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Therapeutic Role of Herbs in Tre

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					Therapeutic role of herbs in
  treatment of parasitic
        diseases

                           1
2
                                   Acknowledgement

I would like to express my sincere indebtedness and profound gratitude for Prof. Dr. Mohamed
Ahmad Abdel Rahman Sarwat, professor of parasitology, Faculty of Medicine, Ain Shams
                University, for his continuous guidance, and valuable suggestions.

I would like to express my deep thanks to Prof. Dr. Nashwa Ibrahim Ibrahim Ramadan,
Professor of parasitology, Faculty of Medicine, Ain Shams University, for her continuous support,
                              her valuable remarks and supervision.

 Also I would like to thank Dr. Hala Kamal Hassan El Deeb , Lecturer of parasitology,
Faculty of Medicine , Ain Shams University , for her meticulous supervision , generous guidance,
             keen interest and precious time she offered me throughout this study.

    Special thanks to Professor Dr. Laila Mohammed El-Okby, Professor and Head of
    Parasitology department Faculty of Medicine, Ain Shams University, for her continuous
                                       encouragement.
                                                                                            3
             Introduction
   The limited availability and affordability of
    pharmaceutical medicines urge the majority of
    the world's population to use traditional
    remedies.
   Phytomedicines combined with the preventive
    model of medical practice can shift the focus
    of modern health care from disease treatment
    to prevention.
                                                    4
         Aim of literature
 Thisliterature declares the therapeutic
 role of herbs in treatment of parasitic
 diseases and their natural role in
 comparison to medical treatment for
 the health of population.



                                       5
               Key points
I.    Role of herbs in treatment of helminthic
      infections
A.    Trematode infections
B.    Cestode infections
C.    Nematode infections

I.    Role of herbs in treatment of protozoal
      infections

II.   Role of herbs in treatment of arthropodal
      infections
                                                  6
I.Helminthic infections


                          7
A.Trematode infections




                         8
 Human fascioliasis is becoming a serious
public health problem with a number of
endemic areas identified in different
countries. An estimated 2 million cases of
fascioliasis exist worldwide.

 After malaria, schistosomiasis is the 2nd
most prevalent tropical disease in the world.
It is estimated that 500-600 million people in
74 tropical and subtropical countries are at
risk of schistosomiasis. Over 200million
people in these countries are infected.
                                                 9
Myrrh (Mirazid)
     Myrrh (Mirazid) is an oleo
     gum resin obtained from the
     stem of Commiphora molmol
     tree. Myrrh is safe, well
     tolerated, and proved
     effective for treating
     fascioliasis and
     schistosomiasis at a dose of
     12 and 10 mg/kg/d, resp for 6
     days.
                              10
Light microscopic study showing the effect of
  myrrh on the liver of mice infected with
              schistosomiasis




                                                11
Artemisia annua
        Artemether a methyl ether
        derivative of A. annua proved
        great antischistosomal properties.
        Administration of oral artemether
        at a dose of 6mg/kg once every 2
        weeks for up to 11 doses was
        effective in treating S. japonicum
        and preventing S. haematobium
        infections while six doses spaced
        by 3 weeks interval showed an
        incidence reduction of 50% in
        S. mansoni.
                                     12
Ferula assafoetida
        Ferula exerted a high
        reduction in worm burden
        and egg count of S. mansoni
        of infected mice at a
        concentration of 100mg/kg
        oil and 64mg/kg powder
        forms.


                                13
Effect of Ferula assafoetida on experimental
   murine Schistosoma mansoni infection
             (histopathology)




                                               14
Effect of Ferula
assafoetida on
experimental murine
Schistosoma mansoni
infection (E.M.)

                      15
Nigella sativa
     The black seed oil exhibited
     hepatoprotective effect. Besides,
     the essential oil was shown to have
     antihelminthic activity. Results
     indicated its strong biocidal effects
     against all stages of Schistosoma
     species and also showed an
     inhibitory effect on egg-laying of
     adult female worms.

                                     16
Areca nut                   Pumpkin seeds




•The effect of water extracts of Areca nut (Areca
catechu) and Pumpkin seeds (Curcubita pepo) in
treatment of puppies experimentally infected with
heterophyiasis gave promising results. So a wide
field of expiraments should be applied to humans.
                                                    17
     Treatment of experimental
heterophyiasis with Areca nuts and
          pumpkin seeds




                                     18
       Herbal Molluscicides
Plant molluscicides were applied as a source
of cheap, effective and environmentally
acceptable alternative for synthetic
molluscicides and chemotherapy



                                          19
   Euphorbia species proved great lethal effect
    against Biomphilaria species.
   Anagallis arvensis and Calendula micrantha,
    were also evaluated against B. alexandrina and
    Melanoides tuberculata.
   Annona squarnosa, Lawsonia inermis, Cedrus
    deodara, Azadirachta indica, Allium sativum
    and Zingiber officinale greatly affected the
    reproduction of Lymnaea acuminata.
                                                 20
B.Cestode Infections



