Sclerocarya birrea [(A. Rich.) Hochst.] [Anacardiaceae] stem-bark ethanolic extract (SBE) modulates blood glucose, glomerular filtration rate (GFR) and mean arterial blood pressure (MAP) of STZ-induced diabetic rats

Ethnomedicinal Uses, Phytochemistry, and Anticancer Potentials of African Medicinal Fruits: A Comprehensive Review

Africa is home to diverse medicinal plants that have been used for generations for the treatment of several different cancers and, presently, they are gaining interest from researchers as promising approaches to cancer treatment. This review aims to provide a comprehensive review of dietary and medicinal African fruits including their traditional uses, botanical description, ethnobotanical uses, bioactive phytochemical compositions, and anticancer properties investigated to date in vitro, in vivo, and in clinical studies. Data on recent updates concerning the traditional uses and anticancer properties of these fruits were collected from a myriad of available publications in electronic databases, such as Web of Science, PubMed, ScienceDirect, Scopus, SpringerLink, and Google Scholar. The results suggest that approximately 12 native or commercially grown African fruits belonging to different plant species, including Tribulus terrestris, Xanthium strumarium, Withania somnifera, Xylopia aethiopica, Abelmoschus esculentus, Carissa macrocarpa, Carpobrotus edulis, Syzygium cumini, Kigelia Africana, Annona muricata, Persea americana, and Punica granatum, have been reported for their potential as treatment options for the management of cancer. We further found that approximately eight different fruits from native plant species from Africa, namely, Sclerocarya birrea, Dovyalis caffra, Parinari curatellifolia, Mimusops caffra, Carpobrotus edulis, Vangueria infausta, Harpephyllum caffrum, and Carissa macrocarpa, have been widely used for the traditional treatment of different ailments but somehow failed to gain the interest of researchers for their use in anticancer research. In this review, we show the potential use of various fruits as anticancer agents, such as Tribulus terrestris, Xanthium strumarium, Withania somnifera, Xylopia aethiopica, Abelmoschus esculentus, Carissa macrocarpa, Carpobrotus edulis, Syzygium cumini, Kigelia Africana, Annona muricata, Persea americana, and Punica granatum; unfortunately, not enough reported research data have been published to gain thorough mechanistic insights and clinical applications. Additionally, we discuss the possibility of the utilization of potential phytochemicals from fruits like Persea americana and Punica granatum in anticancer research, as well as future directions.

Efficacy of Rytigynia senegalensis Blume on Free Radical Scavenging, Inhibition of α-Amylase and α-Glucosidase Activity, and Blood Glucose Level

Rytigynia senegalensis (Rubiaceae) is a plant used in African medicine for the treatment of diabetes. The aim of this study was to evaluate the in vitro antioxidant, enzyme inhibitory, and hypoglycemic effects of Rytigynia senegalensis extract (RSE). The contents of phenols, tannins, and flavonoids were determined by phytochemical screening. 2,2-Azino-bis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) and 2,2-diphenylpicrylhydrazyl (DPPH) were determined to evaluate the free radical scavenging capacity of the RSE. The inhibitory activity of α-amylase and α-glucosidase was evaluated in vitro using the α-amylase and α-glucosidase inhibition methods and in vivo using the sucrose and starch tolerance tests. The glucose tolerance test was performed on normal rats using doses of 50, 100, and 200 mg/kg of RSE. RSE contains total phenols (36.35 mg GAE/g of extract), flavonoids (11.91 mg QE/g of extract), and tannins (13.01 mg CE/g of extract). RSE exhibits significant radical scavenging activity on DPPH and ABTS radicals with an IC₅₀ of 17.51 and 21.89 μg/mL, respectively. RSE showed an inhibitory effect on the activity of α-amylase and α-glucosidase with an IC₅₀ of 308.93 and 354.13 μg/mL, respectively. RSE (100 and 200 mg/kg) caused a significant decrease in area under the curve and postprandial glycemia at 60, 90, and 120 min following the administration of starch or sucrose. Regarding the glucose tolerance test, RSE (100 and 200 mg/kg) significantly reduced postprandial hyperglycemia from the 90th min posttreatment. RSE lowered postprandial hyperglycemia and has antioxidant properties. These effects would be due to the presence of bioactive compounds in the RSE.

