Cross-cultural comparison of medicinal floras used against snakebites

Gallic acid anti-myotoxic activity and mechanism of action, a snake venom phospholipase A2 toxin inhibitor, isolated from the medicinal plant Anacardium humile

Snakebite envenoming is the cause of an ongoing health crisis in several regions of the world, particularly in tropical and neotropical countries. This scenario creates an urgent necessity for new practical solutions to address the limitations of current therapies. The current study investigated the isolation, phytochemical characterization, and myotoxicity inhibition mechanism of gallic acid (GA), a myotoxin inhibitor obtained from Anacardium humile. The identification and isolation of GA was achieved by employing analytical chromatographic separation, which exhibited a compound with retention time and nuclear magnetic resonance spectra compatible with GA's commercial standard and data from the literature. GA alone was able to inhibit the myotoxic activity induced by the crude venom of Bothrops jararacussu and its two main myotoxins, BthTX-I and BthTX-II. Circular dichroism (CD), fluorescence spectroscopy (FS), dynamic light scattering (DLS), and interaction studies by molecular docking suggested that GA forms a complex with BthTX-I and II. Surface plasmon resonance (SPR) kinetics assays showed that GA has a high affinity for BthTX-I with a K_D of 9.146 × 10^-7 M. Taken together, the two-state reaction mode of GA binding to BthTX-I, and CD, FS and DLS assays, suggest that GA is able to induce oligomerization and secondary structure changes for BthTX-I and -II. GA and other tannins have been shown to be effective inhibitors of snake venoms' toxic effects, and herein we demonstrated GA's ability to bind to and inhibit a snake venom PLA₂, thus proposing a new mechanism of PLA₂ inhibition, and presenting more evidence of GA's potential as an antivenom compound.

Macroscopic, biochemical and hystological evaluation of topical anti-inflammatory activity of Casearia sylvestris (Flacourtiaceae) in mice

ETHNOPHARMACOLOGICAL RELEVANCE

Inflammatory skin diseases presents high prevalence and lack of alternatives that can be used for self-care by the population. Casearia sylvestris is a plant used topically in different communities in Brazil, to treat wounds or promote cutaneous healing. To evaluate the topical anti-inflammatory activity for the crude hydroalcoholic extract of Casearia sylvestris (HCE-CS) in the models of single or multiple administration of chroton oil to induce ear edema in mice.

MATERIALS AND METHODS

Experimental study using male Swiss mice (25-35g) kept under constant conditions in the Laboratory of Experimental Neuroscience (LaNEx)-UNISUL. Edema was induced in both models, respectively, by the single or multiple application of croton oil (CO, 2.5%, in 20 μl) on the external surface of the ear. The different groups of animals (n = 8) received different treatments: vehicle, dexamethasone (DEXA) or different doses of HCE-CS. Edema was evaluated macroscopically for 6 h (early edema) or 8 days (late edema) after the first application of the CO and immediately after the animals were submitted to euthanasia for the collection of the samples (treated ears). For early edema, the tissue was biochemically evaluated for myeloperoxidase activity (MPO) and levels of nitrite/nitrate. In the late edema model, the ears were histologically evaluated for general morphometry, degranulated and non-degranulated mast cells, as well as acanthosis.

RESULTS

Topic treatment with HCE-CS significantly reduced the early and late edema, as well as MPO activity and tissue levels of nitrite/nitrate. Finally, in the late edema model there was a lower density of degranulated mast cells in relation to the vehicle treated group and decreased thickness of the epidermis (acanthosis).

CONCLUSION

These results suggest a possible benefit of topical treatment with HCE-CS in inflammatory conditions of the skin.

Label-free SERS characterization of snake venoms by exploring the cysteine environs with bone-shaped gold nanoparticles

Identification of snake venoms is a vital step in the treatment of fatal snakebites. In this study, we use the gold-thiolate interaction between a cysteine residue and gold nanoparticles to establish a SERS method for the differentiation of the venoms of Trimeresurus stejnegeri and Bungarus multicinctus. We confirm the preference of gold nanoparticles over silver for the SERS study of snake venoms by a binding experiment that also functions to differentiate the two venom samples by colorimetry and UV-vis spectroscopy. We report the SERS spectra of Trimeresurus stejnegeri and Bungarus multicinctus venoms for the first time. The spectra display distinct SERS signatures of the snake venoms on bone-shaped gold nanoparticles made with a house recipe. These signatures correlate to selected segments of the venom proteins due to the anchoring effect of the gold-cysteine bond. The method is quick as it accomplishes in situ isolation of the structure of interest to avoid tedious purification of the samples. The location of the interactive cysteine residue makes a novel characteristic of proteins in general.