                       21
Wild asparagus   Zanthoxylum species Acacia auriculiformis




 •Zan species are medicinal vermifuges against Taenia
 solium
 •Wild asparagus (long hollow yellow tubers) proved
 great efficacy in treating cycticercosis and D. caninum,
 while
 •Acacia proved lethal to H. diminuta.                    22
C.Nematode infections



                        23
Carica papaya
           Ascariasis is the most common
           human helminthic infection with
           one billion infected persons
           worldwide. Swallowing crushed
           sun dried Carica papaya seeds
           proved great efficacy in treating
           ascariasis. The adult dosage is 1
           tablespoon and the pediatric dose is
           1 teaspoon of the seed powder in a
           glass of sugar water once a week
           for 2 weeks.
                                          24
Chenopodium ambrosioides
         C. ambrosioides causes
         spontaneous or peristalsis
         induced passage of worms
         immediately following a
         therapeutic episode. Decoctions
         containing 300mg of dry plant
         material were widely used in
         treatment of ascariasis.
                                    25
 Fructus mume           Embelia ribes




F. mume caused a        E. ribes was also
reduction of movement
                        effective in
in roundworms when
placed in a 30% sol.
                        treating ascariasis.

                                           26
Picraena excelsa

           Quassia chips or
           raspings was also
           used as an enema
           to repel ascariasis.



                                  27
Juglans nigra          Artemisia absinthium




Artemisia absinthium (wormwood) and Juglans
nigra (black walnut) are well known to herbalists
with particular application to treating nematode
infestation, especially enterobiasis.
                                                    28
Tansy




        29
Thymus vulgaris
         Hookworms infect more
         than 1 billion people and
         produce morbidity from
         anaemia in more than 96
         million. Thymus vulgaris
         proved greatly effective in
         treating hookworm
         infection in a dose of 2 to
         3ml of the extract 3 times
         daily.
                                 30
Stachytarpheta jamaicensis
         (Gervao)
             •Strongyloides stercoralis
             (dwarf threadworm) should be
             recognized by all emergency
             physicians as the one capable
             of causing life threatening
             infection. Gervao,
             Wormwood, Tansy , Quassia,
             Garlic and thyme all proved
             effective against Strongyloides.

                                        31
Elecampane (Inula helenium)

            Trichuris trichiura (whip
            worm) infections are among
            the most common human
            parasites with an estimated
            750-800 million infections
            worldwide.
            Elecampane is effective in
            treating the infection in a
            dose of 2 to 3ml tincture 3
            times daily.
                                          32
Echinacea purpurea

         T. Spiralis is now classified as
         an emerging disease.
         Echinacea together with
         Allium sativum and cocoa
         caused antiparasitic immunity
         enhancement against
         T. spiralis in mice.




                                    33
Ginkgo biloba
     Lymphatic filariasis affects more
     than 90 million people worldwide.
     G. biloba complex and unique
     chemistry gives it remarkable
     resistance to parasites, tolerance
     to adversity and a storehouse of
     biologically active compounds. It
     is used in treatment of filariasis in
     a dose of 4.5-9 grams tincture.


                                     34
Boerhaavia diffusa

        B. diffusa (Erva tostão) is
        considered an excellent natural
        remedy for guinea worms
        (dracunculiasis). The roots of
        the plant are normally softened
        in boiling water and then
        mashed up and applied as a
        paste or poultice to the affected
        areas to kill the worms and
        expel them from the skin.

                                     35
II.Protozoal infections



                          36
Uncaria tomentosa

         Entamoeba species infect
        approximately 10% of the
        world's population. The
        prevalence of amoebic colitis
        and liver abscess is estimated
        as 40-50 million cases
        worldwide, resulting in
        40.000-110.000 deaths yearly.
         U. tomentosa in 1-4ml/day
        tincture facilitates expulsion of
        E.histolytica.
                                      37
Wheat germ

    Giardiasis is the most common
    protozoal infection. Worldwide
    incidence is between 20-60%.
    In vitro research demonstrated
    that pre-exposure of Giardia
    cysts to WGA inhibits
    excystation by more than 90%.
    Specific dietary
    recommendations include
    consumption of 2 tablets of wheat
    germ 3times/day.
                                38
Berberis vulgaris
                Berberine salts and extracts have
                demonstrated in vitro inhibitory
                activity against Giardia
                trophozoites. Berberine sulfate has
                been shown to induce
                morphological damage to
                trophozoites, including the
                appearance of irregularly shaped
                vacuoles, swollen trophozoites, and
                the development of glycogen
                deposits.
                                              39
Origanum vulgare

      Also,
      Oregano and guava leaves
      (psidium guajava) rich in
      flavonoids and tannins
      demonstrated an antigiardial
      effect superior to tinidazole.


