Abstract

BackgroundPlasmodium falciparum malaria is still one of the most deadly pathology worldwide. Efficient treatment is jeopardized by parasite resistance to artemisinin and its derivatives, and by poor access to treatment in endemic regions. Anti-malarial traditional remedies still offer new tracks for identifying promising antiplasmodial molecules, and a way to ensure that all people have access to care. The present study aims to validate the traditional use of Terminalia macroptera, a Malian plant used in traditional medicine.MethodsTerminalia macroptera was collected in Mali. Leaves (TML) and roots ethanolic extracts (TMR) were prepared and tested at 2000 mg/kg for in vivo acute toxicity in Albino Swiss mice. Antiplasmodial activity of the extracts was assessed against a chloroquine resistant strain P. falciparum (FcB1) in vitro. In vivo, anti-malarial efficacy was assessed by a 4-day suppressive test at 100 mg/kg in two malaria murine models of uncomplicated malaria (Plasmodium chabaudi chabaudi infection) and cerebral malaria (Plasmodium berghei strain ANKA infection). Constituents of TMR were characterized by ultra-high-performance liquid chromatography coupled to high resolution mass spectrometry. Top ranked compounds were putatively identified using plant databases and in silico fragmentation pattern.ResultsLethal dose of TML and TMR were greater than 2000 mg/kg in Albino Swiss mice. According to the OECD’s Globally Harmonized System of Classification, both extracts are non-toxic orally. Antiplasmodial activity of T. macroptera extracts was confirmed in vitro against P. falciparum FcB1 strain with IC50 values of 1.2 and 1.6 µg/mL for TML and TMR, respectively. In vivo, oral administration of TML and TMR induced significant reduction of parasitaemia (37.2 and 46.4% respectively) in P. chabaudi chabaudi infected mice at the 7th day of infection compared to untreated mice. In the cerebral malaria experimental model, mice treated with TMR and TML presented respectively 50 and 66.7% survival rates at day 9 post-infection when all untreated mice died. Eleven major compounds were found in TMR. Among them, several molecules already known could be responsible for the antiplasmodial activity of the roots extract of T. macroptera.ConclusionsThis study confirms both safety and anti-malarial activity of T. macroptera, thus validating its traditional use.

Highlights

  • Plasmodium falciparum malaria is still one of the most deadly pathology worldwide

  • Plasmodium falciparum has become resistant to almost all available anti-malarial drugs in Southeast Asia [3], and an isolate originating from Equatorial Guinea has been recently found resistant to artemisinin [4]

  • According to the Organization for Economic Cooperation and Development (OECD)’s Globally Harmonized System of Classification [22], the fractions can be classified as category 5 and considered non-toxic orally

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Summary

Introduction

Plasmodium falciparum malaria is still one of the most deadly pathology worldwide. Efficient treatment is jeopardized by parasite resistance to artemisinin and its derivatives, and by poor access to treatment in endemic regions. Malaria is still one of the most deadly pathology worldwide with 429,000 deaths reported in 2015 [1]. Despite a recent decrease in malaria mortality due to extensive malaria control through insecticide-impregnated bed nets and increased use of artemisinin derivatives, the state of artemisinin resistance is highly worrying [2]. Plasmodium falciparum has become resistant to almost all available anti-malarial drugs in Southeast Asia [3], and an isolate originating from Equatorial Guinea has been recently found resistant to artemisinin [4]. New effective molecules are urgently needed to combat this pathology

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