Abstract
Introduction Multivisceral, neurological, hepatic, and renal damage has been witnessed following the use of artemisinin-based combination therapy (ACT) and herbal medicine. These multiple organ damages make us think of muscle damage. The objective was to study the myotoxicity of the combination of ACTs with medicinal plants. Materials and Methods Muscle cells (RD cells) were brought into contact with preparations of antimalarial drugs and/or antimalarial herbs. The following drugs were used: artesunate 100 mg/amodiaquine 270 mg (ASAQ) and artemether 80 mg/lumefantrine 480 mg (AL); plant Sida acuta (PSA) and plant Enantia polycarpa (PEP) at 10 µg/ml. After 5 days of incubation, the cells were counted by using a hemocytometer with trypan blue solution. Results Artesunate/amodiaquine caused a significant drop in the number of muscle cells, compared to the control, between D2 and D4 (p < 0.001). There was also a significant difference between the control and artemether/lumefantrine between D2 (p < 0.01) and D4 (p < 0.001) and between the control and the Sida acuta plant, on D2 (p < 0.001), D4 (p < 0.001), and D5 (p < 0.05). In tubes treated with ASAQ and Sida acuta, cell mortality was over 30%. Finally, statistically significant cell destruction in the tubes treated with the combination of antimalarial drugs and traditional plants compared to those of the control was observed from D2 (p < 0.001). Conclusion Artemisinin-based combination therapy remains effective and well tolerated. But its combination with medicinal plants induced myotoxic effects. This toxicity would appear to be of the additive type. Further studies should be able to better elucidate the mechanism of this toxicity.
Highlights
Multivisceral, neurological, hepatic, and renal damage has been witnessed following the use of artemisinin-based combination therapy (ACT) and herbal medicine. ese multiple organ damages make us think of muscle damage. e objective was to study the myotoxicity of the combination of ACTs with medicinal plants
Cell Lines. e musculocytes or myocytes used were RD muscle cells from rhabdomyosarcoma. ese muscle cells were obtained from CDC, Atlanta. ey were continuous heteroploid lines, which, due to their rapid growth, were readily available and widely used. e cells were thawed and cultured in T75 culture dishes (75 cm2) on enriched MEM medium. e MEM culture medium is enriched with 10% decomplemented foetal calf serum (FCS), 1% mixture of antibiotics (10 IU/ml of penicillin, 10 mg/ml of streptomycin; Sigma Aldrich), and 1% of L-glutamine (Sigma Aldrich) for cell growth
Products Used. e antimalarial drugs used were artesunate 100 mg/amodiaquine 270 mg (ASAQ) and artemether 80 mg/lumefantrine 480 mg (AL). e antimalarial plant extracts used were Sida acuta (PSA), Malvaceae and Enantia polycarpa (PEP), Annonaceae obtained from the medicinal plant market in Abidjan. eir efficacy had previously been demonstrated [8,9,10]
Summary
Multivisceral, neurological, hepatic, and renal damage has been witnessed following the use of artemisinin-based combination therapy (ACT) and herbal medicine. ese multiple organ damages make us think of muscle damage. e objective was to study the myotoxicity of the combination of ACTs with medicinal plants. Multivisceral, neurological, hepatic, and renal damage has been witnessed following the use of artemisinin-based combination therapy (ACT) and herbal medicine. Statistically significant cell destruction in the tubes treated with the combination of antimalarial drugs and traditional plants compared to those of the control was observed from D2 (p < 0.001). Organization (WHO) recommends the use of therapeutic combinations, especially those based on artemisinin derivatives (ACTs). Nowadays, they are widely used worldwide, mainly in areas of chloroquine resistance and resistance to artemisinin monotherapy [1]. E objective of this study was to assess the toxicity of the combination of ACTs with antimalarial plant extracts on muscle cells In West Africa, the use of traditional medicine and medicinal plants for primary health care is common [7]. e objective of this study was to assess the toxicity of the combination of ACTs with antimalarial plant extracts on muscle cells
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