Taxonomic affiliation influences the selection of medicinal plants among people from semi-arid and humid regions-a proposition for the evaluation of utilitarian equivalence in Northeast Brazil

Background

This study sought to investigate the occurrence of taxonomic patterns between semi-arid and humid regions, verifying how the taxonomic affiliation can influence the selection of plants for medicinal purposes and act as a selection criterion.

Methods

The relationship between the taxonomic affiliation and the selection of medicinal plants with four different communities was analyzed; two of them associated with a seasonally dry tropical forest and the other two associated with a tropical rain forest. We used the Utilitarian Equivalence Model (transposing the concept of ecological equivalence, proposed by Odum, for ethnobotany) to test the hypothesis that species that have the same taxonomic affiliation tend to have the same therapeutic applications in different environments (utilitarian equivalence). In addition, we used the Utilitarian Redundancy Model to verify whether, within the same medical system, plants of the same taxonomic affiliation tend to be redundant (treating the same diseases).

Results

We found that a pair of plants of the same genus were 9.25 times more likely to be equivalent than a different genus pair (OR = 9.25, CI [1.68-51.02], p < 0.05). When we analyzed the species used by the same population, the chances of a pair having similar therapeutic uses (utilitarian redundancy) increased when they were species of the same family (OR = 1.94, CI [1.06-3.53]; p < 0.05).

Conclusions

These findings confirm the hypothesis that there is an influence of taxonomic affiliation, in terms of genera and family, on the selection of medicinal plants in semi-arid and humid areas in Northeast Brazil. In addition, our Utilitarian Equivalence Model can be an important tool in the search for more common selection criteria, in order to identify the shared characteristics among the equivalent pairs and consequently the main types of perceptions or stimuli that led to the inclusion of such species in local pharmacopoeias.

Perspective on the Therapeutics of Anti-Snake Venom

Snakebite envenomation is a life-threatening disease that was recently re-included as a neglected tropical disease (NTD), affecting millions of people in tropical and subtropical areas of the world. Improvement in the therapeutic approaches to envenomation is required to palliate the morbidity and mortality effects of this NTD. The specific therapeutic treatment for this NTD uses snake antivenom immunoglobulins. Unfortunately, access to these vital drugs is limited, principally due to their cost. Different ethnic groups in the affected regions have achieved notable success in treatment for centuries using natural sources, especially plants, to mitigate the effects of snake envenomation. The ethnopharmacological approach is essential to identify the potential metabolites or derivatives needed to treat this important NTD. Here, the authors describe specific therapeutic snakebite envenomation treatments and conduct a review on different strategies to identify the potential agents that can mitigate the effects of the venoms. The study also covers an increased number of literature reports on the ability of natural sources, particularly plants, to treat snakebites, along with their mechanisms, drawbacks and future perspectives.

Ethnomedicinal plants used for snakebite treatments in Ethiopia: a comprehensive overview

Traditional medicine plays an important role in the daily lives of people living in rural parts of Ethiopia. Despite the fact that Ethiopia has a long history of using traditional medicinal plants as an alternative medicine source, there is no checklist compiling these plants used for snakebite treatment. This review collected and compiled available knowledge on and practical usage of such plants in the country. A literature review on medicinal plants used to treat snakebites was conducted from 67 journal articles, PhD dissertation and MSc theses available online. Data that summarize scientific and folk names, administration methods, plant portion used for treatment and method of preparation of recipes were organized and analyzed based on citation frequency. The summarized results revealed the presence of 184 plant species distributed among 67 families that were cited for treating snakebite in Ethiopia. In this literature search, no single study was entirely dedicated to the study of traditional medicinal plants used for the treatment of snakebite in Ethiopia. Most of the species listed as a snakebite remedy were shrubs and climbers (44%) followed by herbs (33%) and trees (23%). Fabaceae was the most predominant family with the greatest number of species, followed by Solanaceae and Vitaceae. Remedies are mainly prepared from roots and leaves, through decoctions, infusions, powders and juices. Most remedies were administered orally (69%). The six most frequently mentioned therapeutically important plants were Nicotiana tabacum, Solanum incanum, Carissa spinanrum, Calpurnia aurea, Croton macrostachyus and Cynodon dactylon. Authors reviewed the vegetal substances involved in snakebite management and their action mode. In addition to screening the biologically active ingredients and pharmacological activities of these plant materials, future studies are needed to emphasize the conservation and cultivation of important medicinal plants of the country.

