<i>Artemisia</i> spp.: An Update on Its Chemical Composition, Pharmacological and Toxicological Profiles

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Abstract

Artemisia plants are traditional and ethnopharmacologically used to treat several diseases and in addition in food, spices, and beverages. The genus is widely distributed in all continents except the Antarctica, and traditional medicine has been used as antimalarial, antioxidant, anticancer, antinociceptive, anti-inflammatory, and antiviral agents. This review is aimed at systematizing scientific data on the geographical distribution, chemical composition, and pharmacological and toxicological profiles of the Artemisia genus. Data from the literature on Artemisia plants were taken using electronic databases such as PubMed/MEDLINE, Scopus, and Web of Science. Selected papers for this updated study included data about phytochemicals, preclinical pharmacological experimental studies with molecular mechanisms included, clinical studies, and toxicological and safety data. In addition, ancient texts and books were consulted. The essential oils and phytochemicals of the Artemisia genus have reported important biological activities, among them the artemisinin, a sesquiterpene lactone, with antimalarial activity. Artemisia absinthium L. is one of the most famous Artemisia spp. due to its use in the production of the absinthe drink which is restricted in most countries because of neurotoxicity. The analyzed studies confirmed that Artemisia plants have many traditional and pharmacological applications. However, scientific data are limited to clinical and toxicological research. Therefore, further research is needed on these aspects to understand the full therapeutic potential and molecular pharmacological mechanisms of this medicinal species.

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World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19)

Catrin Sohrabi, Zaid Alsafi, Niamh O'Neill … (2020)

An unprecedented outbreak of pneumonia of unknown aetiology in Wuhan City, Hubei province in China emerged in December 2019. A novel coronavirus was identified as the causative agent and was subsequently termed COVID-19 by the World Health Organization (WHO). Considered a relative of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), COVID-19 is caused by a betacoronavirus named SARS-CoV-2 that affects the lower respiratory tract and manifests as pneumonia in humans. Despite rigorous global containment and quarantine efforts, the incidence of COVID-19 continues to rise, with 90,870 laboratory-confirmed cases and over 3,000 deaths worldwide. In response to this global outbreak, we summarise the current state of knowledge surrounding COVID-19.

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Changes in health workers' malaria diagnosis and treatment practices in Kenya

Elizabeth Juma, Dejan Zurovac (2011)

Background Change of Kenyan treatment policy for uncomplicated malaria from sulphadoxine-pyrimethamine to artemether-lumefantrine (AL) was accompanied by revised recommendations promoting presumptive malaria diagnosis in young children and, wherever possible, parasitological diagnosis and adherence to test results in older children and adults. Three years after the policy implementation, health workers' adherence to malaria diagnosis and treatment recommendations was evaluated. Methods A national cross-sectional, cluster sample survey was undertaken at public health facilities. Data were collected using quality-of-care assessment methods. Analysis was restricted to facilities with AL in stock. Main outcomes were diagnosis and treatment practices for febrile outpatients stratified by age, availability of diagnostics, use of malaria diagnostic tests, and test result. Results The analysis included 1,096 febrile patients (567 aged <5 years and 529 aged ≥5 years) at 88 facilities with malaria diagnostics, and 880 febrile patients (407 aged <5 years and 473 aged ≥5 years) at 71 facilities without malaria diagnostic capacity. At all facilities, 19.8% of young children and 28.7% of patients aged ≥5 years were tested, while at facilities with diagnostics, 33.5% and 53.7% were respectively tested in each age group. Overall, AL was prescribed for 63.6% of children aged <5 years and for 65.0% of patients aged ≥5 years, while amodiaquine or sulphadoxine-pyrimethamine monotherapies were prescribed for only 2.0% of children and 3.9% of older children and adults. In children aged <5 years, AL was prescribed for 74.7% of test positive, 40.4% of test negative and 60.7% of patients without test performed. In patients aged ≥5 years, AL was prescribed for 86.7% of test positive, 32.8% of test negative and 58.0% of patients without test performed. At least one anti-malarial treatment was prescribed for 56.6% of children and 50.4% of patients aged ≥5 years with a negative test result. Conclusions Overall, malaria testing rates were low and, despite different age-specific recommendations, only moderate differences in testing rates between the two age groups were observed at facilities with available diagnostics. In both age groups, AL use prevailed, and prior ineffective anti-malarial treatments were nearly non-existent. The large majority of test positive patients were treated with recommended AL; however, anti-malarial treatments for test negative patients were widespread, with AL being the dominant choice. Recent change of diagnostic policy to universal testing in Kenya is an opportunity to improve upon the quality of malaria case management. This will be, however, dependent upon the delivery of a comprehensive case management package including large scale deployment of diagnostics, good quality of training, post-training follow-up, structured supervisory visits, and more intense monitoring.

