Although it is more than 100 years since Robert Koch discovered the tubercle bacillus, and more than 40 years since effective chemotherapy became available, the incidence of tuberculosis is increasing in much of the developing world and has recently re-emerged as a public health problem in industrialized countries. This problem is compounded by the increase in host susceptibility to tuberculosis caused by co-infection with HIV (Human Immunodeficiency Virus) and the emergence of Mycobacterium tuberculosis strains that are resistant to the front-line drugs. These factors highlight the urgent need for development of new drug classes to counter the threat posed by tuberculosis. The purpose of the present study was to develop a mouse model for Mycobacterium tuberculosis with the aim of determining the antimycobacterial activity of medicinal plants used by traditional doctors to treat tuberculosis in South Africa. Furthermore, the toxic effects of these medicinal plants in uninfected mice were determined. A field trip to the Northern Cape, Western Cape, Eastern Cape and Free State provinces was undertaken and medicinal plants used by traditional doctors to treat tuberculosis or its symptoms were collected, identified and examined for their therapeutic effects against Mycobacterium tuberculosis, determined using the mouse model. In addition, the effects of medicinal plants on the production of cytokines and granuloma formation in infected mice were examined. Six-to-ten week old C57BL/6 mice were infected with 107 viable Mycobacterium tuberculosis H37Rv strain by an aerosol exposure model. Bacterial growth was monitored by sacrificing infected but untreated mice at day 1, week 2 and week 4. Treatment with medicinal plant extracts was started 2 weeks after infection and continued for 2 weeks. An INH-RIF combination was used as positive controls. The bacterial load in infected but untreated mice increased by 1 log unit each week for 2 to 3 weeks. Bacterial loads were not detected in INH-RIF treated mice after 2 weeks of treatment. Treatment of mice with high doses of plant extracts was toxic. None of the tested medicinal plant extracts showed any activity against Mycobacterium tuberculosis. The production of IL-12 at week 4 was suppressed/ decreased when plant extract A was given at different concentrations. The bacterial loads in the lungs of the plant extract A treated mice was higher than that of the untreated mice (p < 0.005). Histological analysis of the lungs also revealed a high number of bacilli and increased size of the formed granuloma. In conclusion, the selected plant extracts obtained by water extraction exhibited no anti-tuberculosis activity in the laboratory mouse model for Mycobacterium tuberculosis infection. Furthermore, it was also shown that some plant extracts suppressed the production of IL-12, which plays an important role in the host's defense against Mycobacterium tuberculosis. However, further work is required to test if treatment for longer periods exhibits antituberculous activity.

no / New antimalarial drugs are urgently needed to combat emerging multidrug resistant strains of malaria parasites. This Highlight focuses on plant-derived natural products that are of interest as potential leads towards new antimalarial drugs including synthetic analogues of natural compounds, with the exception of artemisinin derivatives, which are not included due to limited space. Since effective antimalarial treatment is often unavailable or unaffordable to many of those who need it, there is increasing interest in the development of locally produced herbal medicines; recent progress in this area will also be reviewed in this Highlight.

No / This paper reports 35 medicinal plants belonging to 25 families used in the treatment of malaria by the people inhabiting the forests located near to Bhubaneswar, the capital city of Orissa, a south-eastern state in India. The methods adopted for the preparation of plant parts are discussed along with their family and local name(s). The majority of the herbal preparations were made in the form of juices or by using water as the medium in the form of decoctions or infusions. Various plant parts, such as leaves, flowers, fruits, barks, stems, roots, and in some cases the whole plants are used to prepare these remedies each of which contains a single species.

Masters of Science / Background: In Africa, traditional medicine (TM) practice has been in existence since time immemorial as the major source of pharmacotherapy. However, unlike orthodox medicines TM policies and regulations are not formalised let alone standardised. African nations have different approaches and regulatory requirements whereas in some states policies are even non-existent. Aim: The aim of the mini thesis was to assess the current policies and guidelines for regulation of TM in five selected sub-Saharan African countries relative to the WHO recommendations on traditional medicine policy. Method: The mini thesis was a desk review of current policy frameworks and guidelines for regulation of traditional medicines relative to WHO recommendations on TM policy in sub- Saharan Africa using five selected countries. Result: The results from the five selected countries showed significant difference in the current policies and guidelines on the regulation of TM, but no significant difference in the actual WHO TM policy indicators that the countries implemented. Discussion: Regularisation of TM practice by integrating it into main health systems could make it more acceptable. The complexity of TM/herbal products needs a different yet integrated approach. Harmonisation of regulatory requirements eliminates the need for redundant testing, ensures consistency across regions and improves implementation of WHO TM policy indicators.