Epidemiology, ecology and human perceptions of snakebites in a savanna community of northern Ghana

BACKGROUND

Worldwide, snakebite envenomations total ~2.7 million reported cases annually with ~100,000 fatalities. Since 2009, snakebite envenomation has intermittently been classified as a very important 'neglected tropical disease' by the World Health Organisation. Despite this emerging awareness, limited efforts have been geared towards addressing the serious public health implications of snakebites, particularly in sub-Saharan Africa, where baseline epidemiological and ecological data remain incomplete. Due to poverty as well as limited infrastructure and public health facilities, people in rural Africa, including Ghana, often have no other choice than to seek treatment from traditional medical practitioners (TMPs). The African 'snakebite crisis' is highlighted here using regionally representative complementary data from a community-based epidemiological and ecological study in the savanna zone of northern Ghana.

METHODOLOGY AND FINDINGS

Our baseline study involved two data collection methods in the Savelugu-Nanton District (in 2019 the district was separated into Savelugu and Nanton districts) in northern Ghana, comprising a cross-sectional study of 1,000 residents and 24 TMPs between December 2008 and May 2009. Semi-structured interviews, as well as collection of retrospective snakebite and concurrent rainfall records from the Savelugu-Nanton District Hospital and Ghana Meteorological Authority respectively over 10-years (1999-2008) were used in the study. Variables tested included demography, human activity patterns, seasonality, snake ecology and clinical reports. Complementary data showed higher snakebite prevalence during the rainy season, and a hump-shaped correlation between rainfall intensity and snakebite incidences. Almost 6% of respondents had experienced a personal snakebite, whereas ~60% of respondents had witnessed a total of 799 snakebite cases. Out of a total of 857 reported snakebite cases, 24 (~2.8%) died. The highest snakebite prevalence was recorded for males in the age group 15-44 years during farming activities, with most bites occurring in the leg/foot region. The highest snakebite rate was within farmlands, most severe bites frequently caused by the Carpet viper (Echis ocellatus).

CONCLUSION

The relatively high community-based prevalence of ~6%, and case fatality ratio of ~3%, indicate that snakebites represent an important public health risk in northern Ghana. Based on the high number of respondents and long recording period, we believe these data truly reflect the general situation in the rural northern savanna zone of Ghana and West Africa at large. We recommend increased efforts from both local and international health authorities to address the current snakebite health crisis generally compromising livelihoods and productivity of rural farming communities in West Africa.

Ethnobotanical Study of Indigenous Medicinal Plants of Jazan Region, Saudi Arabia

For a long time, the people of Saudi Arabia have been using medicinal plants (MPs) as conventional medicine to heal diverse human and livestock diseases. The present work is the first study on ethnobotanical uses of 124 MPs species used by the local tribal communities of Jazan province in the Southwest of Saudi Arabia. Ethnobotanical data were collected by interviewing 174 local informants using semistructured interviews. Informants of different ages, from several settlements belonging to several tribal communities, were interviewed. It is worth noticing that the age of informants and their knowledge of MPs were positively correlated, whereas the educational level and MP knowledge of participants were negatively correlated. To find out if there was agreement in the use of certain plants in the treatment of given ailments, we used Informant Consensus Factor (ICF). To determine the most frequently used plant species for treating a particular ailment category by local people we used the fidelity level (FL%). The Relative Frequency of Citation (RFC) was used to indicate the local importance of a species and the relative importance (RI) level was used to check the therapeutic potentials of the cited plants. A total of 124 MPs belonging to 103 genera and 48 families were collected and identified. The majority of these plants were shrubs (45%), perennial herbs (21%), annual herbs (19%), or trees (18%). The Asteraceae (10.48%), Fabaceae (7.25%), and Apocynaceae (7.25%) families were the most represented. Leaves, fruits, and whole plant (24%, 18%, and 16%, respectively) were the most used plant parts in formulating traditional medicines. Ziziphus spina-christi and Calotropis procera with the highest RI level (2.0) were found to have the highest range of therapeutic uses. They were followed by Datura stramonium (1.86), Withania somnifera, and Aloe vera (1.81). The ICF ranged from 0.02 to 0.42 covering 12 disease categories with a prevalence of disease categories related to skin and hair problems (ICF=0.42) having 75 species cited, while 73 species were cited for gastrointestinal tract (GIT) disorders (ICF = 0.40). Senna alexandrina (67%), Tribulus terrestris (64%), Pulicaria undulata (60%), Leptadenia pyrotechnica (55%), and Rumex nervosus (55%) had the highest FL which indicates their good healing potential against specific diseases. The high-FL species are the most promising candidate plants for in-depth pharmacological screening and merit further consideration. Accordingly, Jazan flora has good ethnobotanical potential. Unfortunately, many MP species are endangered by drought, overgrazing, and overexploitation. Some protection measures should be undertaken to prevent these species from becoming extinct. Natural reserves and wild nurseries are typical settings to retain medically important plants in their natural habitats, while botanic gardens and seed banks are important paradigms for ex situ conservation.

