Phytochemical contents and biological evaluation of Ruta chalepennsis L. growing in Saudi Arabia

Computational investigation of 2, 4-Di Tert Butyl Phenol as alpha amylase inhibitor isolated from Coccinia grandis (L.) Voigt using molecular docking, and ADMET parameters

INTRODUCTION

Diabetes Mellitus is the metabolic disorder most prevalent globally, accounting for a substantial morbidity rate. The conventional drugs available for the management of diabetes are either expensive or lack the required efficacy. The purpose of this research is to isolate and characterize an active phytoconstituent from Coccinia grandis and assess its anti-diabetic properties.

METHODS AND MATERIALS

Stems of Coccinia grandis are subjected to successive extraction and isolation. The isolated compound by column chromatography was characterized by FTIR (fourier-transform infrared), 1 H NMR (proton nuclear magnetic resonance), and Mass spectroscopy. The antidiabetic potential of the isolated compound was evaluated by in-vitro alpha-amylase inhibitory activity. Further, the compound was subjected to molecular docking studies to study its interaction with the human pancreatic alpha-amylase (Molegro Virtual Docker) as well to determine the pharmacokinetic and toxicity profile using computational techniques (OSIRIS property explorer, Swiss ADME, pkCSM, and PreADMET).

RESULTS

The characterization of the compound suggests the structure to be 2,4-ditertiary butyl phenol. The in-vitro alpha-amylase inhibitory study indicated a concentration-dependent inhibition and the IC50 (median lethal dose) value of the isolated compound was found to be 64.36 μg/ml. The docking study with the A chain of receptor 5EMY yielded a favorable docking score of -81.48 Kcal mol-1, suggesting that the compound binds to the receptor with high affinity through electrostatic, hydrophobic, and hydrogen bonds. Furthermore, the silico ADME analysis of the compound revealed improved metabolism, a skin permeability of -3.87 cm/s, gastrointestinal absorption of 95.48 %, and a total clearance of 0.984 log ml min-1 kg-1. In silico toxicity analysis also predicted cutaneous irritations but no carcinogenicity, mutagenicity, or hepatotoxicity.

CONCLUSION

The data suggested that the isolated compound (2, 4-tertiary butyl phenol) has the potential to inhibit the alpha-amylase activity and possess optimal ADME properties as well as tolerable side effects.

Microscopic and physicochemical evaluation of <em>Ruta angustifolia</em> leaves

Background: There are thousands of species of known medicinal plants in the world. Ruta angustifolia L. has been widely used in traditional medication for jaundice and liver disease. Previous studies have shown that R. angustifolia leaves can inhibit the hepatitis C virus in Huhit culture cells, reduce the value of NS3 protein, and possess a synergistic effect in combination with antiviral drugs. Therefore, this plant is potential to be developed as a drug candidate. Characteristics of plants including microscopic, physicochemical properties, and phytochemical profiles are necessary information to ensure the quality of raw material in drug development. Objective: This study was carried out to examine the microscopic and physicochemical including the standardized parameter of R. angustifolia leaves to fulfil the quality raw materials as traditional medicine. Methods: Simplicia of R. angustifolia leaves obtained from Jombang, East Java, were observed under a microscope and determined its physicochemical properties referred to the Materia Medica Indonesia V. The TLC and HPLC profiles of extract were determined as well. Results: Microscopic analysis were conducted by transfection sections and the presence of epidermis cells, palisade, mesophyll with stomata, and Ca-oxalate crystal were found. The standard parameter obtained value of loss of drying, extractive value in water and ethanol, and ash value. The TLC and HPLC profiles of leaves extract demonstrated to contain with flavonoid, terpenoids, and alkaloids. Conclusion: Ruta angustifolia obtained from Jombang, east Java, has a specific character in microscopic analysis. The physicochemical properties analysis of R. angustifolia leaves as a raw material met the requirements according to Materia Medica Indonesia V.

