The Antimalarial Potential of Three Ghanaian Medicinal Plants

Objective: Malaria is a major public health problem in Ghana and many indigenes, especially those in rural areas, resort to the use of medicinal plants to treat the disease. The plants: Persea americana Mill. (Lauraceae), Theobroma cacao L. (Malvaceae) and Tridax procumbens (L.) L. (Compositae) are used solely or in combination with other medicinal plants to manage malaria and its associated conditions. The leaves of the plants which are normally the main parts employed, were studied for their phytochemistry and antiplasmodial activity to establish their chemical profile and verify the antimalarial claim. Methods: Plant materials were subjected to basic phytochemical screening to identify the major secondary metabolites. The aqueous extracts were evaluated against chloroquine-sensitive 3D7 P. falciparum and chloroquine-resistant W2 P. falciparum strains, using the fluorescence-based SYBR® green I method to determine their antiplasmodial activity. Results: Basic phytochemical screening of the leaves revealed the presence of tannins, flavonoids and alkaloids in all three plant materials. T. cacao and P. americana, in addition, contained purine base alkaloids, triterpenoids including saponins. The aqueous extracts of the leaves showed antiplasmodial activity against the chloroquine-sensitive 3D7 P. falciparum (9.50 ± 1.38 ≤ IC50 ≤ 10.15 ± 0.45 µg/mL) and against chloroquine-resistant W2 P. falciparum strains (6.40 ± 1.94 ≤ IC50 ≤ 44.94 ± 1.12 µg/mL). The aqueous extract of T. cacao was the most active and was more active against W2 than 3D7 P. falciparum. Only T. procumbens displayed cytotoxicity (CC50<25 µg/mL). Conclusion: T. cacao, T. procumbens and P. americana possess antiplamodial activity. The activity illustrates their antimalarial potential, and provides rationale for their use in traditional malaria therapy in Ghana. It thus paves the way for further study of these plants for antiplasmodial lead compound(s)

Differential activity of methylene blue against erythrocytic and hepatic stages of Plasmodium

Background: In the context of malaria elimination/eradication, drugs that are effective against the different developmental stages of the parasite are highly desirable. The oldest synthetic anti-malarial drug, the thiazine dye methylene blue (MB), is known for its activity against Plasmodium blood stages, including gametocytes. The aim of the present study was to investigate a possible effect of MB against malaria parasite liver stages. Methods: MB activity was investigated using both in vitro and in vivo models. In vitro assays consisted of testing MB activity on Plasmodium falciparum, Plasmodium cynomolgi and Plasmodium yoelii parasites in human, simian or murine primary hepatocytes, respectively. MB in vivo activity was evaluated using intravital imaging in BALB/c mice infected with a transgenic bioluminescent P. yoelii parasite line. The transmission-blocking activity of MB was also addressed using mosquitoes fed on MB-treated mice. Results: MB shows no activity on Plasmodium liver stages, including hypnozoites, in vitro in primary hepatocytes. In BALB/c mice, MB has moderate effect on P. yoelii hepatic development but is highly effective against blood stage growth. MB is active against gametocytes and abrogates parasite transmission from mice to mosquitoes. Conclusion: While confirming activity of MB against both sexual and asexual blood stages, the results indicate that MB has only little activity on the development of the hepatic stages of malaria parasites

Evaluation of antiplasmodial activity of extracts from endemicmedicinal plants used to treat malaria in Côte d'Ivoire

Introduction: Plasmodium falciparum strainshad been increasingly resistant to commonlyused molecules including artemisinin. Itis therefore urges to find new therapeuticalternatives. Methods: In this study, the antiplasmodialactivity of 21 extracts obtained from sevenplants of the Anthocleista djalonensis,Cochlospermum planchonii, Harunganamadagascariensis, Hoslundia opposita,Mangifera indica, Margaritaria discoidea and Pericopsis laxiflora of the Ivorian pharmacopoeiawas evaluated on the chloroquine sensitive (NF54) and multi-resistant (K1) reference strains andon clinical isolates as well. The technique used was the microtiter method based on fluorescencereading with SYBR Green. Results: The aqueous extract of the bark of H. madagascariensis and methanolic extracts of P.laxiflora showed the best antiplasmodial activity with IC50 values of 6.16 μg/mL and 7.44 μg/mL, respectively. On the other hand, extracts of M. indica showed a very moderate activitywith IC50 values between 15 μg/mL and 50 μg/mL (5&lt;IC50&lt;50 μg/mL) on the same strains of P.falciparum. Only the aqueous extract of A. djalonensis had IC50 values greater than 50 μg/mL. Thephytochemical analysis showed a strong presence of polyphenols and alkaloids in extracts with acumulative rate of 90.47% and 95.23%, respectively. Conclusion: The results obtained were also justified by the composition of these plants, whichhave several secondary metabolites involved in the treatment of malaria. The antiplasmodialproperties of these plants could partially justify their use in malaria treatment. Further studies onthese extracts are needed to manufacture a stable galenic formulation for the development of animproved traditional medicin

Direct comparison of the histidine-rich protein-2 enzyme-linked immunosorbent assay (HRP-2 ELISA) and malaria SYBR green I fluorescence (MSF) drug sensitivity tests in Plasmodium falciparum reference clones and fresh ex vivo field isolates from Cambodia

