The phytotherapeutic potential of commercial South African medicinal plants: current knowledge and future prospects

South Africa, a country considered affluent in nature, ranks third in global biodiversity and encompasses approximately 9% of higher plants on planet Earth. Many indigenous plants have been utilised as herbal medicine, proving successful in treating numerous ailments. From the common cold to pandemic maladies such as COVID-19 in the 21st century and the treatment of incurable diseases, South African inhabitants have found great promise in the healing properties of these plants. Phytomedicine is a rapidly evolving topic, with in-depth bioactive composition analysis, identifying therapeutic action mechanisms, and disease prevention. While we are now poised to take advantage of nature’s medicine cabinet with greater scientific vigour, it remains critical that these practises are done with caution. Overharvesting significantly impacts biodiversity and cultivation practices amidst the beautiful nature of these nutraceuticals. This book chapter focuses on the therapeutic potential of commonly used South African medicinal plants, their ethnopharmacological properties, and how we can conserve this treasure cove we call home for future generations.

Aloe vera and Streptozotocin-Induced Diabetes Mellitus

Diabetes mellitus is defined as prolonged hyperglycemia, which can harm the eyes, kidneys, and cardiovascular and neurological systems. Herbal agents and their derived supplements have been used for treatment of diabetes mellitus as a part of integrated complementary medicine for centuries. Numerous studies have considered Aloe vera (L.) Burm.f, Xanthorrhoeaceae, as an alternative medicine due to its abundant bioactive chemicals, such as alkaloids, anthraquinones, and enthrones, with therapeutical properties including antioxidant, anti-inflammatory, neuro-protective, and anti-diabetic effects. Aloe vera has received considerable attention in traditional medicine for the treatment of several diseases including diabetes mellitus. Numerous studies have investigated the effects of herbal agents on diabetes mellitus using a streptozotocin-induced diabetic model. Thereby, this article reviews the effects of Aloe vera prescription on streptozotocin-induced diabetes mellitus to provide a clear insight into the role of this medicinal plant in several biological functions, such as antioxidant, wound healing, anti-inflammatory, anti-hyperglycemic, and anti-hyperlipidemic in diabetic models.

Comparative Study of Abiotic Stress Factors on GC-MS-Detected Phytoconstituents of Aloe greatheadii var: davyana Using Heat Map and Hierarchical Clustering Dendrogram

Aloe greatheadii var. davyana or spotted aloe is indigenous to South Africa and widely distributed in the northern provinces. The plant has a vast ethnopharmacological application which is mostly attributed to its phytochemical content. The aim of the study was to examine the effect of abiotic stress factors on the plant's phytochemical content. The phytochemical content of A. greatheadii hexane extracts from four different provinces (Limpopo, Mpumalanga, Gauteng, and North West), harvested from the wild at varied altitudes, rainfall patterns, and soil types, was examined using gas chromatography-mass spectra (GC-MS). The phytochemical content of hexane extracts from the four South African provinces was analysed using heat map analysis and hierarchical clustering dendrogram. The phytochemical content of A. greatheadii hexane extracts was composed of fatty acids, alkanes, benzene, carboxylic acids, ketones, phytosterols, and vitamins. Eicosane, henicosane, and [(2S)-2-[(2R)-4-hexadecanoyloxy-3-hydroxy-5-oxo-2H-furan-2-yl]-2-hydroxyethyl] hexadecanoate were the only compounds detected in all samples from the four provinces. The concentration levels of 2-(((2-ethylhexyl)oxy)carbonyl) benzoic acid, beta-sitosterol, tritetracontane, and ethyl 13-methyltetradecanoate were closely related and expressed a low clustering distance amongst the samples. Variations in soil pH, soil type, and rainfall patterns were detected and differed in the four provinces. The different abiotic stress factors affected the biochemical pathways for the different compounds, with conditions in Gauteng being less favourable for many of the compounds detected. Abiotic stress factors have shown to influence phytochemical biochemical pathways and quantity. Aloe greatheadii plants can be selected based on location seemingly due to the variations that persist in their phytochemical content.

Beneficial effects of Aloe ferox on lipid profile, blood pressure, and glycemic control in obese persons: A CONSORT-clinical study

BACKGROUND

Aloe ferox is one of the most widely used medicinal plants today, with the most intense detoxifying action of all aloe species, being used in the treatment of various diseases, including obesity. Our study aimed to assess the efficacy of Aloe ferox in obesity treatment.

METHODS

The study sample included 20 Romanian persons with obesity treated with diet and Aloe ferox based supplements, and 20 Romanian matched controls treated with diet and a placebo. The treatment included 2 capsules/day (Aloe ferox 460 mg) for 2 weeks, followed by a 2-week break, repeated 3 times. The blood pressure (systolic and diastolic) and anthropometric parameters, such as body mass index (BMI), total cholesterol, and abdominal circumference, as well as the biochemical parameters, fasting blood glucose (FBG), uric acid, and lipid profile was evaluated at baseline and after 3 months.

RESULTS

After 3 months of Aloe ferox administration, significant differences between the study group and the control group were observed regarding BMI (P = .03), total cholesterol (P = .032), low-density lipoprotein cholesterol (LDLc) (P = .01) and FBG (P = .018). Also, between the initial clinical, anthropometric, and biological parameters and those after the administration of Aloe ferox in the study group, we obtained significant differences regarding BMI (P = .002), LDLc (P = .039), fasting glycemia (P < .001) and diastolic blood pressure (P = .006).

CONCLUSIONS

The administration of Aloe ferox to obese patients has been shown to achieve a significant reduction in body weight, BMI, LDLc, and FBG. These effects may be due to the laxative and detoxifying action of Aloe ferox components. As it can only be administered for limited periods due to side effects, further experimental and human studies of the efficacy of this plant in the treatment of obesity are needed.