Headspace Solid Phase Micro-Extraction of Volatile Constituents Produced from Saudi Ruta chalepensis and Molecular Docking Study of Potential Antioxidant Activity

Ruta chalepensis L., commonly known as Shazab in Saudi Arabia, is one of the famous culinary plants belonging to the Rutaceae family. It is commonly used in ethnomedicine in treating numerous diseases. This study was performed to characterize the essential oil isolated from Saudi species using a relatively new advanced headspace solid-phase microextraction technique. Following that, the antioxidant activity of the extracted oil was assessed using in vitro techniques such as the DPPH and nitric oxide scavenging tests, as well as the reducing power FRAP study and the molecular docking tool. The essential oil yield of the dried plant was 0.83% (v/w). Gas chromatography joined with a mass spectrometer was used to determine the chemical composition of the pale-yellow essential oil. Sixty-eight constituents were detected, representing 97.70% of the total oil content. The major constituents were aliphatic ketones dominated by 2-undecanone (37.30%) and 2-nonanone (20.00%), with minor constituents of mono and sesquiterpenoids chemical classes. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase is one of the major causes of many contemporary diseases due to its ability to create a reactive oxygen species (ROS). Thus, molecular docking was used to confirm that some oil phytoconstituents have good docking scores compared to the standard antioxidant drug (Vitamin C), indicating great binding compatibility between the (NADPH) oxidase receptor site and the ligand. In conclusion, our findings suggest that the oil could be used safely and as a cost-effective remedy in treating various modern diseases caused by free radical formation.

Ruta chalepensis L. In Vitro Cultures as a Source of Bioactive Furanocoumarins and Furoquinoline Alkaloids

Recently, due to the decreasing areas of cultivation and climate change, the use of biotechnological methods to obtain biomass, which is a source of valuable bioactive metabolites, is becoming more and more interesting. In this study, Ruta chalepensis in vitro cultures were investigated in RITA^® temporary immersion bioreactors. Biomass growth and the production of secondary metabolites in 4- and 5-week growth cycles on three variants of the Linsmaier and Skoog (LS) medium (naphthyl-1-acetic acid/6-benzylaminopurine (NAA/BAP): 0.5/1.0, 0.1/0.1, and 1.0/1.0 mg/L) were analyzed. Using high-performance liquid chromatography of methanolic extracts of biomass, the presence of linear furanocoumarins (bergapten, isoimperatorin, isopimpinellin, psoralen, and xanthotoxin) and furoquinoline alkaloids (γ-fagarine, 7-isopentenyloxy-γ-fagarine, and skimmianine) was confirmed. The highest content of linear furanocoumarins (1170 mg/100 g DW (dry weight)) was observed in the LS medium variant containing 0.5/1.0 mg/L NAA/BAP (4-week growth cycle). The highest content of furoquinoline alkaloids (449 mg/100 g DW) was observed in the LS medium variant containing 0.1/0.1 mg/L NAA/BAP (5-week growth cycle). Hence, R. chalepensis bioreactor cultures may be used as a biotechnological source of linear furanocoumarins (xanthotoxin and bergapten) and furoquinoline alkaloids (skimmianine and γ-fagarine).

Ethnobotanical study of medicinal plants in Asagirt District, Northeastern Ethiopia

BACKGROUND

The people in Ethiopia have developed their own specific knowledge to use, manage and conserve plant resources, giving traditional medicine its diverse nature. Documenting and investigating the traditional and cultural use of remedial plants is vital to extract bioactive chemicals and preserve plant species. This research was conducted with the aim of documenting ethnobotanical and associated knowledge on medicinal plants in Asagirt District, northeastern Ethiopia.

METHODOLOGY

The study was conducted from September 27, 2018, to April 9, 2019. A total of 367 informants (244 males and 123 females) were involved in the interviews. General informants (n = 349) were randomly selected, whereas key informants (n = 18) were selected purposively. Data were collected by using semistructured interviews, group discussions and guided field walks. We performed direct matrix ranking and preference ranking, and calculated the fidelity level and informant consensus factor (ICF). Descriptive statistics, including analysis of variance (ANOVA) and independent sample t-test were used to analyse the data.

