Therapeutic role of herbs in treatment of parasitic diseases

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Therapeutic role of herbs in treatment of
parasitic diseases
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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.
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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.

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Aim of literature

• This literature 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.

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Key points

• Role of herbs in treatment of helminthic
  infections
• Trematode infections
• Cestode infections
• Nematode infections
• Role of herbs in treatment of protozoal
  infections
• Role of herbs in treatment of arthropodal
  infections

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I.Helminthic infections
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A.Trematode infections
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• 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.

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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.

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Light microscopic study showing the effect of
myrrh on the liver of mice infected with
schistosomiasis
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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.
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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.
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Effect of Ferula assafoetida on experimental
murine Schistosoma mansoni infection
(histopathology)
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Effect of Ferula assafoetida on experimental
murine Schistosoma mansoni infection (E.M.)
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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.
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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.

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Treatment of experimental heterophyiasis with
Areca nuts and pumpkin seeds
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Herbal Molluscicides

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

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• 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.

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B.Cestode Infections
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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.

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C.Nematode infections
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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.
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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.
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Fructus mume Embelia ribes
F. mume caused a reduction of movement in
roundworms when placed in a 30 sol.
E. ribes was also effective in treating
ascariasis.
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Picraena excelsa
Quassia chips or raspings was also used as an
enema to repel ascariasis.
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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.
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Tansy
Enterobius vermicularis (pinworm) is the most
common cosmopolitan of human helminthes.Tansy is
largely used for expelling pinworms in children
by infusion of 1 ounce to a pint of boiling water
taken as teacupful doses 2times/day.
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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.
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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.

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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.
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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.
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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.
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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.
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II.Protozoal infections
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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.

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

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The effect of berberine on T. vaginalis in vitro.
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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.

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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.
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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.
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Kniphofia foliosa Ailanthus altissima
Ailanthus altissima and Kniphofia foliosa
displayed strong in vitro antiplasmodial activity
against the chloroquine sensitive strain of P.
falciparum.
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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.
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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.

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III.Arthropodal infections
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• 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.

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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.
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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.
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Lantana camara Eucalyptus globulus
Eucalyptus globosus is safe, cheap and
recommended to be used in controlling larvae of
M. domestica.
Lantana camara is safely recommended in
controlling M. domestica 3rd stage larvae.
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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.
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Lippia multiflora Ageratum conyzoides
Lippia multiflora has a strong knockdown
properties against lice and mites.
Ageratum conyzoides flower heads was used
externally to treat scabies without side effects.
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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.
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Summary and recommendations
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• 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.

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• 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.

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• 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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Thank you