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Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial

Arjen M. Dondorp, Caterina I Fanello, Ilse CE Hendriksen … (2010)

Summary Background Severe malaria is a major cause of childhood death and often the main reason for paediatric hospital admission in sub-Saharan Africa. Quinine is still the established treatment of choice, although evidence from Asia suggests that artesunate is associated with a lower mortality. We compared parenteral treatment with either artesunate or quinine in African children with severe malaria. Methods This open-label, randomised trial was undertaken in 11 centres in nine African countries. Children (<15 years) with severe falciparum malaria were randomly assigned to parenteral artesunate or parenteral quinine. Randomisation was in blocks of 20, with study numbers corresponding to treatment allocations kept inside opaque sealed paper envelopes. The trial was open label at each site, and none of the investigators or trialists, apart from for the trial statistician, had access to the summaries of treatment allocations. The primary outcome measure was in-hospital mortality, analysed by intention to treat. This trial is registered, number ISRCTN50258054. Findings 5425 children were enrolled; 2712 were assigned to artesunate and 2713 to quinine. All patients were analysed for the primary outcome. 230 (8·5%) patients assigned to artesunate treatment died compared with 297 (10·9%) assigned to quinine treatment (odds ratio [OR] stratified for study site 0·75, 95% CI 0·63–0·90; relative reduction 22·5%, 95% CI 8·1–36·9; p=0·0022). Incidence of neurological sequelae did not differ significantly between groups, but the development of coma (65/1832 [3·5%] with artesunate vs 91/1768 [5·1%] with quinine; OR 0·69 95% CI 0·49–0·95; p=0·0231), convulsions (224/2712 [8·3%] vs 273/2713 [10·1%]; OR 0·80, 0·66–0·97; p=0·0199), and deterioration of the coma score (166/2712 [6·1%] vs 208/2713 [7·7%]; OR 0·78, 0·64–0·97; p=0·0245) were all significantly less frequent in artesunate recipients than in quinine recipients. Post-treatment hypoglycaemia was also less frequent in patients assigned to artesunate than in those assigned to quinine (48/2712 [1·8%] vs 75/2713 [2·8%]; OR 0·63, 0·43–0·91; p=0·0134). Artesunate was well tolerated, with no serious drug-related adverse effects. Interpretation Artesunate substantially reduces mortality in African children with severe malaria. These data, together with a meta-analysis of all trials comparing artesunate and quinine, strongly suggest that parenteral artesunate should replace quinine as the treatment of choice for severe falciparum malaria worldwide. Funding The Wellcome Trust.