RESULTS

Overall, 103 medicinal plant species belonging to 96 genera under 45 plant families were recorded to be used by Asagirt people to alleviate different health problems. The species used to heal human diseases only were (64%, 66 species) followed by both livestock and human ailments (31%, 32 species) and livestock diseases only (5%, 5 species). Asteraceae and Fabaceae were best-represented (10.7%, 11 species each). The most frequently used plant parts were leaves (28%, 29 species), followed by seeds (16%, 17 species). The most important method of herbal remedy preparation was crushing (20.4%, 21 species). The common route of administration was oral (46.6%, 48 species), followed by dermal (22.3%, 23 species). Febrile illness, fever, headache, amoebiasis, typhoid and diarrhoea ailment categories had the highest ICF value (0.99). Ocimum lamiifolium Hochst. ex Benth. scored the maximum fidelity level value (98%).

CONCLUSION

Asagirt District is comparatively rich in medicinal plants and their associated knowledge. However, firewood collection, construction, the expansion of agricultural activities and timber production are the major challenges to medicinal plants. Hence, joint management with the people in Asagirt District in overall medicinal plant conservation would save medicinal plant resources.

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.

Medicinal Plants Used for Dermatological Disorders among the People of the Kingdom of Saudi Arabia: A Narrative Review

Historically, skin disorders have received less attention in health management than other life-threatening diseases that occur on a global scale. However, numerous skin problems are reported to primary health care systems worldwide, particularly in tropical locations. While modern physicians often address most skin conditions, it is estimated that over 70% of individuals with skin illnesses do not seek treatment. Traditional medicine dates all the way back to human civilization's inception. Numerous materials are utilized in traditional medicinal remedies, but the use of plants is particularly critical. Saudi Arabia is one of the world's most botanically varied countries, having an extensive folk medicine heritage. While several reviews on the use of plants to cure skin disorders has been published worldwide, very few have been undertaken in Saudi Arabia, much alone a comprehensive one. Thus, the present review identified the most significant and medicinally relevant herbs used in the treatment of various dermatological conditions in Saudi Arabia. A total of 43 plants were identified and described in this study. This investigation omitted publications that lacked detailed data and had only fragmented information regarding the herb's traditional use in topical applications.

Phytochemical Characterization, and Antioxidant and Antimicrobial Properties of Agitated Cultures of Three Rue Species: Ruta chalepensis, Ruta corsica, and Ruta graveolens

The in vitro cultures of the following three species of the genus Ruta were investigated: R. chalepensis, R. corsica, and R. graveolens. The dynamics of biomass growth and accumulation of secondary metabolites in the 3-, 4-, 5-, 6-, and 7-week growth cycle were analysed. The antioxidant capacity of the methanol extracts obtained from the biomass of the in vitro cultures was also assessed by different in vitro assays: 1,1-diphenyl-2-picrylhydrazil (DPPH), reducing power, and Fe²⁺ chelating activity assays. Moreover, a preliminary screening of the antimicrobial potential of the extracts was performed. The extracts were phytochemically characterized by high-performance liquid chromatography (HPLC), which highlighted the presence of linear furanocoumarins (bergapten, isoimperatorin, isopimpinellin, psoralen, and xanthotoxin) and furoquinoline alkaloids (γ-fagarine, 7-isopentenyloxy-γ-fagarine, and skimmianine). The dominant group of compounds in all the cultures was coumarins (maximum content 1031.5 mg/100 g DW (dry weight), R. chalepensis, 5-week growth cycle). The results of the antioxidant tests showed that the extracts of the three species had varied antioxidant capacity: in particular, the R. chalepensis extract exhibited the best radical scavenging activity (IC₅₀ = 1.665 ± 0.009 mg/mL), while the R. graveolens extract displayed the highest chelating property (IC₅₀ = 0.671 ± 0.013 mg/mL). Finally, all the extracts showed good activity against Staphylococcus aureus with MIC values of 250 μg/mL for the R. corsica extract and 500 μg/mL for both R. graveolens and R. chalepensis extracts.