Medicinal Plants for the Treatment of Local Tissue Damage Induced by Snake Venoms: An Overview from Traditional Use to Pharmacological Evidence

Snakebites are a serious problem in public health due to their high morbimortality. Most of snake venoms produce intense local tissue damage, which could lead to temporary or permanent disability in victims. The available specific treatment is the antivenom serum therapy, whose effectiveness is reduced against these effects. Thus, the search for complementary alternatives for snakebite treatment is relevant. There are several reports of the popular use of medicinal plants against snakebites worldwide. In recent years, many studies have been published giving pharmacological evidence of benefits of several vegetal species against local effects induced by a broad range of snake venoms, including inhibitory potential against hyaluronidase, phospholipase, proteolytic, hemorrhagic, myotoxic, and edematogenic activities. In this context, this review aimed to provide an updated overview of medicinal plants used popularly as antiophidic agents and discuss the main species with pharmacological studies supporting the uses, with emphasis on plants inhibiting local effects of snake envenomation. The present review provides an updated scenario and insights into future research aiming at validation of medicinal plants as antiophidic agents and strengthens the potentiality of ethnopharmacology as a tool for design of potent inhibitors and/or development of herbal medicines against venom toxins, especially local tissue damage.

Treating leishmaniasis in Amazonia: A review of ethnomedicinal concepts and pharmaco-chemical analysis of traditional treatments to inspire modern phytotherapies

ETHNOPHARMACOLOGICAL RELEVANCE

Cutaneous and mucocutaneous leishmaniasis are neglected tropical diseases that occur in all intertropical regions of the world. Amazonian populations have developed an abundant knowledge of the disease and its remedies. Therefore, we undertook to review traditional antileishmanial plants in Amazonia and have developed new tools to analyze this somewhat dispersed information.

MATERIAL AND METHODS

A literature review of traditional remedies for cutaneous/mucocutaneous leishmaniasis in the Amazon was conducted and the data obtained was used to calculate distribution indexes designed to highlight the most relevant uses in Amazonia. The cultural distribution index represents the distribution rate of a given taxon among different cultural groups and was calculated as the ratio of the number of groups using the taxon to the total number of groups cited. The geographical distribution index allowed us to quantify spatial distribution of a taxon's uses in Amazonia and was calculated geometrically by measuring the average distance between the points where uses have been reported and the barycenter of those points. The general distribution index was defined as an arithmetic combination of the previous two and provides information on both cultural and spatial criteria.

RESULTS

475 use reports, concerning 291 botanical species belonging to 83 families have been gathered depicted from 29 sources. Uses concern 34 cultural groups. While the use of some taxa appears to be Pan-Amazonian, some others are clearly restricted to small geographical regions. Particular attention has been paid to the recipes and beliefs surrounding treatments. Topical application of the remedies dominated the other means of administration and this deserves particular attention as the main treatments against Neotropical leishmaniasis are painful systemic injections. The data set was analyzed using the previously defined distribution indexes and the most relevant taxa were further discussed from a phytochemical and pharmacological point of view.

CONCLUSIONS

The Amazonian biodiversity and cultural heritage host a fantastic amount of data whose systematic investigation should allow a better large-scale understanding of the dynamics of traditional therapies and the consequent discovery of therapeutic solutions for neglected diseases. Distribution indices are indeed powerful tools for emphasizing the most relevant treatments against a given disease and should be very useful in the meta-analysis of other regional pharmacopeia. This focus on renowned remedies that have not yet benefitted from extended laboratory studies, could stimulate future research on new treatments of natural origin for leishmaniasis.

Medicinal plants used to treat snakebite in Central America: Review and assessment of scientific evidence

ETHNOPHARMACOLOGICAL RELEVANCE

Every year between 1.2 and 5.5 million people worldwide are victims of snakebites, with about 400,000 left permanently injured. In Central America an estimated 5500 snakebite cases are reported by health centres, but this is likely to be an underestimate due to unreported cases in rural regions. The aim of this study is to review the medicinal plants used traditionally to treat snakebites in seven Central American countries: Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama.

MATERIALS AND METHODS

A literature search was performed on published primary data on medicinal plants of Central America and those specifically pertaining to use against snakebites. Plant use reports for traditional snakebite remedies identified in primary sources were extracted and entered in a database, with data analysed in terms of the most frequent numbers of use reports. The scientific evidence that might support the local uses of the most frequently reported species was also examined.

RESULTS

A total of 260 independent plant use reports were recorded in the 34 sources included in this review, encompassing 208 species used to treat snakebite in Central America. Only nine species were reported in at least three studies: Cissampelos pareira L., Piper amalago L., Aristolochia trilobata L., Sansevieria hyacinthoides (L.) Druce, Strychnos panamensis Seem., Dorstenia contrajerva L., Scoparia dulcis L., Hamelia patens Jacq., and Simaba cedron Planch. Genera with the highest number of species used to treat snakebite were Piper, Aristolochia, Hamelia, Ipomoea, Passiflora and Peperomia. The extent of the scientific evidence available to understand any pharmacological basis for their use against snakebites varied between different plant species.

