Treatment of diarrhoea in rural African communities: an overview of measures to maximise the medicinal potentials of indigenous plants

Evaluation of hepatoprotective and antidiarrheal activities of the hydromethanol crude extract and solvent fractions of Schinus molle L. (Anacardiaceae) leaf and fruit in mice

Background

Liver disease is any disease that negatively affects the normal function of the liver, and it is a major health problem that challenges not only healthcare professionals, but also the pharmaceutical industry and drug regulatory agencies. Similarly, diarrhea is the second leading cause of death among children under five globally next to pneumonia. The available synthetic drugs for the treatment of liver disorders and diarrhoea have limited safety and efficacy.

Objective

To evaluate the in vivo hepatoprotective and antidiarrheal activities of hydroalcoholic leaf and fruit extracts of Schinus molle L. (Anacardiaceae) in mice.

Methods

Hepatoprotective activity of the extracts was evaluated by using CCl4 induced hepatotoxicity in mice model. In this model, mice were divided into groups and treated as follows. The normal control and toxicant control groups were treated with the vehicle used for reconstitution, the positive control was treated with the standard drug (silymarin), and the test groups were treated with different doses of plant extracts daily in the morning for seven days. Additionally, all groups except the normal control were treated with CCl4 (2 mg/kg, IP) on the 4th day of treatment, 30 min post-dose. On the 7th day, blood was collected from each mouse via a cardiac puncture. The collected blood was centrifuged, and serum levels of ALT, AST, and ALP were determined using an automated chemistry analyser. Data were analysed using one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test.The antidiarrheal activity of the extract was investigated using castor oil-induced diarrhoea, enteropooling, and small intestine transit. The test groups received various doses (100, 200, and 400 mg/kg) of the extract, whereas the positive control received loperamide (3 mg/kg), and the negative control received the vehicle (distilled water, 10 ml/kg).

Result

Hepatoprotective activity: The leaf and fruit crude extracts showed significant improvement in the body weight and liver weight of mice compared to the untreated toxicant control. Additionally, treatment with hydromethanol leaf and fruit extracts caused a significant (P < 0.05) improvement in liver biomarkers compared to the toxicant control. Similarly, the n-butanol and chloroform fractions of the fruit extract caused a significant reduction (P < 0.01) in serum AST, ALT, ALP and Bilirubin levels and a significant (P < 0.001) increase in total protein compared to the toxicant control. However, none of the three solvent fractions (n-butanol, chloroform, and aqueous) of the fruit extract significantly affected (P > 0.05) the level of albumin compared with the toxicant control.Antidiarrheal activity: In the castor oil-induced diarrheal model, the 80 % methanol extract delayed the onset of defaecation and significantly reduced the number and weight of faeces at all tested doses compared to the negative control. In the enteropooling test, 80 ME significantly (P < 0.001) reduced the weight and volume of intestinal fluid at all tested doses compared with the negative control. Results from the charcoal meal test revealed that the extracts produced a significant anti-motility effect at all tested doses compared with the negative control.

Conclusion

This study confirmed the hepatoprotective and antidiarrheal activities of hydroalcoholic extracts. The highest test dose produced the maximum hepatoprotective and antidiarrheal activities in all models.

A scoping review on efficacy and safety of medicinal plants used for the treatment of diarrhea in sub-Saharan Africa

BACKGROUND

In sub-Saharan Africa (SSA), significant morbidity and mortality have been linked to diarrhea, which is frequently caused by microorganisms. A rise in antimicrobial-resistant pathogens has reignited the search for alternative therapies. This scoping review aims to map the literature on medicinal plants in relation to their anti-diarrheal potential from SSA.

METHODS

Studies published from 1990 until April 2022 on medicinal plants used for the treatment of diarrhea from each country in SSA were searched on Scopus, Web of Science, Science Direct and PubMed. The selection of articles was based on the availability of data on the in vitro and/or in vivo, ethnobotanical, and cross-sectional studies on the efficacy of medicinal plants against diarrhea. A total of 67 articles (ethnobotanical (n = 40); in vitro (n = 11), in vivo (n = 7), cross-sectional (n = 3), in vitro and in vivo (n = 2) and ethnobotanical and in vitro (n = 2), were considered for the descriptive analysis, which addressed study characteristics, herbal intervention information, phytochemistry, outcome measures, and toxicity findings.

RESULTS

A total of 587 different plant species (from 123 families) used for diarrhea treatment were identified. Most studies were conducted on plants from the Fabaceae family. The plants with the strongest antimicrobial activity were Indigofera daleoides and Punica granatum. Chromatographic methods were used to isolate six pure compounds from ethyl acetate extract of Hydnora johannis, and spectroscopic methods were used to determine their structures. The majority of anti-diarrheal plants were from South Africa (23.9%), Ethiopia (16.4%), and Uganda (9%). This study highlights the value of traditional remedies in treating common human diseases such as diarrhea in SSA.

CONCLUSION

Baseline knowledge gaps were identified in various parts of SSA. It is therefore recommended that future ethnobotanical studies document the knowledge held by other countries in SSA that have so far received less attention. Additionally, we recommend that future studies conduct phytochemical investigations, particularly on the widely used medicinal plants for the treatment of diarrheal illnesses, which can serve as a foundation for future research into the development of contemporary drugs.

Review of Medicinal Plants Traditionally Used to Treat Diarrhea by the People in the Amhara Region of Ethiopia

Background

Diarrheal illness is the second-most common cause of death in under-five children. Worldwide, it results in about 1.7 billion illnesses and 525,000 deaths among under-five children annually. It is the leading cause of malnutrition among under-five children. Different people use medicinal plants to treat diarrhea. The present study aimed to review the medicinal plants used to treat diarrhea by the people in the Amhara region and to diagnose whether the antidiarrheal activities of the medicinal plants have been confirmed by studies using animal models.

Methods

The author searched 21 articles from worldwide databases up to December 2022 using Boolean operators ("AND" and "OR") and the terms "ethnobotanical studies," "ethnobiology," "traditional medicine," "ethnobotanical knowledge," and "Amhara region."

Results

From the 21 studies reviewed, 50 plant species grouped into 28 families were reported to treat diarrhea by the people in the Amhara region. The top most used families were Lamiaceae (12%), Fabaceae (8%), Asteraceae, Cucurbitaceae, Euphorbiaceae, and Poaceae (6% each). The modes of administration of the plant parts were orally 98.88% and topically 1.12%. The different extracts of 18 (or 36%) of the medicinal plants traditionally used to treat diarrhea by the people in the Amhara region have been proven experimentally in animal models.

Conclusions

The people in the Amhara region use different medicinal plants to treat diarrhea. Most of them take the medicinal plants orally. The traditional claim that 60% of medicinal plants are antidiarrheal has been confirmed in in vitro studies.

