alkaline phosphatase (ALP) was significantly elevated in mice that received BSE (500 mg/kg). Furthermore, BSE caused significant increase in oxidative stress expressed in nitrite, malondialdehyde, reduced glutathione and catalase in the brain and liver tissues. Histological staining revealed neuronal damage of brain hippocampus and hepatocellular swelling and necrosis.

Blighia sapida unripe fruit extract increased susceptibility to seizure and impaired locomotor and memory function. The biochemical and histopathological findings revealed potential toxicity mechanisms related to neurotoxicity and hepatotoxicity.

Effect of Khat on apoptosis and related gene Smac/DIABLO expression in the cerebral cortex of rats following transient focal ischemia

BACKGROUND

The leaves of the Khat shrub contain the major alkaloid compounds (cathinone) and cathine. These compounds can induce apoptosis and exacerbate the acute cerebral infarction, but the underlying mechanism is poorly understood. The present study aimed to investigate the effects of Khat treatment on the expression and cellular localization of Smac/Diablo (second mitochondrial activator of caspase) in the cortex of ischemic rat brain.

METHODS

Adult male Sprague-Dawley rats were administered Khat (3g/kg) twice daily for 4 weeks, then underwent left middle cerebral artery occlusion (MCAO) for 2h and reperfusion for 3, 6 and 12h, respectively. The infarction area was evaluated with 2,3,5-triphenyltetrazolium chloride (TTC) staining. Apoptosis was assessed by terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end labeling (TUNEL). Smac/DIABLO expression levels in experimental and control groups were examined by immunohistochemistry and Western blot.

RESULTS

Khat significantly exacerbates the neurological damage compared with control (p<0.05). In addition, Khat-treatment significantly increased the number of TUNEL-positive cells 3h (p<0.01) and 12h (p<0.05) after reperfusion. Ischemia/reperfusion enhanced the release of Smac/DIABLO from the mitochondria to the cytosol after reperfusion. Such release of Smac/DIABLO was elevated after the rats were pretreated with Khat.

CONCLUSIONS

Our results indicate that Khat treatment can induce apoptosis through enhancing the release of Smac/DIABLO from the mitochondria to the cytosol after transient focal ischemia which may be an important mechanism of Khat neurotoxicity. Therefore, Khat chewing should be avoided by people who have cerebrovascular problems.

Oromandibular dystonia in yemeni patients with khat chewing: a response to botulinum toxin treatment

Khat-(Catha edulis)related oromandibular dystonia is a difficult-to-treat subset of movement disorders that involve masticatory muscles with diverse and incapacitating manifestations. The aim of this study was to evaluate the efficacy of Botulinum toxin-type A therapy in khat chewer Yemeni patients with oromandibular dystonia. This prospective study included 18 khat-chewers Yemeni patients with refractory oromandibular dystonia, who were subjected to Botulinum toxin-A injection and followed up for 3 months thereafter. Primary efficacy outcome was the global impression scale, and secondary outcome measure was the Unified Dystonia Rating Scale. Patients showed improvement of both efficacy measures, maximum satisfactory responses were detected at the forth week after injection. No major adverse events were detected. Botulinum toxin-A is considered an effective and safe treatment option for refractory oromandibular dystonia in khat-chewers

Khat (Catha edulis) and ethanol co-dependence modulate seizure expression in a pentylenetetrazol seizure model

ETHNOPHARMACOLOGICAL RELEVANCE

Khat is a plant with psychostimulant properties whose parts, mainly leaves and twigs, are chewed for its euphoriant effects. Khat use and ethanol abuse are increasingly becoming global health concerns especially among many disadvantaged social groups. The present studies were undertaken to investigate seizure susceptibility and responses following chronic co-administration of khat and ethanol.

MATERIALS AND METHODS

Juvenile male Sprague-Dawley (SD) rats were administered khat, ethanol or combined khat and ethanol twice daily for 28 days by gavage. Khat-treated animals received 2 g/kg or 4 g/kg body weight continuously for the study period. Ethanol-treated animals received 20% ethanol at a dose of 4 g/kg body weight. The convulsant, pentylenetetrazol (PTZ), was administered intraperitoneally at a dose of 40 mg/kg body weight. Seizure responses were recorded.

RESULTS

Twice-daily dosing of khat did not produce inhibition of weight gain. Khat alone, combined khat and 20% ethanol, but not 20% ethanol alone, significantly reduced the latency to seize. Khat treatment at 2 g/kg but not 4 g/kg body weight also significantly increased the duration of seizures. Conversely, combined khat and ethanol reduced the duration of seizures compared to controls. Ethanol alone reduced the seizure severity while khat alone, and combined khat and ethanol, produced close to the maximum seizure severity.

CONCLUSIONS

These data suggest that combined moderate to high dose khat and ethanol co-dependence produce a greater deleterious CNS effect than either drug alone. Future studies will address neurochemical effects, in addition to neuroadaptations, resulting from coabuse of these drugs.

Botanicals and herbs: a traditional approach to treating epilepsy

Botanicals and herbs have a centuries-old tradition of use by persons with epilepsy, in many cultures around the world. At present, herbal therapies are tried by patients in developing as well as developed countries for control of seizures or adverse effects from antiepileptic drugs (AEDs), or for general health maintenance, usually without the knowledge of physicians who prescribe their AEDs. Well-designed clinical trials of herbal therapies in patients with epilepsy are scarce, and methodological issues prevent any conclusions of their efficacy or safety in this population. Furthermore, some botanicals and herbs may be proconvulsant or may alter AED metabolism. In spite of these limitations, further preclinical evaluation of botanicals and herbs and their constituent compounds using validated scientific methods is warranted based on numerous anecdotal observations of clinical benefit in patients with epilepsy and published reports showing mechanisms of action relevant to epilepsy or anticonvulsant effects in animal models of epilepsy. This review highlights the use of herbal therapies for epilepsy, outlines the role of the U.S. Food and Drug Administration in regulating herbal products, and presents the author's approach to the scientific assessment of herbal therapies as potential therapies for patients with epilepsy.