CONCLUSION

At least 208 plant species are traditionally used to treat snakebite in Central America but there is a lack of clinical research to evaluate their efficacy and safety. Available pharmacological data suggest different plant species may target different symptoms of snakebites, such as pain or anxiety, although more studies are needed to further evaluate the scientific basis for their use.

Aqueous Leaf Extract of Jatropha mollissima (Pohl) Bail Decreases Local Effects Induced by Bothropic Venom

Snakebites are a serious worldwide public health problem. In Brazil, about 90% of accidents are attributed to snakes from the Bothrops genus. The specific treatment consists of antivenom serum therapy, which has some limitations such as inability to neutralize local effects, difficult access in some regions, risk of immunological reactions, and high cost. Thus, the search for alternative therapies to treat snakebites is relevant. Jatropha mollissima (Euphorbiaceae) is a medicinal plant popularly used in folk medicine as an antiophidic remedy. Therefore, this study aims to evaluate the effect of the aqueous leaf extract from J. mollissima on local effects induced by Bothrops venoms. High Performance Liquid Chromatography with Diode Array Detection analysis and Mass Spectrometry analysis of aqueous leaf extract confirmed the presence of the flavonoids isoschaftoside, schaftoside, isoorientin, orientin, vitexin, and isovitexin. This extract, at 50–200 mg/kg doses administered by intraperitoneal route, showed significant inhibitory potential against local effects induced by Bothrops erythromelas and Bothrops jararaca snake venoms. Local skin hemorrhage, local edema, leukocyte migration, and myotoxicity were significantly inhibited by the extract. These results demonstrate that J. mollissima extract possesses inhibitory potential, especially against bothropic venoms, suggesting its potential as an adjuvant in treatment of snakebites.

High-resolution hyaluronidase inhibition profiling combined with HPLC-HRMS-SPE-NMR for identification of anti-necrosis constituents in Chinese plants used to treat snakebite

Inhibition of the necrotizing hyaluronidase, phospholipase A2 and protease enzymes in four snake venoms by crude water and ethanol extracts of 88 plant species used against snakebites in traditional Chinese medicine was measured. High-resolution hyaluronidase inhibition profiles were constructed for the 22 plants showing highest hyaluronidase inhibition, and the results were used to guide subsequent structural analysis towards specific hyaluronidase inhibitors. Structural analysis was performed by high-performance liquid chromatography, high-resolution mass spectrometry, solid-phase extraction and nuclear magnetic resonance spectroscopy, i.e., HPLC-HRMS-SPE-NMR. This allowed identification of four non-tannin inhibitors, i.e., lansiumamide B (6) from Clausena excavata Burm.f., myricetin 3-O-β-D-glucopyranoside (7) from Androsace umbellata (Lour.) Merr., and vitexin (8) and 4',7-dihydroxy-5-methoxyflavone-8-C-β-D-glucopyranoside (9) from Oxalis corniculata L. Absolute configuration of 2,3-dihydroxy-N-methyl-3-phenyl-N-[(Z)-styryl]propanamide (1) was determined using the Mosher method, which revealed two enantiomers, i.e., (2S,3R)-2,3-dihydroxy-N-methyl-3-phenyl-N-[(Z)-styryl]propanamide and (2R,3S)-2,3-dihydroxy-N-methyl-3-phenyl-N-[(Z)-styryl]propanamide with a ratio of 7:3.

Ethnomedicinal uses of plants for the treatment of snake and scorpion bite in Northern Pakistan

ETHNO-PHARMACOLOGICAL RELEVANCE

Medicinal plants represent one of the most accessible resources available for snake and scorpion bite among the rural communities of Northern Pakistan. This first ethno-botanical study aimed to document the indigenous knowledge and practices of using plants for snake and scorpion bite disorders in Northern Pakistan.

METHODS

Ethno-medicinal data is documented from 187 informants using semi-structured interviews. The data is analyzed using quantitative ethno-botanical indices of frequency citation (FC) and relative Frequency of Citation (RFC). In addition to this, the ethno-medicinal findings of this survey were compared with 10 previous published studies in order to report novel uses of medicinal plants against snake and scorpion bite disorders.

RESULTS

In total 62 medicinal plants belonging to 40 families are reported against snake and scorpion bite in this study. Our results showed that Asteraceae is the most used family (10 species), dominant life form is herb (48.38%), leaves were the most used plants part (18 Use-reports) and the paste is most used method of administration (22 reports). The range of RFC was 0.08-0.27 about the use of documented species. Compared to previous published studies, 33.87% similarity index while 66.12% novelty index is reported. About 40 plant species are first time reported with medicinal uses against snake and scorpion bite from Northern Pakistan.