South African medicinal plants displaying angiotensin-converting enzyme inhibition: Potential use in the management of preeclampsia

In resource-limited settings, such as South Africa, hypertensive disorders of pregnancy such as preeclampsia, is the most common direct cause of maternal deaths. Current management strategies of preeclampsia primarily involve the use of pharmaceutical drugs, which are frequently associated with undesirable side-effects. Moreover, these drugs are often not easily accessible due to financial and economic constraints. Consequently, many patients rely on traditional medicine obtained from medicinal plants to manage health-related conditions. Angiotensin-converting enzyme inhibitors are widely used drugs for the management of preeclampsia. This narrative review aims to highlight the use of indigenous medicinal plants from South Africa with Angiotensin-converting enzyme inhibitory activity whilst also evaluating their potential use in the treatment of hypertension in pregnancy. This information will influence traditional healers and sangomas in their patient management. Furthermore, the antihypertensive potential of these plants will be unraveled thus facilitating the development of new naturally occurring pharmaceutical products to reduce maternal and neonatal mortality and morbidity.

Effect of Dietary Supplementation with a Natural Extract of Sclerocarya birrea on Glycemic Metabolism in Subjects with Prediabetes: A Randomized Double-Blind Placebo-Controlled Study

A randomized, double-blind, placebo-controlled study was conducted with the primary objective of assessing the effect of a natural extract of Sclerocarya birrea on glucose metabolism in subjects with prediabetes. The duration of the study was 90 days. Thirty-three subjects assigned to the experimental group (daily ingestion of 100 mg of the nutraceutical product) and 34 assigned to the placebo group completed the study. There were 36 men and 31 women with a mean age of 32.3 ± 14.1 years. In the area under the curve (AUC) of the oral glucose tolerance test (OGTT), statistically significant decreases in the experimental group at 40 and 90 days as compared with baseline were found, whereas significant changes in the placebo group were not observed. Within-group differences were statistically significant in favor of the experimental group for glucose peak at OGTT, serum insulin, insulin resistance markers, and flow-mediated dilation. Changes in lipid and anthropometric parameters were not observed, although there was a trend for lower cholesterol levels and a decrease in body weight in the experimental group. Decreases in systolic blood pressure were also higher among subjects in the experimental group. This exploratory study confirms the antidiabetic activity of Sclerocarya birrea in prediabetes. Further studies using better measurements of beta-cell function are needed to clarify the underlying mechanisms of the hypoglycemic effect of this natural compound.

Beneficial Effect of Thymelaea hirsuta on Pancreatic Islet Degeneration, Renal Fibrosis, and Liver Damages as Demonstrated in Streptozotocin-Induced Diabetic Rat

OBJECTIVE

In Morocco, Thymelaea hirsuta (T. hirsuta) (Thymelaeacea) is a medicinal plant widely used to treat and prevent diabetes. The present study aimed to evaluate the medium-term antidiabetic effect of aqueous extract (AqTh) and ethyl acetate fraction (EaTh) of Th and to investigate their putative protective effect on pancreatic islet degeneration, diabetic nephropathy, and liver damages in streptozotocin (STZ)-diabetic rats.

METHODS

Experimental diabetes in rats was induced by a single intraperitoneal injection of 50 mg/kg of STZ. During the treatment period (4 weeks), 200 mg/kg AqTh and 50 mg/kg EaTh were orally administrated daily to STZ-diabetic rats. A group of parameters including fasting blood glucose, biochemical parameters, and intestinal α-glucosidase inhibition were studied. Furthermore, histological study of the pancreas, kidney, liver, and aorta was also realized.

RESULTS

At the end of the treatment, both AqTh and EaTh had normalized fasting blood glucose to 1.08 and 1.25 g/l, respectively. AqTh has also reduced urinary creatinine and HbAc1. The EaTh showed inhibitory activity against intestinal α-glucosidase, whereas AqTh did not have this inhibitory effect. Furthermore, pancreas hematoxylin and eosin staining showed that AqTh or EaTh prevents pancreatic islet cell degeneration. As the same kidney, Masson's trichrome staining has shown a significant prevention of renal fibrosis in AqTh- or EaTh-treated diabetic rats. On the other hand, liver hematoxylin and eosin staining showed that AqTh and EaTh prevent liver damage.

CONCLUSION

We conclude that medium-term administration of AqTh and EaTh exerts significant antihyperglycemic effect in STZ-diabetic rats possibly through intestinal α-glucosidase inhibition and protection against pancreatic islet cell damage. Moreover, AqTh and EaTh treatment prevent nephropathy and liver complications in STZ-diabetic rats.

DIA-DB: A Database and Web Server for the Prediction of Diabetes Drugs

The DIA-DB is a web server for the prediction of diabetes drugs that uses two different and complementary approaches: (a) comparison by shape similarity against a curated database of approved antidiabetic drugs and experimental small molecules and (b) inverse virtual screening of the input molecules chosen by the users against a set of therapeutic protein targets identified as key elements in diabetes. As a proof of concept DIA-DB was successfully applied in an integral workflow for the identification of the antidiabetic chemical profile in a complex crude plant extract. To this end, we conducted the extraction and LC-MS based chemical profile analysis of Sclerocarya birrea and subsequently utilized this data as input for our server. The server is open to all users, registration is not necessary, and a detailed report with the results of the prediction is sent to the user by email once calculations are completed. This is a novel public domain database and web server specific for diabetes drugs and can be accessed online through http://bio-hpc.eu/software/dia-db/.