BACKGROUND: Performance of the histidine-rich protein-2 enzyme-linked immunosorbent assay (HRP-2 ELISA) and malaria SYBR Green I fluorescence (MSF) drug sensitivity tests were directly compared using Plasmodium falciparum reference strains and fresh ex vivo isolates from Cambodia against a panel of standard anti-malarials. The objective was to determine which of these two common assays is more appropriate for studying drug susceptibility of “immediate ex vivo” (IEV) isolates, analysed without culture adaption, in a region of relatively low malaria transmission. METHODS: Using the HRP-2 and MSF methods, the 50% inhibitory concentration (IC(50)) values against a panel of malaria drugs were determined for P. falciparum reference clones (W2, D6, 3D7 and K1) and 41 IEV clinical isolates from an area of multidrug resistance in Cambodia. Comparison of the IC(50) values from the two methods was made using Wilcoxon matched pair tests and Pearson’s correlation. The lower limit of parasitaemia detection for both methods was determined for reference clones and IEV isolates. Since human white blood cell (WBC) DNA in clinical samples is known to reduce MSF assay sensitivity, SYBR Green I fluorescence linearity of P. falciparum samples spiked with WBCs was evaluated to assess the relative degree to which MSF sensitivity is reduced in clinical samples. RESULTS: IC(50) values correlated well between the HRP-2 and MSF methods when testing either P. falciparum reference clones or IEV isolates against 4-aminoquinolines (chloroquine, piperaquine and quinine) and the quinoline methanol mefloquine (Pearson r = 0.85-0.99 for reference clones and 0.56-0.84 for IEV isolates), whereas a weaker IC(50) value correlation between methods was noted when testing artemisinins against reference clones and lack of correlation when testing IEV isolates. The HRP-2 ELISA produced a higher overall success rate (90% for producing IC(50) best-fit sigmoidal curves), relative to only a 40% success rate for the MSF assay, when evaluating ex vivo Cambodian isolates. Reduced sensitivity of the MSF assay is likely due to an interference of WBCs in clinical samples. CONCLUSIONS: For clinical samples not depleted of WBCs, HRP-2 ELISA is superior to the MSF assay at evaluating fresh P. falciparum field isolates with low parasitaemia (<0.2%) generally observed in Southeast Asia

syk inhibitors interfere with erythrocyte membrane modification during p falciparum growth and suppress parasite egress

Key Points Inhibitors of human Syk kinase suppress parasite egress. Syk inhibitors prevent the tyrosine phosphorylation of band 3 in P falciparum parasitized red blood cells, reducing the release of microparticles

Inhibition of an erythrocyte tyrosine kinase with imatinib prevents Plasmodium falciparum egress and terminates parasitemia

With half of the world's population at risk for malaria infection and with drug resistance on the rise, the search for mutation-resistant therapies has intensified. We report here a therapy for Plasmodium falciparum malaria that acts by inhibiting the phosphorylation of erythrocyte membrane band 3 by an erythrocyte tyrosine kinase. Because tyrosine phosphorylation of band 3 causes a destabilization of the erythrocyte membrane required for parasite egress, inhibition of the erythrocyte tyrosine kinase leads to parasite entrapment and termination of the infection. Moreover, because one of the kinase inhibitors to demonstrate antimalarial activity is imatinib, i.e. an FDA-approved drug authorized for use in children, translation of the therapy into the clinic will be facilitated. At a time when drug resistant strains of P. falciparum are emerging, a strategy that targets a host enzyme that cannot be mutated by the parasite should constitute a therapeutic mechanism that will retard evolution of resistance

Inhibition of an erythrocyte tyrosine kinase with imatinib prevents <i>Plasmodium falciparum</i> egress and terminates parasitemia

With half of the world’s population at risk for malaria infection and with drug resistance on the rise, the search for mutation-resistant therapies has intensified. We report here a therapy for Plasmodium falciparum malaria that acts by inhibiting the phosphorylation of erythrocyte membrane band 3 by an erythrocyte tyrosine kinase. Because tyrosine phosphorylation of band 3 causes a destabilization of the erythrocyte membrane required for parasite egress, inhibition of the erythrocyte tyrosine kinase leads to parasite entrapment and termination of the infection. Moreover, because one of the kinase inhibitors to demonstrate antimalarial activity is imatinib, i.e. an FDA-approved drug authorized for use in children, translation of the therapy into the clinic will be facilitated. At a time when drug resistant strains of P. falciparum are emerging, a strategy that targets a host enzyme that cannot be mutated by the parasite should constitute a therapeutic mechanism that will retard evolution of resistance

Induction of high tolerance to artemisinin by sub-lethal administration: A new in vitro model of P. falciparum

Artemisinin resistance is a major threat to malaria control efforts. Resistance is characterized by an increase in the Plasmodium falciparum parasite clearance half-life following treatment with artemisinin-based combination therapies (ACTs) and an increase in the percentage of surviving parasites. The remarkably short blood half-life of artemisinin derivatives may contribute to drug-resistance, possibly through factors including sub-lethal plasma concentrations and inadequate exposure. Here we selected for a new strain of artemisinin resistant parasites, termed the artemisinin resistant strain 1 (ARS1), by treating P. falciparum Palo Alto (PA) cultures with sub-lethal concentrations of dihydroartemisinin (DHA). The resistance phenotype was maintained for over 1 year through monthly maintenance treatments with low doses of 2.5 nM DHA. There was a moderate increase in the DHA IC50 in ARS1 when compared with parental strain PA after 72 h of drug exposure (from 0.68 nM to 2 nM DHA). In addition, ARS1 survived treatment physiologically relevant DHA concentrations (700 nM) observed in patients. Furthermore, we confirmed a lack of cross-resistance against a panel of antimalarials commonly used as partner drugs in ACTs. Finally, ARS1 did not contain Pfkl3 propeller domain mutations associated with ART resistance in the Greater Mekong Region. With a stable growth rate, ARS1 represents a valuable tool for the development of new antimalarial compounds and studies to further elucidate the mechanisms of ART resistance