Antioxidant and α-glucosidase inhibitory activities of compound isolated from Stachytarpheta jamaicensis (L) Vahl. leaves

Stachytarpheta jamaicensis is one of the folk medicines used for the treatment of diabetes in Ambon, Indonesia, but there are limited studies on the bioactivities of its constituents. This study aims to assess the antioxidant and antidiabetic activities of four extracts of S. jamaicensis leaves extracted using several solvents. Bioassay guided fractionation on each extract establishes for exploring S. jamaicensis leaves active compounds. The antioxidant was evaluated using the DPPH and ABTS methods, while the α-glucosidase inhibitory was carried out in vitro assay. The results showed that the methanol extract of S. jamaicensis leaves displays inhibition of DPPH, ABTS and α-glucosidase activity compared to other solvent extracts. Furthermore, 6β-hydroxyipolamiide was successfully isolated from the methanol extract of S. jamicensis leaves which was reported to have α-glucosidase inhibitory activity with an IC50 of 539.17 μg/mL. Based on the results, S. jamaicensis could be recommended as an antioxidant and antidiabetic agent.

The efficacy of fermented foods in the treatment and management of diarrhoeal diseases: A systematic review and meta-analysis

Background: Diarrhoeal disease is a major cause of global infant mortality, and compromises the ability of many countries with respect to achieving sustainable development goals. The WHO's recommendation of Oral Rehydration Solution (ORS) and zinc in the management of this disease, may not be readily available. Consideration and assessment of cultural practices in its management has been an area of increased interest over the last decade. Aim: This study aims to systematically evaluate efficacy of the consumption of traditional fermented foods as functional products for the treatment and management of diarrhoea. Methods: Following PRISMA guidelines, a systematic review was conducted of electronic databases (Cochrane Library, Ovid Medline and Pubmed) databases with no restrictions on language and publication date for RCTs that investigated the effect of consumption of fermented foods on the treatment of diarrhoea in children under five years of age. Results: Seven RCTs were included. Meta-analysis showed that compared to control, consumption of fermented foods significantly reduced mean duration of diarrhoea, -0.61 days; (95% CI, -1.04, -0.18); length of hospitalization, -0.35 days (95% CI, -0.69, -0.02); but not mean daily frequency of stool -2.00 (95% CI,-7.03, 3.04). Conclusion: Limited available evidence suggests that consumption of fermented foods may help reduce duration and severity of symptoms as a treatment of diarrhoea. More high quality research needs to be undertaken to investigate the efficacy of fermented food as an effective alternative to ORS as a potential WHO recommendation for management of diarrhoeal disease.

Ethnobotanical survey of medicinal plants used by indigenous knowledge holders to manage healthcare needs in children

Childhood diseases remain an increasing health problem in many developing countries and also associated with an enormous financial burden. In South Africa, many people still rely on traditional medicine for their primary healthcare. However, inadequate documentation of medicinal plants used to manage childhood diseases remain a prominent gap. Hence, the current study explored the importance of medicinal plants to treat and manage childhood diseases in the North West Province, South Africa. An ethnobotanical survey was conducted with 101 participants using semi-structured interviews (face-to-face). Ethnobotanical indices such as Frequency of citation (FC), Use-value (UV) and Informed Consensus Factor (ICF) were used for data analysis. A total of 61 plants from 34 families were recorded as medicine used for managing seven (7) categories of diseases resulting from 29 sub-categories. Skin-related and gastro-intestinal diseases were the most prevalent childhood health conditions encountered by the study participants. Based on their FC values that ranged from approximately 0.9-75%, the most popular medicinal plants used by the participants were Aptosinum elongatum (75.2%), Commelina diffusa (45.5%), Euphorbia prostrata (31.6%) and Bulbine frutescens (31.7%). In terms of the UV, A. elongatum (0.75), C. diffusa (0.45), E. prostrata (0.31), H. hemerocallidea (0.19) and E. elephantina (0.19) were the dominant plants used for treating and managing childhood diseases. Based on ICF, skin-related diseases dominated with the highest ICF value of 0.99. This category had 381 use-reports, comprising 34 plants (55.7% of total plants) used for childhood-related diseases. Particularly, B. frutescens and E. elephantina were the most-cited plants for the aforementioned category. Leaves (23%) and roots (23%) were the most frequently used plant parts. Decoctions and maceration were the main preparation methods, and the plant remedies were mainly administered orally (60%) and topically (39%). The current study revealed the continuous dependence on the plant for primary health care relating to childhood diseases in the study area. We generated a valuable inventory of medicinal plants and associated indigenous knowledge for child healthcare needs. However, investigating the biological efficacies, phytochemical profiles and the safety of these identified plants in relevant test systems remain essential in future research.

In Vitro Selective Combinatory Effect of Ciprofloxacin with Nitroxoline, Sanguinarine, and Zinc Pyrithione against Diarrhea-Causing and Gut Beneficial Bacteria

Antibiotic resistance in diarrhea-causing bacteria and its disruption of gut microbiota composition are health problems worldwide. The development of combinatory agents that increase the selective inhibitory effect (synergism) against diarrheagenic pathogens and, simultaneously, have a lowered impact (antagonism) or no negative action on the gut microbiota is therefore proposed as a new strategy efficient for chemotherapy against diarrheal conditions. In this study, the in vitro selective combinatory effect of ciprofloxacin with nitroxoline, sanguinarine, and zinc pyrithione, representing various classes of alkaloid-related compounds (nitroquinolines, benzylisoquinolines and metal-pyridine derivative complexes) against selected standard diarrhea-causing (Bacillus cereus, Enterococcus faecalis, Listeria monocytogenes, Shigella flexneri, and Vibrio parahaemolyticus) and gut-beneficial (Bifidobacterium adolescentis, Bifidobacterium animalis subsp. lactis, Bifidobacterium breve, Lactobacillus casei, and Lactobacillus rhamnosus) bacteria, was evaluated according to the sum of fractional inhibitory concentration indices (FICIs) obtained by the checkerboard method. The results showed that the individual combination of ciprofloxacin with nitroxoline, sanguinarine, and zinc pyrithione produced a synergistic effect against the pathogenic bacteria, with FICI values ranging from 0.071 to 0.5, whereas their antagonistic interaction toward the Bifidobacterium strains (with FICI values ranging from 4.012 to 8.023) was observed. Ciprofloxacin-zinc pyrithione produced significant synergistic action against S. flexneri, whereas a strong antagonistic interaction was observed toward B. breve for the ciprofloxacin-nitroxoline combination. These findings suggest that certain combinations of agents tested in this study can be used for the development of antidiarrheal therapeutic agents with reduced harmful action on the gastrointestinal microbiome. However, further studies focused on their pharmacological efficacy and safety are needed before they are considered for clinical trials. IMPORTANCE Diarrheal infections, which are commonly treated by antibiotics, are still responsible for over 4 to 5 million cases of human deaths annually. Moreover, the rising incidence of antibiotic resistance and its negative effect on beneficial bacteria (e.g., Bifidobacteria) of the gut microbial community are another problem. Thus, the development of selective agents able to inhibit diarrheal bacteria and, simultaneously, that have no negative impact on the gut microbiota, is important. Our results showed that individual combinations of ciprofloxacin with nitroxoline, sanguinarine, and zinc pyrithione produced synergism against the pathogenic bacteria, whereas their antagonistic interaction toward the beneficial strains was observed. The antagonism can be considered a positive effect contributing to the safety of the therapeutic agents, whereas their synergism against diarrheal bacteria significantly potentiates total antimicrobial efficacy. The certain combinations tested in this study can be used for the development of antidiarrheal agents with reduced harmful action on the gastrointestinal microbiome.