Enhanced Accumulation of Biologically Active Coumarin and Furanocoumarins in Callus Culture and Field-grown Plants of Ruta chalepensis Through LED Light-treatment

Ruta chalepensis, a medicinal plant, produces biologically active coumarins (CRs) and furanocoumarins (FCRs). However, their yield is quite low in cultivated plants. In this work, the influence of light emitting diodes (LEDs) was investigated on the accumulation of CRs and FCRs in the callus cultures and field-grown plants of R. chalepensis. Among the various tested wavelengths of LED lights, maximum accumulation of CR and FCRs was recorded under blue LED treatment in both the callus cultures as well as field-grown plants as compared to respective controls treated with white LED. Metabolite analyses of LED-treated field-grown plants showed that highest concentrations of CR (umbelliferone, 2.8-fold), and FCRs (psoralen, 2.3-fold; xanthotoxin, 3.8-fold; bergapten, 1.16-fold) were accumulated upon blue LED-treatment for six days. CR and FCRs contents were also analyzed in the blue- and red-LED-treated in vitro callus tissue. Upon blue LED-treatment, callus accumulated significantly high levels of umbelliferone (48.6 ± 1.2 µg/g DW), psoralen (370.12 ± 10.6 µg/g DW) and xanthotoxin (10.16 ± 0.48 µg/g DW). These findings imply that blue LED-treatment is a viable option as a non-invasive and low-cost elicitation technology for the enhanced production of biologically active CR and FCRs in field-grown plants and callus cultures of R. chalepensis.

Candidate Anti-COVID-19 Medicinal Plants from Ethiopia: A Review of Plants Traditionally Used to Treat Viral Diseases

Background

Emerging viral infections are among the major global public health concerns. The pandemic COVID-19 is a contagious respiratory and vascular disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There are no medicines that can treat SARS-CoV-2 except the vaccines. Therefore, searching for plant-originated therapeutics for the treatment of COVID-19 is required. Consequently, reviewing medicinal plants used to treat different viral infections is mandatory. This review article aims to review the ethnobotanical knowledge of medicinal plants traditionally used to treat different viral diseases by the Ethiopian people and suggests those plants as candidates to fight COVID-19.

Methods

Articles written in English were searched from online public databases using searching terms like “Traditional Medicine,” “Ethnobotanical study,” “Active components,” “Antiviral activities,” and “Ethiopia.” Ethnobotanical data were analyzed using the Excel statistical software program.

Result

From the 46 articles reviewed, a total of 111 plant species were claimed to treat viral infections. Fifty-six (50.4%) of the plant species had reported to have antiviral active components that are promising to treat COVID-19. Lycorine, gingerol shogaol, resveratrol, rhoifolin, oleanolic acid, kaempferol, rosmarinic acid, almond oil, ursolic acid, hederagenin, nigellidine, α-hederin, apigenin, nobiletin, tangeretin, chalcone, hesperidin, epigallocatechin gallate, allicin, diallyl trisulfide, ajoene, aloenin, artemisinin, glucobrassicin, curcumin, piperine, flavonoids, anthraquinone, hydroxychloroquine, and jensenone were some of them.

Conclusion

The Ethiopian traditional knowledge applies a lot of medicinal plants to treat different viral infections. Reports of the chemical components of many of them confirm that they can be promising to fight COVID-19.

Pharmacological and toxicological effects of Ruta chalepensis L. on experimentally induced seizures and electroencephalographic spectral power in mice

ETHNOPHARMACOLOGICAL RELEVANCE

Ruta chalepensis L. (Rutaceae) is used in traditional medicine to treat a wide variety of disorders such as rheumatism, fever, mental disorders, dropsy, neuralgia, menstrual problems, anxiety, and epilepsy.

AIM OF THE STUDY

To evaluate and compare the anticonvulsant properties of an aqueous extract and ethyl acetate (AcOEt) fraction of R. chalepensis on pentylenetetrazole (PTZ)-induced seizures and maximal electroshock (MES) test in mice, by analyzing behavior and electroencephalogram (EEG), as well as GABA_A receptors involvement.

METHODS

The effect of an acute administration of different dosage of the aqueous extract (300 or 500 mg/kg) or AcOEt fraction (100, 300, 500 or 1000 mg/kg) of R. chalepensis was explored on two different models of acute seizure induction in mice, the PTZ and maximal electroshock (MES) tests. Behavioral and electrographic effects were quantified. Additionally, the possible involvement of the GABA_A receptors was explored in the presence of picrotoxin (a non-competitive antagonist of the GABA_A receptor).