Medicinal plants with concomitant anti-diabetic and anti-hypertensive effects as potential sources of dual acting therapies against diabetes and hypertension: A review

ETHNOPHARMACOLOGICAL RELEVANCE

Diabetes and hypertension are pathophysiologically related diseases that co-exist with a wider complex of metabolic diseases having similar set of risk factors. There are numerous ethnopharmacological evidences on the anti-diabetic and/or anti-hypertensive properties of medicinal plants from various parts of the world, which are used as therapies to concomitantly manage diabetes and hypertension.

AIM OF THE REVIEW

This article reviewed findings on medicinal plants with both anti-diabetic and anti-hypertensive effects reported in same experimental study to facilitate the development of dual-acting therapies against diabetes and hypertension.

MATERIALS AND METHODS

A literature search was carried out on different scientific search engines including, but not limited to "PubMed", "Google Scholar", "Scopus" and ScienceDirect to identify published data in which plants in same experimental studies were reported to possess both anti-hyperglycemic and anti-hypertensive effects. Subsequently, the anti-diabetic/anti-hypertensive potency ratio (ψ) of the medicinal plants was computed.

RESULTS

Sixty-four studies with 102 plant species matched the selection criteria. Members of the Fabaceae family were the most investigated plants, while the ψ greatly varied across the plants, with only 11 plants having a ψ ≃ 1. Withania somnifera Dunal was the only plant reported to show blood glucose-lowering and diuretic effects in humans, comparable to daonil. Caffeic acid, chlorogenic acid, caftaric acid, cichoric acid, verbascoside, leucosceptoside A, isoacteoside, fucoxanthin and nicotinamide were the reported dual acting anti-diabetic and anti-hypertensive compounds identified and/or isolated in the plants.

CONCLUSIONS

This review suggests that medicinal plants possess varied therapeutic dynamics against hypertension and diabetes that could be exploited for the discovery of therapeutic preparation(s) or agent(s) for treating the two diseases.

Enhancing the Yield of Bioactive Compounds from Sclerocarya birrea Bark by Green Extraction Approaches

Sclerocarya birrea is a tree indigenous to Southern Africa with significant importance in rural livelihoods for food, medicine, and carving. The bark, which contains 10⁻20% tannin, provides several pharmacological benefits as an antidiabetic, anti-inflammatory, antimicrobial, anti-atherogenic, and antioxidant medication, among others. This study compared different extraction techniques used to recover bioactive compounds from marula bark. For this purpose, solid⁻liquid extraction, supercritical fluid extraction (SFE), and pressurized liquid extraction (PLE) were performed under selected conditions, using only "food-grade" solvents. The potential use of the proposed extraction methodologies was evaluated in term of yield, and the individual phenolic composition determined by HPLC⁻ESI⁻TOF⁻MS. PLE provided a high extraction yield in all experimental conditions. With regard to bioactive compounds composition, a total of 71 compounds, a significant percentage of which in a galloyl form, were distributed in five major categories. The largest number of compounds, mostly flavonoid aglycones, were extracted by PLE, generally when the extraction was developed at low temperatures. SFE did prove effective as a way of extracting antidiabetic proanthocyanidins. Advanced extraction techniques represent a powerful tool to obtain bioactive compounds from S. birrea bark, which can be used as supplements or food ingredients, promoting the valorization of this crop.

The role of pollutants in type 2 diabetes mellitus (T2DM) and their prospective impact on phytomedicinal treatment strategies

Type 2 diabetes mellitus (T2DM) is the most common form of diabetes and it is characterized by high blood sugar and abnormal sera lipid levels. Although the specific reasons for the development of these abnormalities are still not well understood, traditionally, genetic and lifestyle behavior have been reported as the leading causes of this disease. In the last three decades, the number of diabetic patients has drastically increased worldwide, with current statistics suggesting the number is to double in the next two decades. To combat this incurable ailment, orthodox medicines, to which economically disadvantaged patients have minimal access to, have been used. Thus, a considerable amalgamation of medicinal plants has recently been proven to possess therapeutic capabilities to manage T2DM, and this has prompted studies primarily focusing on the healing aspect of these plants, and ultimately, their commercialization. Hence, this review aims to highlight the potential threat of pollutants, i.e., polyfluoroalkyl compounds (PFCs), endocrine disrupting chemicals (EDCs) and heavy metals, to medicinal plants, and their prospective impact on the phytomedicinal therapy strategies for T2DM. It is further suggested that auxiliary research be undertaken to better comprehend the factors that influence the uptake of these compounds by these plants. This should include a comprehensive risk assessment of phytomedicinal products destined for the treatment of T2DM. Regulations that control the use of PFC-precursors in certain developing countries are also long overdue.

