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Ethnomedicines and Anti-Parasitic Activities of Pakistani Medicinal Plants Against Plasmodia and Leishmania Parasites

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Ethnomedicines and Anti-Parasitic Activities of Pakistani Medicinal Plants Against Plasmodia and Leishmania Parasites Tariq et al. Ann Clin Microbiol Antimicrob (2016) 15:52 DOI 10.1186/s12941-016-0170-0 Annals of Clinical Microbiology and Antimicrobials REVIEW Open Access Ethnomedicines and anti‑parasitic activities of Pakistani medicinal plants against Plasmodia and Leishmania parasites Akash Tariq1,2*, Muhammad Adnan2, Rahila Amber3, Kaiwen Pan1, Sakina Mussarat2 and Zabta Khan Shinwari4 Abstract Background: Leishmaniasis and malaria are the two most common parasitic diseases and responsible for large number of deaths per year particularly in developing countries like Pakistan. Majority of Pakistan population rely on medicinal plants due to their low socio-economic status. The present review was designed to gather utmost frag- mented published data on traditionally used medicinal plants against leishmaniasis and malaria in Pakistan and their scientific validation. Methods: Pub Med, Google Scholar, Web of Science, ISI Web of knowledge and Flora of Pakistan were searched for the collection of data on ethnomedicinal plants. Total 89 articles were reviewed for present study which was mostly published in English. We selected only those articles in which complete information was given regarding traditional uses of medicinal plants in Pakistan. Results: Total of 56 plants (malaria 33, leishmaniasis 23) was found to be used traditionally against reported parasites. Leaves were the most focused plant part both in traditional use and in in vitro screening against both parasites. Most extensively used plant families against Leishmaniasis and Malaria were Lamiaceae and Asteraceae respectively. Out of 56 documented plants only 15 plants (Plasmodia 4, Leishmania 11) were assessed in vitro against these parasites. Mostly crude and ethanolic plant extracts were checked against Leishmania and Plasmodia respectively and showed good inhibition zone. Four pure compounds like artemisinin, physalins and sitosterol extracted from different plants proved their efficacy against these parasites. Conclusions: Present review provides the efficacy and reliability of ethnomedicinal practices and also invites the attention of chemists, pharmacologist and pharmacist to scientifically validate unexplored plants that could lead toward the development of novel anti-malarial and anti-leishmanial drugs. Keywords: Ethnomedicines, Malaria, Leishmaniasis, Phytochemicals, In vitro activities Background million deaths per year particularly in developing coun- Leishmaniasis and malaria are two most common para- tries [2]. sitic diseases and infects a large number of human pop- Leishmaniasis is caused by an obligate intracellular ulations worldwide. Leishmaniasis is endemic disease protozoan parasite of genus Leishmania while transmit- of almost 88 countries in which about 350 million peo- ted to humans and other animals by many species of ples are at risk of infection [1]. Malaria is a major pub- phlebotomus sand flies [3, 4]. The main causative agents lic health problem throughout the world and causes one for leishmaniasis are Leishmania tropica, Leishmania major, Leishmania aethiopica, Leishmania donovani and Leishmania infantum. The four main clinical types *Correspondence: [email protected] of leishmaniasis are cutaneous leishmaniasis, mucocu- 2 Department of Botany, Kohat University of Science and Technology, taneous leishmaniasis, diffuse cutaneous leishmania- Kohat 26000, Pakistan Full list of author information is available at the end of the article sis and visceral leishmaniasis. Among these visceral © 2016 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Tariq et al. Ann Clin Microbiol Antimicrob (2016) 15:52 Page 2 of 13 leishmaniasis is very fatal if left untreated. About 90 % Methods cases of visceral leishmaniasis are reported from many This review paper was designed by collecting and con- countries like Brazil, Bangladesh, Sudan, India and sulting large number of mostly published literature on Nepal [5, 6]. Leishmaniasis is a complex group of dis- medicinal plants used to treat leishmaniasis and malaria eases produces various symptoms in host depending in Pakistan. Pub Med, Google Scholar, Web of Sci- upon parasite’s type [7]. Commonly used allopathic ence, ISI Web of Knowledge and Flora of Pakistan were drugs against leishmaniasis are pentavalent antimonials searched for the collection of data on ethnomedicinal like sodium stibogluconate and