                                40
Melaleuca alternifolia (Tea Tree )
                   • Trichomoniasis affects
                   approximately 180 million
                   women worldwide.

                   • Tea Tree (Melaleuca
                   alternifolia) oil 40% solution
                   emulsified with isopropyl
                   alcohol and water in a
                   tampoon proved to be an
                   effective germicidal against
                   T. vaginalis.
                                             41
The effect of berberine on T. vaginalis in vitro.




                                                    42
Chinese licorice plant
         It is estimated that
         leishmaniasis is responsible for
         more than 80.000 deaths
         annually.
          Licochalcone A an
         oxygenated chalcone isolated
         from the roots of Chinese
         licorice plant, inhibited the
         growth of Leishmania species
         with intracellular amastigotes
         more susceptible than
         promastigotes.
                                        43
Scoparia dulcis               Kigelia pinnata




Scoparia dulcis was involved in modulating the
severity of African trypanosomiasis associated
lesions. Also Kigelia pinnata root and stem bark
proved potent activities in in vitro cultures of T. cruzi
and T. brucei rhodesiense.                                  44
 Malaria remains an enormous
international medical issue, with 300-500
million cases reported annually.

Artemisia annua (annual wormwood) has
been used in traditional Chinese medicine for
the treatment of febrile diseases and malaria
for many centuries. In the last two decades,
artemisinin and its semisynthetic derivates
artemether and artesunate have been
established as safe and effective antimalarials.
                                                   45
Kniphofia foliosa       Ailanthus altissima




Ailanthus altissima and Kniphofia foliosa
displayed strong in vitro antiplasmodial
activity against the chloroquine sensitive strain
of P. falciparum.                                46
Usnea longissimaseu
               Usneic acid, from Usnea
               longissimaseu was
               effective in killing the
               tachyzoite stage of
               Toxoplasma in 4 hours at
               a dose of 50µg which
               was better than
               spiramicin.
                                   47
Pinus maritima (Pine bark)

            It is estimated that 3-7% of
           reported diarrheal disease in
           developing countries is caused by
           Cryptosporidium spp.
            Pinus maritima significantly
           reduced fecal oocyst shedding,
           but did not decrease parasite
           colonization in intestinal tissue.


                                        48
III.Arthropodal infections


                         49
• The majority of arthropods function
indirectly in human disease which
they transmit and not produce.

• Botanical insecticides are relatively
safe and degradable, and are readily
available sources of biopesticides.


                                          50
Azadirachta indica (Neem tree)
             Neem products exhibit various
             modes of action against
             arthropods such as growth
             regulation, fecundity
             suppression and sterilization,
             oviposition repellency or
             attractancy, changes in
             biological fitness, and blocking
             development.

                                           51
Foeniculum vulgare Pelargonium citrosum




Fennel oil exhibited the best repellency against
Ae. aegypti female. Also Pelargonium citrosum
(citrosa) was marketed as an effective biological
repellent against mosquitoes.
                                                    52
  Lantana camara            Eucalyptus globulus




   Lantana camara is       Eucalyptus globosus is
 safely recommended in     safe, cheap and
controlling M. domestica   recommended to be used
     3rd stage larvae.     in controlling larvae of
                           M. domestica.              53
Chamaecyparis nootkatensis

           Chamaecyparis nootkatensis
           contains nootkatone
           eremophilane which was the
           most effective against ticks
           and nootkatone grapefruit
           extract which exhibited the
           greatest biocidal activity
           against fleas.

                                   54
 Lippia multiflora Ageratum conyzoides




Lippia multiflora has a   Ageratum conyzoides
strong knockdown          flower heads was used
properties against lice   externally to treat scabies
and mites.                without side effects.
                                                  55
Cnidium monnieri
       Cnidium monnieri seeds
       are often combined with
       other herbs like Stemona
       species and Sophora
       species for treatment of
       scabies. It proved great
       efficacy in decreasing the
       itch scratch response.
                             56
  Summary and
recommendations

                  57
   Plants continued as a mainstay of
    medicine as it evolved.

    Herbal medicines are the staple of
    medical treatment in many developing
    countries whether for general illness or
    for parasitic diseases.




                                               58
   Globally, herbal remedies have been
    researched under rigorous controls and
    have been approved by the governments of
    technologically advanced nations. Many
    phytomedicines have been used by
    thousands of physicians in their practices
    and are consumed under medical
    supervision by tens of millions of people.



                                             59
   It is recommended that the bias against
    plant medicines must be eliminated by
    restructuring the requirements for proof
    of efficacy and concentrating on safety of
    herbal products. The cost, expense, side
    effects and tolerance to the conventional
    therapy potentiates our urge to the
    establishment and settlement of use of
    phytomedicine.


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