Inhibition of Angiotensin Converting Enzyme, Angiotensin II Receptor Blocking, and Blood Pressure Lowering Bioactivity across Plant Families

Hypertension is a major risk factor for coronary heart disease, kidney disease, and stroke. Interest in medicinal or nutraceutical plant bioactives to reduce hypertension has increased dramatically. The main biological regulation of mammalian blood pressure is via the renin-angiotensin-aldosterone system. The key enzyme is angiotensin converting enzyme (ACE) that converts angiotensin I into the powerful vasoconstrictor, angiotensin II. Angiotensin II binds to its receptors (AT1) on smooth muscle cells of the arteriole vasculature causing vasoconstriction and elevation of blood pressure. This review focuses on the in vitro and in vivo reports of plant-derived extracts that inhibit ACE activity, block angiotensin II receptor binding and demonstrate hypotensive activity in animal or human studies. We describe 74 families of plants that exhibited significant ACE inhibitory activity and 16 plant families with potential AT1 receptor blocking activity, according to in vitro studies. From 43 plant families including some of those with in vitro bioactivity, the extracts from 73 plant species lowered blood pressure in various normotensive or hypertensive in vivo models by the oral route. Of these, 19 species from 15 families lowered human BP when administered orally. Some of the active plant extracts, isolated bioactives and BP-lowering mechanisms are discussed.

THE PURVIEW OF PHYTOTHERAPY IN THE MANAGEMENT OF KIDNEY DISORDERS: A SYSTEMATIC REVIEW ON NIGERIA AND SOUTH AFRICA

BACKGROUND

The kidney is tasked with a number of metabolic functions in the body. In its role as a detoxifier and primary eliminator of xenobiotics, it becomes vulnerable to developing injuries. Currently, over 1 million people in the world are living on renal replacement therapies (RRTs). The case in sub-Sahara African countries like Nigeria and South Africa is not any better than the global trend.

MATERIALS AND METHODS

A systematic review of medicinal plants used in the treatment of kidney disorders was conducted. Information were gathered from published scientific journals, books, reports from national, regional and international institutions, conference proceedings and other high profile intellectual resources. MeSH words like 'prevalence of kidney disorders in Africa', 'renal replacement therapy', 'nephrotoxins or nephrotoxicants', 'nephroprotective plants', 'nephroprotective plants in Nigeria or South Africa' and 'nephroprotective phytocompounds' were used to retrieve information from online databases (Google, Pubmed, MEDLINE, Science Direct, Scopus and SID).

RESULTS

Interestingly, our findings revealed that phytotherapy has emerged and is being employed to protect renal functions and delay progression of renal pathological conditions into end episodes where the last resort is RRT. In fact, in recent times, Phytotherapists are not only interested in developing relatively safe, more affordable, easily accessible and potent nephroprotective formulations but also increasing awareness on the prevalence of the disease and educating the populace on the probable preventive measures. More importantly, efforts at scientifically elucidating the pharmacological efficacy of the identified nephroprotective plants yet to be validated must be intensified through informed expert opinions. Till date, there is paucity of information on the concept of nephroprotection in most developing countries where kidney disorder is a major threat. Although, the concept is just emerging in South Africa, evidences have given credence to its application in complementary and alternative system of medicine in Nigeria.

CONCLUSION

This review, therefore, reawaken researchers' consciousness in the continuous search for auspicious nephroprotective plants that could potentially be excellent candidates in developing new lead drugs to manage and treat renal disorders.

Oxidised palm oil and sucrose induced hyperglycemia in normal rats: effects of Sclerocarya birrea stem barks aqueous extract

Background

Consumption of foods rich in carbohydrates and fats, result in an increase in obesity and consequently type 2 diabetes. The present study was carried out to evaluate the effects of oxidised palm oil and sucrose (SOPO +S) on some metabolic parameters and to investigate the effects of aqueous extract from barks of Sclerocarrya birrea on SOPO + S induced damages.

Methods

During 16 weeks, animals received every day a supplement of oxidised palm oil (10 %) and 10 % sucrose as drinking water). Control rat received standard diet and drinking water without sucrose. At the end of this period, animal presenting intolerance in glucose test and insensitivity to insulin were continuously feed with hypercaloric diet along with the administration of the plant extract (150 or 300 mg/kg) or glibenclamide (10 mg/kg) during three weeks. OGTT was performed; insulin sensitivity was assessed by performing insulin tolerance test and determining insulin sensitivity index (Kitt). Several parameters were evaluated including body weight, abdominal fat mass, blood glucose levels, blood pressure, serum lipid profile, and serum transaminases (ALT and AST). Oxidative parameters were measured by MDA levels, nitrites levels, SOD levels, reduced glutathione content and by enzyme activities of SOD and catalase.