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Author and article information

Contributors

Javad Sharifi-Rad:

ORCID: https://orcid.org/0000-0002-7301-8151

Natallia Lapava:

ORCID: https://orcid.org/0000-0003-1924-717X

Miquel Martorell:

ORCID: https://orcid.org/0000-0003-3183-7623

Daniela Calina:

ORCID: https://orcid.org/0000-0002-1523-9116

William C. Cho:

ORCID: https://orcid.org/0000-0003-4174-4586

Journal

Journal ID (nlm-ta): Oxid Med Cell Longev

Journal ID (iso-abbrev): Oxid Med Cell Longev

Journal ID (publisher-id): OMCL

Title: Oxidative Medicine and Cellular Longevity

Publisher: Hindawi

ISSN (Print): 1942-0900

ISSN (Electronic): 1942-0994

Publication date Collection: 2022

Publication date (Electronic): 5 September 2022

Volume: 2022

Electronic Location Identifier: 5628601

Affiliations

¹Facultad de Medicina, Universidad del Azuay, Cuenca, Ecuador

²Departamento de Ciencias Básicas, Facultad de Ciencias, Universidad Santo Tomas, Chile

³Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus, Universidad de La Frontera, Temuco 4811230, Chile

⁴Department of Life Sciences, Graphic Era Deemed To Be University, Dehradun, 248002, Uttarakhand, India

⁵Uttarakhand Council for Biotechnology (UCB), Prem Nagar, Dehradun, 248007 Uttarakhand, India

⁶Department of Biotechnology, School of Applied and Life Sciences, Uttaranchal University, Prem Nagar, Dehradun, 248007, Uttarakhand, India

⁷Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt

⁸Department of Pharmacognosy, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza 12451, Egypt

⁹Department of Phytochemistry and Plant Systematics, National Research Centre, 33 El Bohouth St., Dokki, P. O. 12622, Giza, Egypt

¹⁰Pharmacognosy Department, Pharmaceutical and Drug Industries Research Institute, National Research Centre (NRC), 33 El-Bohouth street, Dokki, Giza, Egypt

¹¹Department of Biochemistry, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza 12451, Egypt

¹²Department of Pharmacognosy, Faculty of Pharmacy, Menoufia University, Gamal Abd El Nasr St., Shibin El Kom, 32511 Menoufia, Egypt

¹³Molecular and Applied Mycology and Plant Pathology Laboratory, Department of Botany, University of Calcutta, Kolkata 700019, India

¹⁴Department of Botany, Fakir Chand College, Diamond Harbour, West Bengal 743331, India

¹⁵Medicine Standardization Department, Vitebsk State Medical University, Belarus

¹⁶Department of Nutrition and Dietetics, Faculty of Pharmacy, And Centre for Healthy Living, University of Concepción, Concepción, Chile

¹⁷Universidad de Concepción, Unidad de Desarrollo Tecnológico (UDT), 4070386 Concepción, Chile

¹⁸Department of Biodiversity of Bioresources, Al-Farabi Kazakh National University, Almaty, Kazakhstan

¹⁹Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania

²⁰Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong

Author notes

Academic Editor: Muhammad Saleem Kalhoro

Author information

Javad Sharifi-Rad https://orcid.org/0000-0002-7301-8151

Jesús Herrera-Bravo https://orcid.org/0000-0003-0739-7920

Prabhakar Semwal https://orcid.org/0000-0001-5137-5169

Shahira M. Ezzat https://orcid.org/0000-0003-2232-7357

Natallia Lapava https://orcid.org/0000-0003-1924-717X

Miquel Martorell https://orcid.org/0000-0003-3183-7623

Daniela Calina https://orcid.org/0000-0002-1523-9116

William C. Cho https://orcid.org/0000-0003-4174-4586

Article

DOI: 10.1155/2022/5628601

PMC ID: 9467740

SO-VID: b0c8e1e6-4c6d-4282-8fcc-58158d7828c9

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 27 June 2022

Date revision received : 7 August 2022

Date accepted : 12 August 2022

Funding

Funded by: ANID Centros Basales

Award ID: ACE210012

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Artemisia spp.: An Update on Its Chemical Composition, Pharmacological and Toxicological Profiles

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Network and Systems Medicine

Most cited references 229

World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19)

Changes in health workers' malaria diagnosis and treatment practices in Kenya

Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial

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