The Potential Therapeutic Value of Medicinal Plants in the Management of Metabolic Disorders

Metabolic syndrome (MetS) is a prevalent, multifactorial and complex disease that is associated with an increased risk of developing diabetes and other major cardiovascular complications. The rise in the global prevalence of MetS has been attributed to genetic, epigenetic, and environmental factors. The adoption of sedentary lifestyles that are characterized by low physical activity and the consumption of high-energy diets contributes to MetS development. Current management criteria for MetS risk factors involve changes in lifestyle and the use of pharmacological agents that target specific biochemical pathways involved in the metabolism of nutrients. Pharmaceutical drugs are usually expensive and are associated with several undesirable side effects. Alternative management strategies of MetS risk factors involve the use of medicinal plants that are considered to have multiple therapeutic targets and are easily accessible. Medicinal plants contain several different biologically active compounds that provide health benefits. The impact of phytochemicals present in local medicinal plants on sustainable health and well-being of individuals has been studied for many years and found to involve a plethora of complex biochemical, metabolic, and physiological mechanisms. While some of these phytochemicals are the basis of mainstream prescribed drugs (e.g., metformin, reserpine, quinine, and salicin), there is a need to identify more medicinal plants that can be used for the management of components of MetS and to describe their possible mechanisms of action. In this review, we assess the potential health benefits of South African ethnomedicinal plants in protecting against the development of health outcomes associated with MetS. We aim to provide the state of the current knowledge on the use of medicinal plants and their therapeutically important phytochemicals by discussing the current trends, with critical examples from recent primary references of how medicinal plants are being used in South African rural and urban communities.

Medicinal Plants Used for the Traditional Management of Diabetes in the Eastern Cape, South Africa: Pharmacology and Toxicology

The use of medicinal plants for the management of diabetes mellitus is on the rise in the developing countries, including South Africa. There is increasing scientific evidence that supports the claims by the traditional healers. In this review, we compare the families of previously reported anti-diabetic plants in the Eastern Cape by rating the anti-diabetic activity, mode of action and also highlight their therapeutic potentials based on the available evidence on their pharmacology and toxicity. Forty-five plants mentioned in ethnobotanical surveys were subjected to a comprehensive literature search in the available electronic databases such as PubMed, ScienceDirect, Google Scholar and Elsevier, by using “plant name” and “family” as the keywords for the primary searches to determine the plants that have been scientifically investigated for anti-diabetic activity. The search returned 25 families with Asteraceae highly reported, followed by Asphodelaceae and Alliaceae. Most of the plants have been studied for their anti-diabetic potentials in vivo and/or in vitro, with most of the plants having a higher percentage of insulin release and inhibition against carbohydrate digesting enzymes as compared with insulin mimetic and peripheral glucose uptake. Almost all the investigated plants also inhibit oxidative stress as part of their hypoglycemic activity with less toxicity. However, the isolation of their bioactive molecules is still lacking. This review provides a resource to enable thorough assessments of the therapeutic profiles of available medicinal plants used for the management of diabetes in the Eastern Cape, South Africa. Further studies such as the identification of the active ingredients of potent plants still need to be carried out; this may lead to new molecules in drug discovery and development.

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.

Improved early performance of turkey poults given an Aloe ferox leaf extract with bentonite

AT-402 (20 g/kg), a proprietary blend of Aloe ferox leaf extract and calcium bentonite, had no adverse effect on poult body weights at 3 weeks of age. Lower body weights and lower feed consumption were observed in 4-week-old poults given 10 and 20 g/kg of AT-402 compared to poults given 0 or 5 g/kg. Floor-reared poults, given either 5 or 10 g/kg AT-402 to 4 weeks of age, were significantly heavier than controls (0 g/kg AT-402), and feed conversion ratios for AT-402 given poults were improved. Xylose uptake in 5 g/kg AT-402-fed poults was significantly greater than in poults given AT-402 at 0 and 10 g/kg, reflecting increased body weights of 5 g/kg AT-402-fed poults. Delayed access by poults to the AT-402 until 10 d of age also improved 4-week body weights, suggesting that the AT-402 might improve performance as soon as it is given. AT-402 at 5 g/kg was most efficacious as demonstrated by improved body weights and feed conversions.

Unraveling the medicinal potential of South African Aloe species

ETHNOPHARMACOLOGICAL RELEVANCE

Aloe species (family: Xanthorrhoeaceae) are widely used in ethnomedicine for treating various ailments. Approximately 125 Aloe taxa are documented as indigenous to South Africa. This review was aimed at critically evaluating the available data on the ethnomedicinal uses, pharmacological activities, safety and conservation status of the documented South African Aloe species.

MATERIALS AND METHODS

A detailed search using major electronic search engines (such as Google Scholar, Scopus and Scirus) and ethnobotanical literature was undertaken. Search terms used included 'medicinal properties of Aloe species', 'biological activity of South African Aloe species' and 'safety and toxicological evaluation of aloes'.

RESULTS

Although Aloe species are widely used as laxatives and for treating wound and skin-related ailments, only about 20% of South African Aloe species have been clearly documented for their medicinal uses. The pharmacological potential including the antimicrobial, antiinflammatory, antiplasmodial and anthelmintic activities of some of the species has been established, providing a rationale for their use in traditional medicine. Successful micropropagation protocols have been developed as a conservation strategy, but only for a few species.

CONCLUSIONS

The highlighted medicinal activities of some Aloe species indicate their therapeutic potential. Nonetheless, further research especially on the understudied species is required to properly document their ethnomedicinal uses and fully explore their pharmacological value.