Antidiarrheal Activity of Dialium guineense Willd Fruit Pulp in Wistar Rats

Objective. This study is aimed at evaluating the effects of Dialium guineense Willd fruit pulp powder on diarrhea induced by castor oil in Wistar rats. Materials and Methods. Three different tests were carried out. A preventive test by administration of a single dose of 250, 500, 1000, 2000, and 4000 mg/kg before the induction of diarrhea by castor oil. Another preventive test after repeated administration of Dialium guineense at 250, 500, and 1000 mg/kg/day for 8 days, before the induction of diarrhea, was done. The third test was a curative test with a single dose of 250, 500, 1000, and 2000 mg/kg after the induction of diarrhea by castor oil. Results. D. guineense fruit pulp at 1000, 2000, and 4000 mg/kg administered before the induction of diarrhea, has significantly delayed diarrhea; reduced the frequency of defecation, reduced the amount of diarrheal stools, and also reduced the purging index, with a degree of inhibition comparable to that of loperamide. But the water content of the stools of the group treated with D. guineense does not change significantly compared to the controls. D. guineense has reduced significantly from 500 mg/kg the diarrhea induced by castor oil after 8 days of treatment. It appears that the doses of 250 and 500 mg/kg, which were not effective with the single-dose preventive test, significantly delayed diarrhea; reduces the frequency of diarrheal stools and also reduces the purging index. D. guineense administered, after the induction of diarrhea, by castor oil has significantly reduced the diarrhea from 250 mg/kg. Conclusion. The fruit pulp of D. guineense has showed antidiarrheal activities in Wistar rats by reducing the frequency of defecation, the amount of diarrheal fecal matter emitted as well as the water content. It also delayed the onset of diarrhea and significantly reduced the purging index like loperamide.

Detection of Enteric Viruses from Wastewater and River Water in Botswana

Waterborne diseases remain a public health concern in developing countries where many lack access to safe water. Water testing mainly uses bacterial indicators to assess water quality, which may not fully indicate the threat from other non-bacterial pathogens like enteric viruses. This study was done to ascertain and establish the viral load, the temporal and spatial distribution of rotavirus A and norovirus (GI and GII) in sewage and river water samples. A total of 45 samples of raw and treated sewage, and surface water, were collected from a sludge activated wastewater treatment plant in Gaborone, and after treatment from the Notwane River, Botswana, over a period of 9 months (February 2016 to October 2016). Viruses were concentrated using polyethylene glycol/NaCl precipitation. Virus detection was performed using real-time polymerase chain reaction (RT-PCR). Rotavirus A was the most prevalent (84.4% positive samples), followed by Norovirus GI (48.9% positive samples), and Norovirus GII 46.7% positive samples). Detected viral loads went up to 10⁴ genome copies per liter (copies/L) for all the viruses. The enteric viruses were detected in all the study sites with highest detection from site S1 (inlet). There was no significant association between physicochemical parameters and viral loads, except for pH which showed significant relationship with rotavirus and norovirus GII (p ≤ 0.05). This is the first study in Botswana to highlight the occurrence and quantification of the enteric viruses in treated and untreated wastewater, as well as surface water.

Ethnobotany, Ethnopharmacology, and Phytochemistry of Medicinal Plants Used for Treating Human Diarrheal Cases in Rwanda: A Review

Diarrhea, often caused by microorganisms, has been associated with high morbidity and mortality in Africa. Increased rates of antimicrobial-resistant pathogens have reignited the quest for alternative therapies. This review aimed at identifying medicinal plants used in the treatment of human diarrheal cases in Rwanda and analyzing their ethnobotany, ethnopharmacology, and phytochemistry. We searched PubMed/Medline, Google Scholar, ScienceDirect, and the Web of Science for published articles on medicinal plants used to treat diarrhea in Rwanda. Additionally, specialized herbarium documents of different institutes were reviewed. Articles were assessed for relevance, quality, and taxonomical accuracy before being included in this review. Overall, 63 species of medicinal plants belonging to 35 families were recorded. Asteraceae was the predominant family with six species, followed by Fabaceae and Lamiaceae, with five species each. The most reported species with anti-diarrheal properties were Vernonia amygdalina Delile, Tetradenia riparia (Hochst.) Codd, Clerodendrum myricoides R. Br. and Chenopodium ugandae (Aellen) Aellen. Leaves (66.7%) and roots (17.5%) were the commonly used plant parts in the preparation of medicine. Phytochemicals from medicinal plants with antidiarrheic activities were sesquiterpene lactones (V. amygdalina); terpene, sterols, saponosides, and flavonoids (C. ugandae); saponins and tannins (T. riparia); and tannins, flavonoids, and alkaloids (C. myricoides). Six studies tested the antimicrobial activities of the plants against bacteria and viruses known to cause diarrhea. Erythrina abyssinica, Euphorbia tirucalli, Dracaena afromontana, and Ficus thonningii are socio-culturally important. Further research on toxicity and posology is needed to ensure the safety of medicinal plants.

Towards Advances in Medicinal Plant Antimicrobial Activity: A Review Study on Challenges and Future Perspectives

The increasing incidence of drug- resistant pathogens raises an urgent need to identify and isolate new bioactive compounds from medicinal plants using standardized modern analytical procedures. Medicinal plant-derived compounds could provide novel straightforward approaches against pathogenic bacteria. This review explores the antimicrobial activity of plant-derived components, their possible mechanisms of action, as well as their chemical potential. The focus is put on the current challenges and future perspectives surrounding medicinal plants antimicrobial activity. There are some inherent challenges regarding medicinal plant extracts and their antimicrobial efficacy. Appropriate and optimized extraction methodology plant species dependent leads to upgraded and selective extracted compounds. Antimicrobial susceptibility tests for the determination of the antimicrobial activity of plant extracts may show variations in obtained results. Moreover, there are several difficulties and problems that need to be overcome for the development of new antimicrobials from plant extracts, while efforts have been made to enhance the antimicrobial activity of chemical compounds. Research on the mechanisms of action, interplay with other substances, and the pharmacokinetic and/or pharmacodynamic profile of the medicinal plant extracts should be given high priority to characterize them as potential antimicrobial agents.