meglumine antimoniate plants. Plant list and Tropicos were searched for the cor- etc. These allopathic drugs are mostly unaffordable to rections of plant scientific names, publication authors, the local people and are also not safe due to their toxic- synonyms and families. Different search indicators like ity on living system. Many drugs need long term admin- ethnomedicinal plants used against leishmaniasis and istration to recover from the disease and show side malaria, in vitro activity of different medicinal flora of effects depending on the patient’s reaction to medicine Pakistan, epidemiology of leishmaniasis and malaria in [8]. world, prevalence of leishmaniasis and malaria in Paki- Malaria is caused by an intra-erhytrocytic protozoan stan, drug resistance potential of Leishmania and Plas- parasite of the genus Plasmodium and transmitted by modia parasites were used for the collection of data female anopheles mosquito [9]. The four main species of from the database. Total 89 articles were reviewed for Plasmodia which infects humans are Plasmodium falci- present study which was mostly published in English. parum, Plasmodium vivax, Plasmodium knowlesi, Plas- We selected only those articles in which complete infor- modium malariae, and Plasmodium ovale. Globally the mation was given regarding traditional use of medicinal most important species is P. falciparum causing severe plants in Pakistan. In-vitro activity of those plants has and potentially fatal malaria [2, 10]. For the treatment been mentioned which were checked against Leishma- of malaria many drugs like chloroquine, halofantrine, nia and plasmodia parasites. On the bases of selected pyrimethamine, mefloquine, quinine and artemisinin data from literature, three tables were formulated using are used [2, 4]. Many problems like resistance of the Microsoft Excel 2007 and Microsoft Word 2007. Tables 1 parasites to drugs, lack of effective vaccines, resistance and 2 were formulated on medicinal plants used to treat of mosquito vectors to insecticides and socioeconomic leishmaniasis and malaria in Pakistan. These tables con- problems rendering treatment of malaria through tains plant name, family, local name, part used, study chemotherapy ineffective [11, 12]. area and phytochemistry. Table 3 was formulated on Leishmaniasis and malaria has become a particular anti-parasitic activity of medicinal plants against L. trop- problem in the rural areas of Pakistan of all the prov- ica, L. major and P. falciparum. Concentration of plant’s inces [13]. Approximately 66 % people of Pakistan live extract (µg/ml) and their inhibition (%) against parasites in rural areas [14] and majority of the rural population were also mentioned. Pure compounds isolated from eth- in Pakistan is poor and cannot afford such expensive nomedicinal plants and assessed against these parasites drugs for the treatment of leishmaniasis and malaria [15, have also been mentioned in this review article. Chemical 16]. Mostly in rural areas peoples depend on medicinal structures of compounds were drawn using ChemDraw plants for the treatment of various diseases particularly software and shown in (Figs. 1, 2 and 3) (CambridgeSoft\ leishmaniasis and malaria [17]. Traditional medicines are ChemOffice2004\ChemDraw). extensively using in Pakistan due to easily affordability and efficacy against various diseases [18, 19]. Medicinal plants used to treat leishmaniasis The present review was designed to gather utmost frag- in Pakistan mented published literature on anti-malarial and anti- Leishmaniasis is a neglected tropical disease. Visceral leishmanial plants used by local people in Pakistan. This leishmaniasis and cutaneous leishmaniasis are the two review will also provide information on in vitro screening main clinical types of leishmaniasis widespread in Paki- and phytochemical investigation of documented plants stan. The incidence of visceral leishmaniasis has been against these parasites. Future outcomes of this review reported from Dera Ismail Khan, Quetta, Tank, Hazara are to provide evidences regarding the efficacy and relia- Division, Northern areas and Azad Jammu Kashmir [20]. bility of ethnomedicines against Leishmania and Plasmo- About 90 % cases of cutaneous leishmaniasis have been dia parasites, identify scientific gaps present in current reported from all the provinces of Pakistan [21]. The knowledge and to recommend future research areas for reported endemic areas of cutaneous leishmaniasis are the development of effective anti-malarial and anti-leish- Dir, Chitral, Swat, Mansehra, Dera Ghazi khan, Gilgat, manial drugs with fewer side effects. Skardu, Abbotabad,
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