CONCLUSIONS

This study presents useful traditional knowledge of rural communities for the control of snake and scorpion bite using medicinal plants. The study mainly focused on ethno-medicinal documentation to preserve the valuable traditional knowledge that can be used in future phytochemical and pharmacological studies on medicinal plants of the area.

Investigation of skin permeation, ex vivo inhibition of venom-induced tissue destruction, and wound healing of African plants used against snakebites

ETHNOPHARMACOLOGICAL RELEVANCE

Snakebite envenomation causes 5000-10,000 mortalities and results in more than 5-15,000 amputations in sub-Saharan Africa alone every year. The inaccessibility of antiserum therapy is a vast problem, and only about 2.5% of the actual need for antiserum in Africa is covered. Numerous plants have shown in vitro inhibitory activity against one or more of the hydrolytic enzymes involved in snakebite-induced necrosis. However, a more thorough examination of the plant species in ex vivo and in vitro cell assay models is needed to test their ability to inhibit necrosis.

MATERIALS AND METHODS

Extracts which had previously shown in vitro inhibitory activity against necrosis enzymes, were tested in an ex vivo air-liquid-interface model, and a wound healing scratch assay as well as for their ability to permeate the skin barrier and inhibit venom induced cell death.

RESULTS

Of the 14 water extracts and 16 ethanol extracts tested at a concentration of 10 μg/mL, only the ethanol extracts of Tamarindus indica and Paullinia pinnata resulted in a small but significant increase in cell migration of around 10% compared to treatment with buffer after 24h treatment. The remaining extracts showed no effect, or they even delayed the cell migration compared to the treatment with buffer. After 48 h treatment, 10 of the tested extracts showed a decreased cell migration compared to no treatment. At a 100 μg/mL concentration all the extracts inhibited cell migration and five extracts killed some of the cells, while four extracts killed all the cells. Ten of the thirty extracts were tested in a Franz cell set-up but none of the extracts tested did permeate the skin barrier over a 48 h period, and will therefore be of very limited use topically in the initial treatment of snakebites in its present form. None of the extracts were able to directly interact with the enzyme to lower the cell toxicity of the venom. Two extracts, Dichrostachys cinerea and Grewia mollis, were tested in the ex vivo model, but none of them inhibited the tissue destruction caused by venom.

CONCLUSION

On the basis of this study, topical treatment with plant extracts for snakebite-induced tissue necrosis cannot be recommended.

Medicinal plants of the Achuar (Jivaro) of Amazonian Ecuador: ethnobotanical survey and comparison with other Amazonian pharmacopoeias

AIM OF THE STUDY AND ETHNOPHARMACOLOGICAL RELEVANCE

This paper presents the first ethnobotanical survey conducted among the Achuar (Jivaro), indigenous people living in Amazonian Ecuador and Peru. The aims of this study are: (a) to present and discuss Achuar medicinal plant knowledge in the context of the epidemiology of this population (b) to compare the use of Achuar medicinal plants with the uses reported among the Shuar Jivaro and other Amazonian peoples.

MATERIALS AND METHODS

The author conducted field research in 9 indigenous villages in the region of Morona Santiago and Pastaza in Ecuador. Semi-structured interviews on local illnesses and herbal remedies were carried out with 82 informants and plant specimens were collected and later identified in Quito. A literature research was conducted on the medicinal species reported by Achuar people during this study.

RESULTS

The most reported medicinal plants are species used by the Achuar to treat diarrhoea, parasites infection, fractures, wounds, and snakebites. Informants reported the use of 134 medicinal species for a total of 733 recorded use-reports. Of these 134 species, 44 are reported at least 3 times for one or more specific disease condition for a total of 56 uses. These species are considered a core kit of medicinal plants of the Achuar of Ecuador. Most of these medicinal species are widely used in the Amazon rainforest and in many other parts of Latin America.

CONCLUSION

The author documented a core kit of 44 medicinal plants used among the Achuar of Ecuador and found that this core set of medicinal plants reflects local epidemiological concerns and the pharmacopoeias of the Shuar and other Amazonian groups. These findings suggest that inter-group diffusion of medicinal plant knowledge had a prominent role in the acquisition of current Achuar knowledge of medicinal plants.