An ethnobotanical survey of seventeen plants species used against diarrhoea and other diseases in southern Benin (West Africa)

Ethnobotanical relevance: Many plants are widely used in traditional medicine across Africa. In Benin, practitioners of Beninese traditional medicine make use of diverse medicinal plants in the traditional management of various diseases including diarrhoea. Aim of the study: This study aimed at highlighting the ethnomedicinal uses of 17 plants in the traditional treatment of diarrhoea and other diseases in southern Benin. Methods: An ethnomedicinal survey was carried out using the semi-structured interview method among practitioners of traditional medicine in Benin. This allowed for the identification of the traditional uses of these plants. The ethnobotanical data collected was analyzed using indices such as Use Value, Informant Consensus Factor and Fidelity Index of medicinal plants. A total of 72 informants participated in this study, including 52 market herbalists and 20 traditional healers. Results: The cited plants were involved in the treatment of 39 diseases and symptoms of diseases which have been divided into 15 categories. The most frequently mentioned disease categories were infectious-, blood and digestive diseases,offering treatement for malaria, diarrhoea and fever, amongst others. These plants have maximum potential for the treatment of infectious diseases, as well as metabolic, respiratory, skin, blood, digestive and circulatory diseases. Conclusion: This study revealed that interviewed informants (market herbalists and traditional healers) had good knowledge of the treatment of several diseases using the 17 plants . . It confirmed that the 17 selected plants are used in the traditional treatment of diarrhoea as well as other diseases. This study provided a database for Future pharmacological investigations on the basis of this ethnobotanical documentation.

Mechanisms of antidiarrhoeal activity of methanol leaf extract of Combretum hypopilinum diels (combretaceae): Involvement of opioidergic and (α1 and β)-adrenergic pathways

ETHNOPHARMACOLOGICAL RELEVANCE

The plant Combretum hypopilinum Diels (Combretaceae) is used in traditional medicine for the treatment of diarrhoea and other diseases in Africa. Previously, the antidiarrhoeal activity of its methanol leaf extract was reported. However, the mechanism(s) responsible for this activity is yet to be evaluated.

AIM OF THE STUDY

This study aimed to elucidate the possible mechanism(s) of antidiarrhoeal activity of methanol leaf extract of Combretum hypopilinum (MECH) in mice.

MATERIALS AND METHODS

Phytochemical screening and acute toxicity study were conducted according to standard methods. Adult mice were orally (p.o) administered distilled water (10 ml/kg), MECH (1000 mg/kg) and loperamide (5 mg/kg). The probable mechanisms of antidiarrhoeal activity of MECH were investigated following pretreatment with naloxone (2 mg/kg, subcutaneously), prazosin (1 mg/kg, s.c), yohimbine (2 mg/kg, intraperitoneally), propranolol (1 mg/kg, i.p), pilocarpine (1 mg/kg, s.c) and isosorbide dinitrate (150 mg/kg, p.o) 30 min before administration of MECH (1000 mg/kg). The mice were then subjected to castor oil-induced intestinal motility test.

RESULTS

The oral median lethal dose (LD₅₀) of MECH was found to be higher than 5000 mg/kg. There were significant (p < 0.05) decrease in the charcoal movement in the mice treated with the MECH (1000 mg/kg) and loperamide (5 mg/kg). The pretreatment of the mice with naloxone, prazosin and propranolol each significantly (p<0.05) reversed the antidiarrhoeal activity produced by MECH.

CONCLUSION

The results obtained in this study suggest the probable involvement of opioidergic and (α₁ and β)-adrenergic systems in the antidiarrhoeal activity of the methanol leaf extract of Combretum hypopilinum.

The SARS-Coronavirus Infection Cycle: A Survey of Viral Membrane Proteins, Their Functional Interactions and Pathogenesis

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a novel epidemic strain of Betacoronavirus that is responsible for the current viral pandemic, coronavirus disease 2019 (COVID-19), a global health crisis. Other epidemic Betacoronaviruses include the 2003 SARS-CoV-1 and the 2009 Middle East Respiratory Syndrome Coronavirus (MERS-CoV), the genomes of which, particularly that of SARS-CoV-1, are similar to that of the 2019 SARS-CoV-2. In this extensive review, we document the most recent information on Coronavirus proteins, with emphasis on the membrane proteins in the Coronaviridae family. We include information on their structures, functions, and participation in pathogenesis. While the shared proteins among the different coronaviruses may vary in structure and function, they all seem to be multifunctional, a common theme interconnecting these viruses. Many transmembrane proteins encoded within the SARS-CoV-2 genome play important roles in the infection cycle while others have functions yet to be understood. We compare the various structural and nonstructural proteins within the Coronaviridae family to elucidate potential overlaps and parallels in function, focusing primarily on the transmembrane proteins and their influences on host membrane arrangements, secretory pathways, cellular growth inhibition, cell death and immune responses during the viral replication cycle. We also offer bioinformatic analyses of potential viroporin activities of the membrane proteins and their sequence similarities to the Envelope (E) protein. In the last major part of the review, we discuss complement, stimulation of inflammation, and immune evasion/suppression that leads to CoV-derived severe disease and mortality. The overall pathogenesis and disease progression of CoVs is put into perspective by indicating several stages in the resulting infection process in which both host and antiviral therapies could be targeted to block the viral cycle. Lastly, we discuss the development of adaptive immunity against various structural proteins, indicating specific vulnerable regions in the proteins. We discuss current CoV vaccine development approaches with purified proteins, attenuated viruses and DNA vaccines.

Antibacterial, Mutagenic Properties and Chemical Characterisation of Sugar Bush (Protea caffra Meisn.): A South African Native Shrub Species

Protea caffra is used as a diarrhoeal remedy in South African herbal medicine, however, its pharmacological properties remain largely unknown. In the present study, extracts from different Protea caffra organs were screened against drug-sensitive and -resistant diarrhoeagenic pathogens using the microdilution assay (minimum inhibitory concentration, MIC). Twig extracts (70% methanol, MeOH) of the plant were purified and the resultant fractions screened for antibacterial properties (MIC). The chemical profiles of the fractions were determined by Gas Chromatography-Mass Spectrometry (GC-MS), while ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) was used to quantify the phenolic acids in the plant. The mutagenic properties of bioactive extracts were assessed using the Ames test. The extracts demonstrated weak-moderate antibacterial properties (MIC: 0.3–0.6 mg/mL). A cold ethyl acetate fraction of MeOH twig extract exhibited significant antibacterial properties (MIC = 0.078 mg/mL) against Enterococcus faecalis. The presence of antibacterial compounds (1-adamantane carboxylic acid, heptacosanol, levoglucosan, nonadecanol) in the plant was putatively confirmed based on GC-MS analysis. Furthermore, UHPLC-MS/MS analysis revealed varying concentrations of phenolic acids (0.08–374.55 µg/g DW). Based on the Ames test, the extracts were non-mutagenic thereby suggesting their safety. To a certain degree, the current study supports the traditional use of Protea caffra to manage diarrhoea among local communities in South Africa.