RESULTS

AcOEt fraction of R. chalepensis was more efficient than aqueous extract to reduce the incidence of tonic-clonic seizures and mortality in a significant and dose-dependent manner in both the PTZ and MES tests. This anticonvulsant effect was not abolished in the presence of picrotoxin. The EEG spectral power analysis revealed that aqueous extract decreased alpha and beta power, while AcOEt fraction decreased alpha and gamma power confirming previous findings of its depressant effect in the central nervous system. It is important to mention that the highest dosage of the AcOEt (1000 mg/kg) produced a severe suppression or isoelectric EEG activity (EEG flattening), recognized as a comatose state, suggesting a neurotoxic effect at this dosage.

CONCLUSION

Our data reinforce that depressant and anticonvulsant effects of R. chalepensis depend in part on the presence of constituents from medium polarity. We also found that anticonvulsant effect is not mediated by GABA_A receptors. In addition, cautious is emphasized when high doses of this natural product are used in traditional medicine since it might produce neurotoxic effects.

Misuse, consequences and phototoxic skin-related effects of Rutaceae: a comprehensive literature review

Ruta is a common plant growing in Italy and in the Mediterranean area. It has been used in popular tradition with different aims, ranging from therapeutic to esoteric purposes. However, the plant is still used as a common remedy in some of present-day rural and urban communities and it can be found in gardens all over Europe. Ruta's photosensitizing effect has been described in the literature and seems to be mediated by furanocoumarins. We collected data from the 18 case-reports for a total of 32 patients that we included in our analysis, assessing demographic variables, clinical findings, diagnosis, time of onset of lesions, time of resolution and therapy. The main aim of this work was to outline the clinical presentation, therapeutic management and demography of phytophototoxic reactions from contact with Ruta in order to suggest the correct diagnostic approach and disease recognition, as well as its possible prevention.

Identification of Alkaloid Compounds Arborinine and Graveoline from Ruta angustifolia (L.) Pers for their Antifungal Potential against Isocitrate lyase (ICL1) gene of Candida albicans

Candida albicans has been reported globally as the most widespread pathogenic species contributing candidiasis from superficial to systemic infections in immunocompromised individuals. Their metabolic adaptation depends on glyoxylate cycle to survive in nutrient-limited host. The long term usage of fungistatic drugs and the lack of cidal drugs frequently result in strains that could resist commonly used antifungals and display multidrug resistance (MDR). In search of potential therapeutic intervention and novel fungicidals, we have explored a plant alkaloids, namely arborinine and graveoline for its antifungal potential. Alkaloids belongs to Rutaceae family have been reported with numerous antimicrobial activities. In this study, we aimed to isolate and identify the antifungal active alkaloids of R. angustifolia and assess antifungal effect targeting C. albicans isocitrate lyase (ICL) gene which regulates isocitrate lyase, key enzyme in glyoxylate cycle contributing to the virulence potential of C. albicans. Alkaloids were extracted by bioassay guided isolation technique which further identified by TLC profile and compared with the standard through HPLC and NMR analysis. The antifungal activities of the extracted alkaloids were quantified by means of MIC (Minimum Inhibitory Concentration). The gene expression of the targeted gene upon treatment was analysed using RT-qPCR and western blot. Additionally, this study looked at the drug-likeness and potential toxicity effect of the active alkaloid compounds in silico analysis. Spectroscopic analysis showed that the isolated active alkaloids were characterized as acridone, furoquinoline, 4-quinolone known as arborinine and graveoline. Results showed that each compound significantly inhibited the growth of C. albicans at the dose of 250 to 500 µg/mL which confirm its antifungal activity. Each alkaloid was found to successfully downregulate the expression of both ICL1 gene CaIcl1 protein. Finally, ADMET analysis suggests a good prediction of chemical properties, namely absorption, distribution, metabolism, excretion and toxicity (ADMET) that will contribute in drug discovery and development later on.