Hyaluronidase, phospholipase A2 and protease inhibitory activity of plants used in traditional treatment of snakebite-induced tissue necrosis in Mali, DR Congo and South Africa

ETHNOPHARMACOLOGICAL RELEVANCE

Snakebite envenomation, every year, causes estimated 5-10,000 mortalities and results in more than 5-15,000 amputations in sub-Saharan Africa alone. Antiserum is not easily accessible in these regions or doctors are simply not available, thus more than 80% of all patients seek traditional practitioners as first-choice. Therefore it is important to investigate whether the plants used in traditional medicine systems contain compounds against the necrosis-inducing enzymes of snake venom.

MATERIALS AND METHODS

Extracts from traditionally used plants from DR Congo, Mali and South Africa were tested in hyaluronidase, phospholipase A2 and protease enzyme bioassays using Bitis arietans and Naja nigricollis as enzyme source.

RESULTS

A total of 226 extracts from 94 different plant species from the three countries, Mali, Democratic Republic of Congo and South Africa were tested in phospholipase A2, proteases and hyaluronidase enzyme assays. Forty plant species showed more than 90% inhibition in one or more assay. Fabaceae, Anacardiaceae and Malvaceae were the families with the highest number of active species, and the active compounds were distributed in different plant parts depending on plant species. Polyphenols were removed in the search for specific enzyme inhibitors against hyaluronidase, phospholipase A2 or proteases from extracts with IC50 values below 100µg/ml. Water extracts of Pupalia lappacea, Combretum molle, Strychnos innocua and Grewia mollis and ethanol extract of Lannea acida and Bauhinia thonningii still showed IC50 values below 100µg/ml in either the hyaluronidase or protease bioassay after removal of polyphenols.

CONCLUSION

As four of the active plants are widely distributed in the areas where the snake species Bitis arietans and Naja nigricollis occur a potential inhibitor of the necrotic enzymes is accessible for many people in sub-Saharan Africa.

High-resolution bacterial growth inhibition profiling combined with HPLC-HRMS-SPE-NMR for identification of antibacterial constituents in Chinese plants used to treat snakebites

ETHNOPHARMACOGICAL RELEVANCE

Bacterial infection is one of the main secondary infections caused by snakebite. The 88 plant species investigated in this study have been used as folk remedies for treatment of snakebite, and it is therefore the aim of this study to investigate whether the plants contain compounds with bacterial growth inhibition.

MATERIALS AND METHODS

The water and ethanol extracts of 88 plant species were screened at 200 μg/mL against Bacillus subtilis, Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa for their antibacterial activity by micro-broth dilution assay. The most active extracts were fractionated into microplates using analytical-scale RP-HPLC, and subsequently growth inhibition was assessed for each well. The biochromatograms constructed from these assays were used to identify compounds responsible for antibacterial activity. The structures of five compounds were elucidated by HPLC-HRMS-SPE-NMR.

RESULTS

Crude extracts of Boehmeria nivea, Colocasia esculenta, Fagopyrum cymosum, Glochidion puberum, Melastoma dodecandrum, Polygonum bistorta, Polygonum cuspidatum and Sanguisorba officinalis showed MIC values below 200 μg/mL against either Bacillus subtilis, Staphylococcus aureus, Escherichia coli or Pseudomonas aeruginosa. The biochromatograms demonstrated that tannins play a main role for the bacterial growth inhibition observed for all above-mentioned plants except for Polygonum cuspidatum. Furthermore, the high-resolution bacterial growth inhibition profiling combined with HPLC-HRMS-SPE-NMR allowed fast identification of three non-tannin active compounds, i.e., piceid, resveratrol and emodin from ethanol extract of Polygonum cuspidatum.

CONCLUSION

The high-resolution bacterial growth inhibition profiling allowed fast pinpointing of constituents responsible for the bioactivity, e.g., either showing tannins being the main bacterial growth inhibitors as observed for the majority of the active plants, or combined with HPLC-HRMS-SPE-NMR for fast structural identification of non-tannin constituents correlated with antibacterial activity.

Jatropha gossypiifolia L. (Euphorbiaceae): A Review of Traditional Uses, Phytochemistry, Pharmacology, and Toxicology of This Medicinal Plant

Jatropha gossypiifolia L. (Euphorbiaceae), widely known as “bellyache bush,” is a medicinal plant largely used throughout Africa and America. Several human and veterinary uses in traditional medicine are described for different parts and preparations based on this plant. However, critical reviews discussing emphatically its medicinal value are missing. This review aims to provide an up-to-date overview of the traditional uses, as well as the phytochemistry, pharmacology, and toxicity data of J. gossypiifolia species, in view of discussing its medicinal value and potential application in complementary and alternative medicine. Pharmacological studies have demonstrated significant action of different extracts and/or isolated compounds as antimicrobial, anti-inflammatory, antidiarrheal, antihypertensive, and anticancer agents, among others, supporting some of its popular uses. No clinical trial has been detected to date. Further studies are necessary to assay important folk uses, as well as to find new bioactive molecules with pharmacological relevance based on the popular claims. Toxicological studies associated with phytochemical analysis are important to understand the eventual toxic effects that could reduce its medicinal value. The present review provides insights for future research aiming for both ethnopharmacological validation of its popular use and its exploration as a new source of herbal drugs and/or bioactive natural products.