Worldwide Research Trends on Medicinal Plants

The use of medicinal plants has been done since ancient times and may even be considered the origin of modern medicine. Compounds of plant origin have been and still are an important source of compounds for drugs. In this study a bibliometric study of all the works indexed in the Scopus database until 2019 has been carried out, analyzing more than 100,000 publications. On the one hand, the main countries, institutions and authors researching this topic have been identified, as well as their evolution over time. On the other hand, the links between the authors, the countries and the topics under research have been analyzed through the detection of communities. The last two periods, from 2009 to 2014 and from 2015 to 2019, have been examined in terms of research topics. It has been observed that the areas of study or clusters have been reduced, those of the last period being those engaged in unclassified drug, traditional medicine, cancer, in vivo study—antidiabetic activity, and animals—anti-inflammatory activity. In summary, it has been observed that the trend in global research is focused more on the search for new medicines or active compounds rather than on the cultivation or domestication of plant species with this demonstrated potential.

Investigating In Vitro Antibacterial Activities of Medicinal Plants Having Folkloric Repute in Ethiopian Traditional Medicine

Medicinal plants are targeted in the search for new antimicrobial agents. Nowadays, there is an alarmingly increasing antimicrobial resistance to available agents with a very slow development of new antimicrobials. It is, therefore, necessary to extensively search for new agents based on the traditional use of herbal medicines as potential source. The antibacterial activity of 80% methanol extracts of the leaves of Verbena officinalis (Vo-80ME), Myrtus communis (Mc-80ME), and Melilotus elegans (Me-80ME) was tested against 6 bacterial isolates using agar well diffusion technique. In each extract, 3 concentrations of 10, 20, and 40 mg/well were tested for each bacterium. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were also determined. Vo-80ME and Mc-80ME exhibited promising antibacterial activity against Staphylococcus aureus with the highest zone of inhibition being 18.67 and 26.16 mm, respectively at concentration of 40 mg/well. Regarding gram-negative bacteria, Vo-80ME exhibited an appreciable activity against Escherichia coli and Salmonella typhi. Mc-80ME displayed remarkable activity against all isolates including Pseudomonas aeruginosa with the maximum zone of inhibition being 22.83 mm. Me-80ME exhibited better antibacterial activity against E coli, but its secondary metabolites had little or no activity against other gram-negative isolates. The MIC values of Vo-80ME ranged from 0.16 to 4.00 mg/mL. The lowest MIC was observed in Mc-80ME, with the value being 0.032 mg/mL. Mc-80ME had bactericidal activity against all tested bacterial isolates. Mc-80ME showed remarkable zone of inhibitions in all tested bacterial isolates. Besides, Vo-80ME showed good antibacterial activity against S aureus, E coli, and S typhi. Conversely, Me-80ME has shown good activity against E coli only. Generally, M communis L and V officinalis have good MIC and MBC results.

Combinations of Alchornea cordifolia, Cassytha filiformis and Pterocarpus santalinoides in diarrhoegenic bacterial infections

Objectives

This study examines the rationale, if any, behind combining the extracts from the fruits of Alchornea cordifolia and Pterocarpus santalinoides and aerial parts of Cassytha filiformis in the traditional treatment of diarrhoegenic bacterial infections.

Results

Four diarrhoegenic bacterial isolates: Salmonella typhi, Shigellae dysenteriae, Escherichia coli and Staphylococcus aureus were used and their antibiotic susceptibility screening showed that they were multi-antibiotic resistant. The extracts exhibited activity against all the test isolates with minimum inhibitory concentration values ranging from 3.125 to 12.5 mg/mL. From the checkerboard assay, the fractional inhibitory concentration indices showed that C. filiformis has antagonistic and indifference activities in combination with either P. santalinoides or A. cordifolia. This showed that the combination of extracts from the fruits of A. cordifolia and P. santalinoides and aerial parts of C. filiformis is counterproductive and invalidates any claim for positive results in the management of diarrhoegenic bacterial infections.

Modelling the dynamics of direct and pathogens-induced dysentery diarrhoea epidemic with controls

In this paper, the dysentery dynamics model with controls is theoretically investigated using the stability theory of differential equations. The system is considered as SIRSB deterministic compartmental model with treatment and sanitation. A threshold number R0 is obtained such that R0≤ 1 indicates the possibility of dysentery eradication in the community while R0>1 represents uniform persistence of the disease. The Lyapunov-LaSalle method is used to prove the global stability of the disease-free equilibrium. Moreover, the geometric approach method is used to obtain the sufficient condition for the global stability of the unique endemic equilibrium for R0>1 . Numerical simulation is performed to justify the analytical results. Graphical results are presented and discussed quantitatively. It is found out that the aggravation of the disease can be decreased by using the constant controls treatment and sanitation.

Indonesia basic health survey: self-medication profile for diarrhea with traditional medicine

BACKGROUND

In Indonesia, diarrhea is an endemic disease and often leads fatal and an outbreak potential. Diarrhea can occur for several days and often can be cured without any medication. Commonly, to treat diarrhea atthe first time is by doing self-medication. Basic health survey data in 2013 showed that 15.7% of Indonesian people kept and used traditional medicines (TM).

OBJECTIVE

This study was conducted to find out the characteristic of Indonesian people do for diarrhea self-medication.

METHOD

We analyzes household data cross-sectionally from the 2013 basic health survey in 33 provinces and 497 cities in Indonesian. Data analysis included household characteristics, economic status, education, information of getting and keeping the TM, and status of the TM kept in households.

RESULT

The result showed 89% of households store traditional medicines. Traditional diarrhea medicines were stored by 66.54% households in the urban, and were mostly obtained from traditional medicine store, stored for supply 55.86%, and used only if needed 50.65%.

CONCLUSION

The study concluded that mostly people preferred to keep and use traditional Indonesian medicine produced by the TM national industry rather than others. Duration of use for self-medication in most of the households is thought to be appropriate.

Winning the War against Multi-Drug Resistant Diarrhoeagenic Bacteria

Drug-resistant-diarrhoeagenic bacteria are currently emerging healthcare challenge. This study investigated the effects of Vernonia amygdalina, Garcinia kola, tetracycline and metronidazole combinations on such bacteria. Agar well diffusion method was employed to determine the inhibitory effects of the herbal extracts on diarrhoeagenic bacteria while Time-Kill Assay was used to determine bactericidal effects of the extracts against test isolates. Interactions between plant extracts and antibiotics were investigated using Checkerboard assay. Minimum inhibitory concentrations of the extracts against the bacterial isolates ranged between 3.125–50 mg/mL, while those of tetracycline and metronidazole ranged from 30–50 μg/mL. Synergism was observed against B. cereus and S. aureus for metronidazole + aqueous G. kola at all ratios. Generally, the combinations aqueous G. kola + ethanolic G. kola and aqueous G. kola + ethanolic V. amygdalina showed more pronounced synergism against the Staphylococcus aureus than B. cereus isolates with the fractional inhibition concentration (FIC) indices ranging from 0.32–0.95. Synergism of tetracycline + crude extracts and metronidazole combinations were more pronounced on the test isolates and especially on the Gram-negative organisms with FIC indices ranging from 0.41–0.91. Conclusion: The herbal extracts combinations and extracts–antibiotics combinations are synergistic on diarrhoeagenic bacteria at defined combination ratios.