An Up-to-Date Review on Bio-Resource Therapeutics Effective against Bacterial Species Frequently Associated with Chronic Sinusitis and Tonsillitis

Upper respiratory tract infections include inflammations of the nose, sinuses (sinusitis), pharynx (tonsillitis, pharyngitis) and larynx (laryngitis) with bacteria or viruses as the main cause of these conditions. Due to their repetitive nature, chronic respiratory infections represent a global problem which is often a result of improper treatment. If not treated adequately, these conditions may have serious consequences. On the other hand, mis - and overuse of antibiotics has reduced their efficiency and accelerated the development of resistant bacterial strains, which further complicates the treatment of infections. This literature review will focus on current knowledge regarding medicinal plants and mushrooms which have been traditionally used in the treatment of infections caused by chronic sinusitis and tonsillitis commonly linked to bacteria - Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Fusobacterium nucleatum, Haemophilus influenzae and Moraxella catarrhalis. The present literature overview might be considered as a starting point for the development of novel, natural antimicrobial products with potential practical use in the treatment of chronic tonsillitis and sinusitis.

Genus Ruta: A natural source of high value products with biological and pharmacological properties

ETHNOPHARMACOLOGICAL RELEVANCE

Ruta genus is constituted by ten species, of which the most commonly described are R. chalepensis and R. graveolens. Ruta plants are perennial shrubs belonging to the family Rutaceae, which are traditionally used in folk medicine, since ancient times mostly for the treatment of various ailments of the womb.

AIM OF THE STUDY

To provide a review of the different uses of Ruta species in traditional medicine, as well as, on their multifactorial biological and pharmacological properties.

MATERIAL AND METHODS

A search of the literature on genus Ruta and Ruta species was performed using various scientific databases and search engines and the information of articles were reviewed and compiled.

RESULTS

Different parts of the plants belonging to Ruta genus are used in folk medicine to treat a wide range of different diseases. The principal use of these is in gynaecological field, but the treatment of pain, fever, nausea, inflammation, infections, nervous disorders, among others, are also described. These plants have been used to fertility regulation, as anti-fertility agent, to control menstrual flux and bleedings, as abortifacient and as contraceptive. The phytochemical composition of these plants consists mainly in essential oil (EO), but phenolic compounds were also reported, like coumarins and flavonoids, as well as alkaloids. Ruta species products like extracts and EOs have shown broad pharmacological activities, such as antimicrobial and antifungal activities, as well as, antiviral and antiparasitic. Moreover, Ruta plants products present antioxidant, neuroprotective, anti-inflammatory, anti-cancer and anti-diabetic activities and demonstrated contraceptive and abortifacient effects. These plants were also tested to be used for non-therapeutic approaches, as bio-insecticides in the control of different insect pests showing to be able to reduce infestation.

CONCLUSIONS

Ruta species could be a potential source of natural products with biological activities. Ruta extracts, essential oils and isolated compounds have shown a diverse potential for use in the treatment of different diseases, as well as, for pests control, contributing to the valorisation of these plants. Nonetheless, this review indicates that more studies are needed to demonstrate the full potential of Ruta species, and to further explore the toxicology and safety of these plants.

Traditional Herbal Medicine in Mesoamerica: Toward Its Evidence Base for Improving Universal Health Coverage

The quality of health care in Mesoamerica is influenced by its rich cultural diversity and characterized by social inequalities. Especially indigenous and rural communities confront diverse barriers to accessing formal health services, leading to often conflicting plurimedical systems. Fostering integrative medicine is a fundamental pillar for achieving universal health coverage (UHC) for marginalized populations. Recent developments toward health sovereignty in the region are concerned with assessing the role of traditional medicines, and particularly herbal medicines, to foster accessible and culturally pertinent healthcare provision models. In Mesoamerica, as in most regions of the world, a wealth of information on traditional and complementary medicine has been recorded. Yet these data are often scattered, making it difficult for policy makers to regulate and integrate traditionally used botanical products into primary health care. This critical review is based on a quantitative analysis of 28 survey papers focusing on the traditional use of botanical drugs in Mesoamerica used for the compilation of the "Mesoamerican Medicinal Plant Database" (MAMPDB), which includes a total of 12,537 use-records for 2188 plant taxa. Our approach presents a fundamental step toward UHC by presenting a pharmacological and toxicological review of the cross-culturally salient plant taxa and associated botanical drugs used in traditional medicine in Mesoamerica. Especially for native herbal drugs, data about safety and effectiveness are limited. Commonly used cross-culturally salient botanical drugs, which are considered safe but for which data on effectiveness is lacking constitute ideal candidates for treatment outcome studies.