Results

Animal receiving a supplement of oxidised palm oil and sucrose showed hyperglycaemia, glucose intolerance, insulin resistance and a significant increase in body weight and abdominal fat mass compared to normal rats. In addition, there was a significant increase of SOD in aorta and heart, nitrites in liver and kidney, malondialdehyde (MDA) in heart, liver and kidney. It was also observed a significant reduction in the activities of the SOD and catalase in liver, kidney and reduced glutathione levels in heart. Concomitant treatment of plant extract with SOPO + S brought glycaemia and blood pressure towards normal value, restored glucose tolerance and insulin sensitivity. The plant extract prevent the increase or decrease in the activity of the enzyme depending to the organ, reduced MDA and nitrites levels.

Conclusion

These results highlighted the hyperglycaemic and oxidant character of SOPO + S diet and confirm the hypoglycaemic, and antioxidant action of sclerocarya birrea aqueous extract in diabetes.

An ethnobotanical survey of medicinal plants used by communities of Northern Kordofan region, Sudan

ETHNOPHARMACOLOGICAL RELEVANCE

The present study provides significant ethnopharmacological information on plant species used in North Kordofan region, western Sudan. The study was undertaken with an aim to document the medicinal uses of the species known to some Northern Kordofan communities.

MATERIAL AND METHODS

The study was conducted between 2012 and 2013. The plants were identified and voucher specimens prepared. Information was collected by means of semi-structured interviews with 258 informants (195 men and 63 women). In addition, the use value (UV) of the species was determined and the informant consensus factor (ICF) was calculated for the medicinal plants researched in the study. Further analysis was carried out to compare results with previous studies from the study area and other regions of Sudan.

RESULTS

A total of 44 plant species representing 24 families were found to be commonly used in the treatment of 73 different human health problems. The families most represented were Leguminosae (18%), Caesalpiniaceae (9%), Malvaceae (9%), Asclepiadaceae (6.8%) and Combretaceae (6.8%). The highest number of plant species are used against digestive system disorders (23 species) followed by microbial infections (21 species) and dermatology (19 species). Among all the plant parts leaves (20%), roots (19%), fruits and bark (14% each) were the most preferred plant parts used by the informants. There was strong agreement among the informants as to the usages of the plants (informant consensus factor 0.63-0.93). The most important plants on the basis of use-value were Acacia nilotica, Acacia seyal, Balanites aegyptiaca, Cassia occidentalis, Cassia senna, Guiera senegalensis and Tamarindus indica.

CONCLUSION

This study has helped to document information that may otherwise be lost to future generations. This is the first ethnobotanical study in which statistical calculations about plants are carried out by means of the ICF and UV methods in the study area. Plants with high ICF and UV values should be subjected for further phytochemical and pharmacological investigation for scientific validation.

Changes in Renal Function and Oxidative Status Associated with the Hypotensive Effects of Oleanolic Acid and Related Synthetic Derivatives in Experimental Animals

Purpose

The triterpene oleanolic acid (OA) is known to possess antihypertensive actions. In the present study we to compared the effects of the triterpene on mean arterial blood pressure (MAP) and kidney function following acute administration in normotensive animals with those of its related oleanane synthetic derivatives (brominated oleanolic acid, Br-OA and oleanolic acid methyl ester, Me-OA). We also used experimental models of hypertension to further explore the effects of sub-chronic oral OA treatment and evaluated influences on oxidative status.

Methods

OA was extracted from dried flower buds of Syzygium aromaticum using a previously validated protocol in our laboratory. Me-OA and Br-OA were synthesized according to a method described. Rats were supplemented with lithium chloride (12 mmol L^-1) prior to experimentation in order to raise plasma lithium to allow measurements of lithium clearance and fractional excretion (FE_Li) as indices of proximal tubular Na⁺ handling. Anaesthetized animals were continuously infused via the right jugular with 0.077M NaCl. MAP was measured via a cannula inserted in the carotid artery, and urine was collected through a cannula inserted in the bladder. After a 3.5 h equilibration, MAP, urine flow, electrolyte excretion rates were determined for 4 h of 1 h control, 1.5 h treatment and 1.5 h recovery periods. OA, Me-OA and Br-OA were added to the infusate during the treatment period. We evaluated sub-chronic effects on MAP and kidney function in normotensive Wistar rats and in two animal models of hypertension, spontaneously hypertensive rats (SHR) and Dahl salt-sensitive (DSS) rats, during 9-week administration of OA (p.o.). Tissue oxidative status was examined in these animals at the end of the study. Increasing evidence suggests that and renal function disturbances and oxidative stress play major roles in the pathogenesis of hypertension.