Dietary Factors in Prevention of Pediatric Escherichia coli Infection: A Model Using Domestic Piglets

Enterotoxigenic Escherichia coli (ETEC) is the major etiological agent causing acute watery diarrhea that is most frequently seen in young children in lower-income countries. The duration of diarrheal symptom may be shortened by antibiotic treatment, but ETEC is relative refractory to common antibiotics. Burgeoning evidence suggests bioactive components that naturally occur in human milk (e.g., lysozyme and oligosaccharides) and plants (e.g., nondigestible carbohydrates and phytochemicals) contain antimicrobial functions are promising preventive measures to control ETEC infection. Although the exact protective mechanisms may vary for each compound and are still not completely understood, they generally act to (1) competitively inhibit the binding of pathogenic bacteria and toxins to gut epithelium; (2) directly kill pathogens; and (3) stimulate and/or enhance host mucosal and systemic immune defense against pathogenic microorganisms. An appropriate ETEC-challenge animal model is critical to evaluate the effect and unveil the mechanism of bioactive compounds in prevention of enteric infection. Despite wide application in biomedical research, rodents do not usually manifest typical clinical signs of enteric infections. The remarkable differences in digestive physiology, immune response, and gut microbiota between rodents and human beings necessitate the use of alternative animal models. Pigs are closely related to humans in terms of genomes, physiology, anatomy of gastrointestinal tracts, digestive enzymes, components of immune system, and gut microbiota. Like human infants and young children, nursing and nursery piglets are more susceptible to ETEC infection and reproduce the clinical signs as observed in humans. Hence, the ETEC-challenge piglet represents a valuable translational model to study pathogenesis and evaluate dietary factors (e.g., milk bioactive compounds, nondigestible carbohydrates, and phytochemicals) as preventive measures for ETEC infection in pediatrics.

Mangifera indica Bark Essential Oil: Chemical Composition and Biological Activities in Comparison with Aqueous and Ethanol Extracts

Ethnobotanic surveys have revealed the use of Mangifera indica L. (Anacardiaceae) bark for the treatment of infectious diarrhea. The essential oil of M. indica bark is described for the first time for its chemical composition, radical scavenging activity (DPPH method) and antimicrobial properties. The total phenols content of its water and ethanol bark extracts as well as their radical scavenging and antimicrobial properties were also evaluated. Four commercial plant extracts were also studied for a comparison purpose. The antimicrobial activities were measured for all samples against three Gram (-): Escherichia coli, Salmonella enteritidis, Shigella and two Gram (+): Staphylococcus aureus and Bacillus cereus bacteria. The M. indica bark essential oil was characterized by the association of two major sesquiterpenes: ( E)-β-caryophyllene (60.3%) and α-humulene (36.7%). It presented the lowest ratio of concentration to inhibition zone diameter on all the strains. The aqueous and ethanol extracts of M. indica bark were characterized by high contents of total phenols compounds and high radical scavenging activity compared to the essential oil. Finally, the interesting combination of the antibacterial and antiradical activities of the aqueous M. indica bark extract justifies the traditional use of this plant part in decoction form for the treatment of diarrheal infections.

Medicinal Plants Used for Treatment of Diarrhoeal Related Diseases in Ethiopia

This paper presents a review of relevant antidiarrhoeal medicinal plants based on the fundamental knowledge accumulated by indigenous people of Ethiopia. The review includes an inventory carried out on the phytochemical and pharmacological analysis of plant species used in the treatments of diarrhoeal diseases. This study is based on a review of the literature published in scientific journals, books, theses, proceedings, and reports. A total of 132 medicinal plants used by local people of Ethiopia are reported in the reviewed literature. Herbs (43.6%) were the primary source of medicinal plants, followed by trees (27%). Some findings include the predominance of leaf material used (78%), as well as the frequent use of crushing of the plant parts (38%) as a mode of preparation. This study demonstrates the importance of traditional medicines in the treatment of basic human ailments such as diarrhoeal diseases in Ethiopia. Baseline information gaps were observed in different regions of Ethiopia. Thus, documentation of the knowledge held by other regions of Ethiopia that have so far received less attention and urban ethnobotany is recommended for future ethnobotanical studies. In addition, phytochemical studies are recommended mainly on frequently utilized medicinal plants for treatment of diarrhoeal diseases which can serve as a basis for future investigation of modern drug development. Although societies in Ethiopia have long used medicinal plants for diarrhoeal diseases treatment, it is also a good practice to perform toxicological tests.

Antimicrobial natural product research: A review from a South African perspective for the years 2009-2016

ETHNOPHARMACOLOGICAL RELEVANCE

This review provides information on the antimicrobial research which has taken place on South African natural products for the last eight years (2009-2016). This important field is the backbone of all studies involving the use of medicinal plants against infectious diseases and hence can form the mainstay for future studies.

MATERIALS AND METHODS

All publications within the years 2009-2016 were considered. Exclusion criteria were studies not involving South African medicinal natural products and those publications where full articles could not be accessed. An overview of the most common experimental methods used and new advances in terms of antimicrobial investigations are provided. Disease categories selected for further investigation were skin and wounds, respiratory, gastrointestinal, sexually transmitted and ophthalmic infections amongst others. Alternate natural products and combinations studies were also included.

RESULTS

The minimum inhibitory concentration (MIC) was the most commonly used experimental method to determine antimicrobial activity. Staphylococcus aureus was the most commonly tested skin pathogen and Klebsiella pneumoniae was the most common pathogen implicated in respiratory disorders. Only 20% of gastrointestinal studies included commonly implicated pathogens such as Shigella flexneri and Campylobacter species.

CONCLUSION

Multidisciplinary studies have emerged as a strong support for antimicrobial investigations and show the importance of including toxicity when studying antimicrobial efficacy. Alternate approaches (for example biofilms and quorum sensing) at examining antimicrobial effects are encouraged. Studies on resistant strains require more insight and future recommendations should look at consistent dosing and investigations on compound interactions amongst others.

Antidiarrhoeal activity of eriosematin E isolated from the roots of Eriosema chinense Vogel

BACKGROUND

Roots of the plant Eriosema chinense Vogel (Fabaceae) is distributed mainly over the Eastern Himalayan region of India and China. The roots of the plant are used as a vegetable by the people of Northern Australia, China and North East India and are used traditionally by the tribal people of Meghalaya (India) for the treatment of diarrhoea. It has been reported to have significant antidiarrhoeal, cytotoxic and antimycobacterial activity.