Effects of Schizolobium parahyba extract on experimental Bothrops venom-induced acute kidney injury

BACKGROUND

Venom-induced acute kidney injury (AKI) is a frequent complication of Bothrops snakebite with relevant morbidity and mortality. The aim of this study was to assess the effects of Schizolobium parahyba (SP) extract, a natural medicine with presumed anti-Bothrops venom effects, in an experimental model of Bothrops jararaca venom (BV)-induced AKI.

METHODOLOGY

Groups of 8 to 10 rats received infusions of 0.9% saline (control, C), SP 2 mg/kg, BV 0.25 mg/kg and BV immediately followed by SP (treatment, T) in the doses already described. After the respective infusions, animals were assessed for their glomerular filtration rate (GFR, inulin clearance), renal blood flow (RBF, Doppler), blood pressure (BP, intra-arterial transducer), renal vascular resistance (RVR), urinary osmolality (UO, freezing point), urinary neutrophil gelatinase-associated lipocalin (NGAL, enzyme-linked immunosorbent assay [ELISA]), lactate dehydrogenase (LDH, kinetic method), hematocrit (Hct, microhematocrit), fibrinogen (Fi, Klauss modified) and blinded renal histology (acute tubular necrosis score).

PRINCIPAL FINDINGS

BV caused significant decreases in GFR, RBF, UO, HcT and Fi; significant increases in RVR, NGAL and LDH; and acute tubular necrosis. SP did not prevent these changes; instead, it caused a significant decrease in GFR when used alone.

CONCLUSION

SP administered simultaneously with BV, in an approximate 10∶1 concentration, did not prevent BV-induced AKI, hemolysis and fibrinogen consumption. SP used alone caused a decrease in GFR.

Acute kidney injury caused by Crotalus and Bothrops snake venom: a review of epidemiology, clinical manifestations and treatment

SUMMARY

Ophidic accidents are an important public health problem due to their incidence, morbidity and mortality. An increasing number of cases have been registered in Brazil in the last few years. Several studies point to the importance of knowing the clinical complications and adequate approach in these accidents. However, knowledge about the risk factors is not enough and there are an increasing number of deaths due to these accidents in Brazil. In this context, acute kidney injury (AKI) appears as one of the main causes of death and consequences for these victims, which are mainly young males working in rural areas. Snakes of the Bothrops and Crotalus genera are the main responsible for renal involvement in ophidic accidents in South America. The present study is a literature review of AKI caused by Bothrops and Crotalus snake venom regarding diverse characteristics, emphasizing the most appropriate therapeutic approach for these cases. Recent studies have been carried out searching for complementary therapies for the treatment of ophidic accidents, including the use of lipoic acid, simvastatin and allopurinol. Some plants, such as Apocynaceae, Lamiaceae and Rubiaceae seem to have a beneficial role in the treatment of this type of envenomation. Future studies will certainly find new therapeutic measures for ophidic accidents.

Does the selection of medicinal plants by Brazilian local populations suffer taxonomic influence?

ETHNOPHARMACOLOGICAL RELEVANCE

The analysis of the influence of taxonomic affiliation on the selection of medicinal plants by Brazilian local populations can help elucidate theoretical aspects of medicinal plant selection.

MATERIALS AND METHODS

Ethnobotanical medicinal plant studies were compiled and the resulting medicinal flora was compared to the total angiosperm flora with a Bayesian approach and the IDM model.

RESULTS

A total of 35 families were considered to be overused and six were classified as underused for the Bayesian approach. On the other hand, the IDM model considered 13 families as overused and five as underused (all of them were also highlighted by the Bayesian approach). A high overuse level of Bixaceae, Amaranthaceae, Anacardiaceae and Smilacaceae was recorded for both Bayesian and IDM model, while Orchidaceae, Melastomataceae, Eriocaulaceae, Poaceae and Bromeliaceae were considered as underused for both analyses. The most dissimilar body system in terms of family composition was 'mental and behavioral disorders'. It was also found that the body systems are different from one another in the proportion of taxonomic groups, which could indicate chemical specificity in the treatment of diseases.

CONCLUSIONS

Results indicate that the chemical specificity of taxonomic groups directly influences medicinal plant selection. Moreover, when data presented here are compared to other studies, there is clearly an overuse pattern for families like Lamiaceae, Rosaceae and Euphorbiaceae and an underuse pattern for Poaceae and Orchidaceae.