Results

Acute infusion OA and oleanane derivatives displayed qualitatively similar effects in decreasing MAP and increasing urinary Na⁺ outputs. The drugs increased the FE_Na and FE_Li without influencing GFR indicating that at least part of the overall natriuretic effect involved proximal tubular Na⁺ reabsorption. Sub-chronic OA administration (p.o.) also elicited hypotensive responses in Wistar, DSS and SHR rats. The MAP lowering effect was more marked in hypertensive animals and were positively correlated with increased urinary Na⁺ excretion. Compared with respective control rats, OA treatment reduced malondialdehyde (MDA, a marker of lipid peroxidation) and increased activities of antioxidant enzymes; superoxide dismutase and glutathione peroxidase in hepatic, cardiac and renal tissues.

Conclusions

OA and oleanane derivatives have similar effects on MAP, kidney function and oxidative stress. The amelioration of oxidative stress and blood pressure lowering effects by OA are more marked in hypertensive animals and correlated with an increased urinary Na⁺ output.

Novelty of the Work

The results of this study are novel in that they show 1) a correlation between blood pressure reduction and increased urinary Na⁺ excretion by OA, 2) a more marked MAP reduction in hypertensive animals and 3) a drug-induced decrease in proximal tubule Na⁺ reabsorption. The results may also be clinically relevant because OA is effective via oral administration.

In Vitro Anti-diabetic Activity of Sclerocarya Birrea and Ziziphus Mucronata

Type 2 diabetes mellitus is on the increase worldwide. Current treatments possess undesirable side-effects and therefore investigations into alternative remedies, which may be cost-effective and devoid of such side-effects, are on-going. Aqueous and methanol extracts of the bark of Sclerocarya birrea (A. Rich.) Hochst. subsp. caffra (Sond.) Kokwaro (Anacardiaceae) and Ziziphus mucronata Willd. subsp. mucronata (Rhamnaceae) were subjected to testing in order to assess their in vitro anti-diabetic activity. Total polyphenolic content and antioxidant activity, as well as the effect on α-amylase, α-glucosidase and cytotoxicity, were measured. Furthermore, glucose uptake was evaluated in C2C12 myotubes, 3T3-L1 adipocytes and HepG2 hepatocarcinoma cells, and insulin secretion in RIN-m5F rat pancreatic β-cells. The extracts of both plants inhibited the activities of α-amylase and α-glucosidase in a concentration dependent manner, with results being comparable with the positive control, acarbose. All the extracts contained antioxidant activity, with the methanol extracts of S. birrea displaying the strongest free radical scavenging capacity (IC50 = 2.16 μg/mL). Most of the extracts were not cytotoxic to the cell lines with IC50 values > 100 μg/mL. Extracts of both plants significantly increased glucose uptake in C2C12, 3T3-L1 and HepG2 cells. However, insulin secretion from RIN-m5F cells was not altered. This study provides evidence that the plants possess in vitro anti-diabetic properties.

The effects of medicinal plants on renal function and blood pressure in diabetes mellitus

Abstract

Diabetes mellitus is one of the most common chronic global diseases affecting children and adolescents in both the developed and developing nations. The major types of diabetes mellitus are type 1 and type 2, the former arising from inadequate production of insulin due to pancreatic β-cell dysfunction, and the latter from reduced sensitivity to insulin in the target tissues and/or inadequate insulin secretion. Sustained hyperglycaemia is a common result of uncontrolled diabetes and, over time, can damage the heart, eyes, kidneys and nerves, mainly through deteriorating blood vessels supplying the organs. Microvascular (retinopathy and nephropathy) and macrovascular (atherosclerotic) disorders are the leading causes of morbidity and mortality in diabetic patients. Therefore, emphasis on diabetes care and management is on optimal blood glucose control to avert these adverse outcomes.

Studies have demonstrated that diabetic nephropathy is associated with increased cardiovascular mortality. In general, about one in three patients with diabetes develops end-stage renal disease (ESRD) which proceeds to diabetic nephropathy (DN), the principal cause of significant morbidity and mortality in diabetes. Hypertension, a well-established major risk factor for cardiovascular disease contributes to ESRD in diabetes. Clinical evidence suggests that there is no effective treatment for diabetic nephropathy and prevention of the progression of diabetic nephropathy. However, biomedical evidence indicates that some plant extracts have beneficial effects on certain processes associated with reduced renal function in diabetes mellitus. On the other hand, other plant extracts may be hazardous in diabetes, as reports indicate impairment of renal function. This article outlines therapeutic and pharmacological evidence supporting the potential of some medicinal plants to control or compensate for diabetes-associated complications, with particular emphasis on kidney function and hypertension.