PURPOSE/OBJECTIVE

The present investigation was undertaken to isolate a lead molecule responsible for the observed antidiarrhoeal activity.

METHODS

Eriosematin E, a prenylated flavanone, was isolated using column chromatography and was characterized by comparing its melting point and spectroscopic data (UV, IR, ¹H NMR, ¹³C NMR, Mass Spectra) from literature. Eriosematin E (2.5, 5 and 10mg/kg p.o.) was then screened for normal faecal excretion rate and castor oil-induced diarrhoea models in rats. Further, it was examined for small intestinal transit, intestinal fluid accumulation and PGE₂ induced enteropooling models in rats. Biochemical estimations and Na⁺ and K⁺ concentration in intestinal fluid were also determined along with colonic histopathological studies.

RESULTS

The results illustrated a significant (P< 0.05) reduction in normal faecal output at 10mg/kg p.o. after 5th and 7thh of treatment and also showed maximum protection of 69.43% from diarrhoea in the castor oil-induced diarrhoea model. Significant results were also observed at the maximum effective dose of eriosematin E (10mg/kg p.o.) in inhibiting peristaltic index (small intestinal transit) and reducing intestinal fluid volume of castor oil induced and PGE₂ induced enteropooling models. Further, eriosematin E restored all the alterations in biochemical parameters such as nitric oxide, protein, DNA, superoxide dismutase, catalase and lipid peroxidation. It also significantly recovered Na⁺ and K⁺ loss from body and confirmed its protective nature through the histopathological studies.

CONCLUSION

The study corroborates the antidiarrhoeal potential of eriosematin E which may be attributed to its antisecretory and antioxidant potential.

Psidium guajava L., from ethnobiology to scientific evaluation: Elucidating bioactivity against pathogenic microorganisms

ETHNOPHARMACOLOGICAL RELEVANCE

The use of popular plants has guided pharmaceutical research aimed at combating pathogenic microorganisms. Psidium guajava L. is a plant of great versatility and it has been used both as food and as a therapeutic agent. Root, bark, leaves, fruits, flowers and seeds are used for medicinal purposes, especially in infusions and decoctions for oral and topical use. P. guajava is utilized in symptomatology treatment related to organ malfunction and of diseases caused by the action of pathogenic and/or opportunistic microorganisms. Many pharmacological studies have been conducted to scientifically assess its therapeutic potential.

AIMS OF STUDY

The aim of the current study is to relate the popular use of this plant and its bioscientific assessment as a therapeutic agent in the treatment of diseases and symptoms caused by the action of protozoa, fungi, bacteria and viruses, and also evaluate the safety for the usage and the interaction with drugs.

MATERIALS AND METHODS

A bibliographic database the ethnobiology of Psidium guajava (2005-2015) and the pharmacological infections and parasitic diseases (2010-2015). Searches were done in scientific disclosure databases such as PubMed, Web of Science, and Scopus.

RESULTS

P. guajava leaf extracts were scientifically investigated for the treatment of diseases caused by protozoa (leishmaniasis, malaria, giardiasis, amoebiasis and trichomoniasis), fungi (dermatosis, systemic and mucocutaneous diseases), bacteria (respiratory, mucocutaneous and gastrointestinal infections, cholera, gastritis and stomach ulcers, oral and periodontal infections, venereal diseases and urinary infections) and viruses (herpes, influenza, rotavirus disease and AIDS). The toxicity assays indicates the safet for usage.

CONCLUSIONS

Highlight and elucidate the therapeutic potential and versatility of P. guajava. They also justify using ethnobiology efficiency to guide pharmacological studies. Some limitations can be observed in this kind of study, as the lack for ethnobiological informations and the absence of some controls in the assays.

Can Probiotics Reduce Diarrhea and Infant Mortality in Africa?: The Project of a Pilot Study

BACKGROUND

Diarrhea accounts for 9% of the mortality among children under 5 years of age worldwide, and it is significantly associated with malnutrition. Each year, diarrhea kills around 760,000 children under 5 years of age and most of these are in sub-Saharan Africa.In Uganda, the infant mortality rate of 58 per 1000 is unacceptably high, and the major contributors include malnutrition, diarrhea, pneumonia, malaria, prematurity, sepsis, and newborn illnesses.There is an urgent need for intervention to prevent and control diarrheal diseases.

STUDY DESIGN

Our open-label, randomized controlled study has the primary endpoint of reducing diarrhea and infectious diseases (number of episodes/severity) and the secondary endpoint of decreasing infant mortality. The trial is currently conducted in Luzira, a suburb of Kampala, the capital of Uganda, and in Gulu and Lira, in the north of Uganda.The study is projected to enroll 4000 babies (control=2000 and treatment=2000) who will be followed till 1 year of life. As controls, 2000 babies of the same community are planned to be considered.The probiotic product selected for the trial is composed of 3 designated microorganisms, namely Bifidobacterium breve BR03 (DSM 16604), B. breve B632 (DSM 24706), and Lactobacillus delbrueckii subsp. delbrueckii LDD01 (DSM 22106). The concentration of the 3 bacteria is 10 viable cells/strain/daily dose (5 drops).

PERSPECTIVES

For a total sample of 4000 babies, the study has an 80% power at a 5% significance level.

Rapid cessation of acute diarrhea using a novel solution of bioactive polyphenols: a randomized trial in Nicaraguan children

Goal. We assessed the effectiveness of bioactive polyphenols contained in solution (LX) to restore normal bowel function in pediatric patients with acute diarrhea. Background. While providing oral rehydration solution (ORS) is standard treatment for diarrhea in developing countries, plant-derived products have been shown to positively affect intestinal function. If a supplement to ORS resolves diarrhea more rapidly than ORS alone, it is an improvement to current care. Study. In a randomized, double-blind, placebo-controlled cross-over study, 61 pediatric patients with uncontrolled diarrhea were randomized to receive either ORS + LX on day 1 and then ORS + water on day 2 (study arm) or ORS + water on day 1 and then ORS + LX on day 2 (control arm). Time to resolution and number of bowel movements were recorded. Results. On day 1, the mean time to diarrhea resolution was 3.1 h (study arm) versus 9.2 h (control arm) (p = 0.002). In the study arm, 60% of patients had normal stool at their first bowel movement after consumption of the phenolic redoxigen solution (LX). On day 2, patients in the study arm continued to have normal stool while patients in the control arm achieved normal stool within 24 h after consuming the test solution. Patients in the control arm experienced a reduction in the mean number of bowel movements from day 1 to day 2 after consuming the test solution (p = 0.0001). No adverse events were observed. Conclusions. Significant decreases in bowel movement frequency and rapid normalization of stool consistency were observed with consumption of this novel solution.