Traditional medicines (TM) have been used for centuries to treat illnesses, but in many cases their modes-of-action (MOAs) remain unclear. Given the increasing data of chemical ingredients of traditional medicines and the availability of large-scale bioactivity data linking chemical structures to activities against protein targets, we are now in a position to propose computational hypotheses for the MOAs using in silico target prediction. The MOAs were established from supporting literature. The in silico target prediction, which is based on the “Molecular Similarity Principle”, was modelled via two models: a Naïve Bayes Classifier and a Random Forest Classifier. Chapter 2 discovered the relationship of 46 traditional Chinese medicine (TCM) therapeutic action subclasses by mapping them into a dendrogram using the predicted targets. Overall, the most frequent top three enriched targets/pathways were immune-related targets such as tyrosine-protein phosphatase non-receptor type 2 (PTPN2) and digestive system such as mineral absorption. Two major protein families, G-protein coupled receptor (GPCR), and protein kinase family contributed to the diversity of the bioactivity space, while digestive system was consistently annotated pathway motif. Chapter 3 compared the chemical and bioactivity space of 97 anti-cancer plants’ compounds of TCM, Ayurveda and Malay traditional medicine. The comparison of the chemical space revealed that benzene, anthraquinone, flavone, sterol, pentacyclic triterpene and cyclohexene were the most frequent scaffolds in those TM. The annotation of the bioactivity space with target classes showed that kinase class was the most significant target class for all groups. From a phylogenetic tree of the anti-cancer plants, only eight pairs of plants were phylogenetically related at either genus, family or order level. Chapter 4 evaluated synergy score of pairwise compound combination of Shexiang Baoxin Pill (SBP), a TCM formulation for myocardial infarction. The score was measured from the topological properties, pathway dissimilarity and mean distance of all the predicted targets of a combination on a representative network of the disease. The method found four synergistic combinations, ginsenoside Rb3 and cholic acid, ginsenoside Rb2 and ginsenoside Rb3, ginsenoside Rb3 and 11-hydroxyprogesterone and ginsenoside Rb2 and ginsenoside Rd agreed with the experimental results. The modulation of androgen receptor, epidermal growth factor and caspases were proposed for the synergistic actions. Altogether, in silico target prediction was able to discover the bioactivity space of different TMs and elucidate the MOA of multiple formulations and two major health concerns: cancer and myocardial infarction. Hence, understanding the MOA of the traditional medicine could be beneficial in providing testable hypotheses to guide towards finding new molecular entities.

Yes / Ancient Chinese herbal texts as far back as the 4th Century Zhou hou bei ji fang describe methods for the use of Qing Hao (Artemisia annua) for the treatment of intermittent fevers. Today, the A. annua constituent artemisinin is an important antimalarial drug and the herb itself is being grown and used locally for malaria treatment although this practice is controversial. Here we show that the ancient Chinese methods that involved either soaking, (followed by wringing) or pounding, (followed by squeezing) the fresh herb are more effective in producing artemisinin-rich extracts than the usual current method of preparing herbal teas from the dried herb. The concentrations of artemisinin in the extracts was up to 20-fold higher than that in a herbal tea prepared from the dried herb, but the amount of total artemisinin extracted by the Chinese methods was much less than that removed in the herbal tea. While both extracts exhibited potent in vitro activities against Plasmodium falciparum, only the pounded juice contained sufficient artemisinin to suppress parasitaemia in P. berghei infected mice. The implications of these results are discussed in the context of malaria treatment using A. annua infusions.

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In Thailand, Acanthus ebracteatus Vahl and Clerodendrum petasites S. Moore have been prescribed to treat skin diseases, such as rash, abscess, and urticaria, for at least 30 years. However, there is limited scientific support and no clinical trials that identify and verify the compounds that elicit useful pharmacological effects following their topical delivery. Vanillic acid was identified for the first time in A. ebracteatus together with verbascoside; furthermore, nine phenolic compounds, vanillic acid, 4-coumaric acid, ferulic acid, verbascoside, nepetin, luteolin, chrysin, naringenin, and hesperetin, and two reported, apigenin and hispidulin, were found in C. petasites. C. petasites (CP) was therefore chosen as the principal plant to be studied in this thesis. Hispidulin was quantified as a predominant compound, being present at 39 μmol/g (1.2% w/w) in a dried ethanolic extract. Various formulations of CP extracts were examined (a) in in vitro skin penetration experiments using Franz diffusion cells, and (b) in vivo using the tape-stripping method. Hispidulin penetrated through the skin within 3 hours; vanillic acid and nepetin were absorbed after 6 hours. In contrast, verbascoside was only taken up into the superficial layers of SC. There was no difference in the permeation of hispidulin, nepetin and vanillic acid from 10% w/w CP cream and lotion formulations. Hispidulin was percutaneously absorbed through the skin and taken up into the stratum corneum in the greatest amount, followed by vanillic acid and nepetin. It was found that the in vitro model was useful for preliminary formulation development, and that the tape-stripping method was robust and effective. Verbascoside, although a poor penetrant, was well released from the formulations in an in vitro release test, suggesting that it might be a potential skin surface-active compound, such as an antimicrobial. Hispidulin, nepetin and vanillic acid, based on their uptake and penetration into the skin, together with their known biological activities, may be considered as feasible candidates for the development of novel and effective antimicrobial, anti-inflammatory, and antioxidant formulations.

Thesis (M. A. (Sociology)) -- University of the North, 2000 / Refer to the document / NRF (National Research Foundation)