Commercially Important Medicinal Plants of South Africa: A Review

There is a growing interest in natural plant-based remedies as a source for commercial products. Around 80% of the South African population use traditional medicines to meet their primary health care needs; however, only a few South African medicinal plants have been exploited to their full potential in terms of commercialization. The opportunity for bioprospecting of plant compounds for novel pharmaceuticals remains largely untapped. Certain renowned medicinal plants of international acclaim including buchu and rooibos are currently contributing to local enterprise; however, other exciting opportunities exist for commonly used plants which have not yet reached the international arena. This paper focuses on the key research and development contributions of 10 commercially important medicinal plants of South Africa. Traditional uses, scientific validation, commercialisation developments, as well as both potential opportunities and setbacks are discussed.

The effects of Syzygium aromaticum-derived oleanolic acid on kidney function of male Sprague-Dawley rats and on kidney and liver cell lines

Studies indicate that Syzygium spp-derived oleanolic acid (OA) enhances renal function of streptozotocin (STZ)-induced diabetic rats as evidenced by its reversal of the previously reported inability of the kidney to excrete Na(+) in these animals. We postulated that OA influences Na(+) excretion in the proximal tubule, the site where two-thirds of filtered NaCl is reabsorbed through a process mediated by transport proteins. Therefore, the study investigated the effects of OA on proximal tubular Na(+) handling in male Sprague-Dawley rats using renal lithium clearance (C(Li)). Renal C(Li) has been used widely in animal and clinical studies to assess proximal tubular function. Sub-chronic doses of OA were administered to rats twice every third day for 5 weeks. Rats treated with deionized water served as control animals. Cytotoxicity of OA on kidney and liver cell lines was assessed by the MTT and comet assays. OA increased Na(+) excretion of conscious male Sprague-Dawley rats from week 3 to week 5. By the end of the 5-week experimental period, OA treatment significantly reduced (p < 0.05) plasma creatinine concentration of STZ-induced diabetic rats with a concomitant elevation in glomerular filtration rate (GFR). Acute OA infusion was also associated with increases in fractional excretion of sodium (FE(Na)) and lithium (FE(Li)) in anesthetized rats in the absence of significant changes in GFR. The MTT assay studies demonstrated that OA increased the metabolic activity of kidney and liver cell lines. Taken together with previous observations, this study implicates the proximal tubule in OA-evoked increases in urinary Na(+) output.

A pharmacological appraisal of medicinal plants with antidiabetic potential

Diabetes mellitus is a complicated metabolic disorder that has gravely troubled the human health and quality of life. Conventional agents are being used to control diabetes along with lifestyle management. However, they are not entirely effective and no one has ever been reported to have fully recovered from diabetes. Numerous medicinal plants have been used for the management of diabetes mellitus in various traditional systems of medicine worldwide as they are a great source of biological constituents and many of them are known to be effective against diabetes. Medicinal plants with antihyperglycemic activities are being more desired, owing to lesser side-effects and low cost. This review focuses on the various plants that have been reported to be effective in diabetes. A record of various medicinal plants with their established antidiabetic and other health benefits has been reported. These include Allium sativa, Eugenia jambolana, Panax ginseng, Gymnema sylvestre, Momrodica charantia, Ocimum sanctum, Phyllanthus amarus, Pterocarpus marsupium, Trigonella foenum graecum and Tinospora cordifolia. All of them have shown a certain degree of antidiabetic activity by different mechanisms of action.

Chinese medicine for treating diabetic nephropathy

Diabetic nephropathy is one of the main causes of renal end-stage disease. The pathogenesis of diabetic nephropathy is complex. The current treatment is only for a particular cause without multi-target therapeutic drugs. Chinese medicine is a great treasure with multi-component complex drugs interacting with multiple targets and functions. This paper reviewed the protective effect of Chinese medicine for treating diabetic nephropathy in clinical studies, in vivo studies, and in vitro studies. The possible mechanisms, the major compounds and active crude drugs were also summarized. It was shown that Chinese medicine could not only relieve several symptoms and improve the quality of life, but also reduce the levels of proteinuria and kidney damage, and further improve renal function via multiple pathways based on the whole human system. Moreover, there were no reports of severe adverse reactions during the treatment.

Cameroonian medicinal plants: pharmacology and derived natural products

Many developing countries including Cameroon have mortality patterns that reflect high levels of infectious diseases and the risk of death during pregnancy and childbirth, in addition to cancers, cardiovascular diseases and chronic respiratory diseases that account for most deaths in the developed world. Several medicinal plants are used traditionally for their treatment. In this review, plants used in Cameroonian traditional medicine with evidence for the activities of their crude extracts and/or derived products have been discussed. A considerable number of plant extracts and isolated compounds possess significant antimicrobial, anti-parasitic including antimalarial, anti-proliferative, anti-inflammatory, anti-diabetes, and antioxidant effects. Most of the biologically active compounds belong to terpenoids, phenolics, and alkaloids. Terpenoids from Cameroonian plants showed best activities as anti-parasitic, but rather poor antimicrobial effects. The best antimicrobial, anti-proliferative, and antioxidant compounds were phenolics. In conclusion, many medicinal plants traditionally used in Cameroon to treat various ailments displayed good activities in vitro. This explains the endeavor of Cameroonian research institutes in drug discovery from indigenous medicinal plants. However, much work is still to be done to standardize methodologies and to study the mechanisms of action of isolated natural products.