Antimicrobial evaluation of plants used for the treatment of diarrhoea in a rural community in northern Maputaland, KwaZulu-Natal, South Africa

BACKGROUND

Zulu people living in the rural area of Maputaland (KwaZulu-Natal, South Africa) rely heavily on medicinal plants for the treatment of diarrhoea. Abundant availability of medicinal plants in the study area offers low cost health care, but scientific validation is needed in order to lend credibility to the traditional use against many ailments including diarrhoeal infections. With this in mind a study was designed to test the in vitro antimicrobial efficacy of 23 plant species which are used for the treatment of diarrhoea in rural Maputaland. Four 1:1 plant combinations were also evaluated to determine their interactive effects against seven diarrhoea-related bacterial pathogens.

METHODS

Minimum inhibitory concentration (MIC) assays were undertaken on dichloromethane-methanol (CH2Cl2: MeOH) and aqueous crude extracts. The following micro-organisms were selected for this study and were tested based on their association with stomach ailments and diarrhoea; Bacillus cereus (ATCC 11778), Enterococcus faecalis (ATCC 29212), Escherichia coli (ATCC 8739), Proteus vulgaris (ATCC 33420), Salmonella typhimurium (ATCC 14028), Shigella flexneri (ATCC 25875) and Staphylococcus aureus (ATCC 12600). The fractional inhibitory concentration index (ΣFIC) was determined for plants traditionally used in combination.

RESULTS

Shigella flexneri proved to be the most susceptible pathogen, where the organic extract of Terminalia sericea showed the most prominent noteworthy antibacterial activity (mean MIC value of 0.04 mg/mL). The aqueous extracts generally showed poorer antimicrobial activity with some exceptions i.e. Acacia burkei, Brachylaena transvaalensis against B. cereus and B. transvaalensis against S. flexneri. In the combination studies, synergy was predominant with mean (across all pathogens) ΣFIC values of 0.30 for Acanthospermum glabratum with Krauseola mosambicina; ΣFIC values of 0.46 for A. glabratum with Psidium guajava; ΣFIC values of 0.39 for B. transvaalensis with P. guajava and ΣFIC values of 0.88 (additive) for the combination of B. transvaalensis with Sclerocarya birrea.

CONCLUSION

This study provided some insight into the bacterial in vitro efficacies of plants traditionally used to treat diarrhoea by the people of Northern Maputaland. Very little connection was observed between frequency of use and efficacy. Plant combinations demonstrated favourable efficacy with mostly synergistic effects noted, lending some credibility to their use in combination.

PF2405, standardized fraction of Scutellaria baicalensis, ameliorates colitis in vitro and in vivo

Standardized extraction procedures for herb are as important as their authentication to maintain their quality and ensure their safe use. We had prepared a standardized and purified Scutellaria baicalensis Georgi extract, PF2405, which was enriched with three major components, baicalein, oroxylin A and wogonin. In the present study, we investigated the potential anti-inflammatory effects of PF2405 in vitro and in two different experimental animal models of inflammatory bowel disease. Effect of PF2405 studied in tumor necrosis factor (TNF)-α-induced HT-29 cells in vitro. In vivo experimental colitis models were induced by administration of trinitrobenzene sulfonic acid (TNBS) or dextran sulfate sodium (DSS). PF2405 (50 μg/ml) decreased TNF-α-induced cyclooxygenase (COX)-2 expressions through inhibition of phosphorylation of c-Jun N-terminal kinases and p38 mitogen-activated protein kinase in HT-29 cells. Combination of baicalein (20 μg/ml), oroxylin A (8 μg/ml), and wogonin (2 μg/ml) markedly inhibits TNF-α-induced COX-2 expression when compared with individual components. PF2405 (25 mg/kg b.w.) treatment significantly reduced histopathological severity; suppressed expression of COX-2, TNF-α, and interleukin-1β in TNBS-induced mice. Moreover, PF2405 (25 mg/kg b.w.) has both potent preventive and therapeutic activities in DSS-induced colitis. Collectively, PF2405 shows prominent anti-inflammatory effect that can be used as a new therapeutic approach for intestinal inflammatory disorders.

Plants used for treatment of dysentery and diarrhoea by the Bhoxa community of district Dehradun, Uttarakhand, India

ETHNOPHARMACOLOGICAL RELEVANCE

Dysentery and diarrhoea are major causes of morbidity and mortality in rural communities of developing world. The Bhoxa community is an important primitive indigenous community of Uttarakhand, India. In this paper we have tried to scientifically enumerate ethnomedicinal plants and herbal preparations used by Bhoxa community to treat dysentery and diarrhoea, and discuss their antidiarrhoeal properties in the light of previous ethnomedicinal, pharmacological, microbiological and phytochemical studies. To record plants and herbal preparations used by Bhoxa community of district Dehradun, Uttarakhand, India in treatment of dysentery and diarrhoea, and to discuss antidiarrhoeal and antimicrobial properties of the recorded plants.

MATERIALS AND METHODS

Ethnomedicinal survey was conducted in different villages of Bhoxa community located in district Dehradun, Uttarakhand, India. Thirty Bhoxa traditional healers were interviewed to collect information on plants used by them for treating dysentery and diarrhoea. For each of the recorded plant species the use value (UV) and fidelity level (FL) was calculated. Detailed literature survey was conducted to summarize ethnomedicinal, pharmacological, microbiological and phytochemical information on the medicinal plants listed in the present study.

RESULTS

Fifty medicinal plants (45 genera and 30 families) were used by Bhoxa community to treat dysentery and diarrhoea, among which 27 species were used for dysentery, 41 for diarrhoea and 18 for both dysentery and diarrhoea. Three plants viz., Dioscorea bulbifera L., Euphorbia thymifolia L. and Prunus persica (L.) Stokes, recorded in the present survey have been reported for the first time in treatment of dysentery and diarrhoea by any indigenous communities in India. FL and UV values revealed that most preferred species for the treatment of dysentery and diarrhoea by Bhoxa community are Euphorbia hirta L. followed by Holarrhena pubescens Wall., Helicteres isora L. and Cassia fistula L. Earlier pharmacological studies confirmed that 27 of the recorded plants have some proven antidiarrhoeal properties and remaining 23 plants have to be pharmacologically evaluated for their antidiarrhoeal properties. Except 6 plants all the other recorded plants have shown antimicrobial properties in previous microbiological studies. Previous studies have corroborated the ethnomedicinal claims made by the traditional healers of the Bhoxa community.

CONCLUSIONS

Present study has provided new information on many medicinal plants and their uses. All the three newly reported plants for treatment of dysentery and diarrhoea have not been pharmacologically evaluated yet for their possible antidiarrhoeal properties. Twenty-three and six plants have not been evaluated pharmacologically and microbiologically, respectively. The present information may serve as a baseline data to initiate further research for discovery of new compounds and biological activities of these potential plants. Further research on these plants may provide some important clues for development of new drugs for dysentery and diarrhoea or other related diseases.