Sclerocarya birrea (A. Rich) Hochst. ['Marula'] (Anacardiaceae): a review of its phytochemistry, pharmacology and toxicology and its ethnomedicinal uses

A plethora of ethnotherapeutic properties and pharmacological actions have been attributed to Sclerocarya birrea (family: Anacardiaceae). It is one of the most highly valued indigenous trees of southern Africa. Reports in biomedical literature have indicated the presence of medicinally-important chemical constituents in the plant, notably: polyphenols, tannins, coumarins, flavonoids, triterpenoids, phytosterols, and so forth. Pharmacological studies by various groups of investigators have shown that S. birrea possesses antidiarrhoeal, antidiabetic, anti-inflammatory, antimicrobial, antiplasmodial, antihypertensive, anticonvulsant, antinociceptive and antioxidant properties, thus lending pharmacological support to the plant's folkloric, ethnotherapeutic uses in South African traditional medicine. In view of the immense medicinal importance of the plant, this review aimed at compiling all currently available information on S. birrea's chemical constituents, as well as its ethnomedicinal, pharmacological and toxicological properties.

In vivo Studies on Antidiabetic Plants Used in South African Herbal Medicine

Diabetes is one of the most common metabolic disorders worldwide. It is a major health problem with its frequency increasing every day in most countries. The disease is generally believed to be incurable; and the few orthodox drugs available to manage the disease are not readily affordable to the poor. Based on the historical success of natural products as antidiabetic agents and the ever increasing need for new antidiabetics, a number of South African medicinal plants have been evaluated for their antidiabetic properties. In this article, we review the major studies conducted based on ethnobotanical surveys carried out between 2005 and 2008 in South Africa on plants that are traditionally used for the treatment of diabetes. Overall, the results of the studies conducted confirmed the potential of South African medicinal plants in antidiabetic drug discovery and identified a number of promising taxa for further in vivo investigation as plant-based antidiabetic agents.

Renal effects of plant-derived oleanolic acid in streptozotocin-induced diabetic rats

Previous studies from our laboratories indicate that the anti-diabetic effects of Syzygium cordatum (Hochst.) [Myrtaceae] leaf extract in streptozotocin-induced diabetic rats may be attributed in part to mixtures of triterpenes, oleanolic acid (3ss-hydroxy-olea-12-en-28-oic acid, OA) and ursolic acid (3ss -hydroxyl-urs-12-en-28-oic acid, UA). For the bioactive compounds to have potential in diabetes management, they should alleviate or prevent complications of diabetes mellitus, kidney function, and cardiovascular disorders. This study was, therefore, designed to assess whether S. cordatum leaf derived OA influenced renal function evaluated by the ability to increase urinary Na(+) outputs parameters and creatinine clearance (Ccr) of streptozotocin (STZ)-induced diabetic rats. Extraction and fractionation of S. cordatum powdered leaf ethyl acetate-solubles (EAS) yielded mixtures of OA/UA and methyl maslinate/methyl corosolate. Recrystallization of OA/UA mixture using ethanol afforded OA, the structure of which was confirmed by NMR spectroscopy ((1)H & (13)C). Acute effects of OA on kidney function and mean arterial blood pressure (MAP) were investigated in anesthetized rats challenged with hypotonic saline after a 3.5-h equilibration for 4h of 1 h control, 1.5 h treatment, and 1.5 h recovery periods. OA was added to the infusate during the treatment period. Chronic effects of OA were studied in individually caged rats treated twice daily with OA (60 mg/kg, p.o.) for five weeks. By comparison with respective control animals administration, OA significantly increased Na(+) excretion rates of non-diabetic and STZ-induced diabetic rats without affecting urine flow, K(+) and Cl(-) rates. At the end of five weeks, OA treatment significantly (p < 0.05) increased Ccr in non-diabetic (2.88 +/- 0.14 vs. 3.71 +/- 0.30 ml/min) and STZ-diabetic rats (1.81 +/- 0.32 vs. 3.07 +/- 0.16 ml/min) with concomitant reduction of plasma creatinine concentration (n = 6 in all groups). OA also caused significant decreases in MAP in non-diabetic and STZ-induced diabetic rats. These findings suggest that OA may have beneficial effects on some processes associated with renal derangement of STZ-induced diabetic rats.