Action in vivo de la poudre de parties aériennes d’Artemisia annua sur la Malaria (Modèle animal)

2012

Mostafa A. Elfawal, Melissa J. Towler, Nicholas G. Reich, Douglas Golenbock, Pamela J. Weathers, Stephen M. Rich
Dried Whole Plant Artemisia annua as an Antimalarial Therapy

Dried Whole Plant Artemisia annua as an Antimalarial Therapy

Abstract : Drugs are primary weapons for reducing malaria in human populations. However emergence of resistant parasites has repeatedly curtailed the lifespan of each drug that is developed and deployed. Currently the most effective anti-malarial is artemisinin, which is extracted from the leaves of Artemisia annua. Due to poor pharmacokinetic properties and prudent efforts to curtail resistance to monotherapies, artemisinin is prescribed only in combination with other anti-malarials composing an Artemisinin Combination Therapy (ACT). Low yield in the plant, and the added cost of secondary anti-malarials in the ACT, make artemisinin costly for the developing world. As an alternative, we compared the efficacy of oral delivery of the dried leaves of whole plant (WP) A. annua to a comparable dose of pure artemisinin in a rodent malaria model (Plasmodium chabaudi). We found that a single dose of WP (containing 24 mg/kg artemisinin) reduces parasitemia more effectively than a comparable dose of purified drug. This increased efficacy may result from a documented 40-fold increase in the bioavailability of artemisinin in the blood of mice fed the whole plant, in comparison to those administered synthetic drug. Synergistic benefits may derive from the presence of other anti-malarial compounds in A. annua. If shown to be clinically efficacious, well-tolerated, and compatible with the public health imperative of forestalling evolution of drug resistance, inexpensive, locally grown and processed A. annua might prove to be an effective addition to the global effort to reduce malaria morbidity and mortality.

2014

Mostafa A. Elfawa, Melissa J. Towler, , Nicholas G. Reich, Pamela J. Weathers, and Stephen M. Rich
Dried whole-plant Artemisia annua slows evolution of malaria drug resistance and overcomes resistance to artemisinin
Proceedings of the National Academy of Sciences of the United States of America (PNAS), January 20, 2015 ; vol. 112, no. 3

Dried whole-plant Artemisia annua slows evolution of malaria drug resistance and overcomes resistance to artemisinin

Abstract

Pharmaceutical monotherapies against human malaria have proven effective, although ephemeral, owing to the inevitable evolution of resistant parasites. Resistance to two or more drugs delivered in combination will evolve more slowly ; hence combination therapies have become the preferred norm in the fight against malaria. At the forefront of these efforts has been the promotion of Artemisinin Combination Therapy, but despite these efforts, resistance to artemisinin has begun to emerge. In 2012, we demonstrated the efficacy of the whole plant (WP)—not a tea, not an infusion—as a malaria therapy and found it to be more effective than a comparable dose of pure artemisinin in a rodent malaria model. Here we show that WP overcomes existing resistance to pure artemisinin in the rodent malaria Plasmodium yoelii. Moreover, in a long-term artificial selection for resistance in Plasmodium chabaudi, we tested resilience of WP against drug resistance in comparison with pure artemisinin (AN). Stable resistance to WP was achieved three times more slowly than stable resistance to AN. WP treatment proved even more resilient than the double dose of AN. The resilience of WP may be attributable to the evolutionary refinement of the plant’s secondary metabolic products into a redundant, multicomponent defense system. Efficacy and resilience of WP treatment against rodent malaria provides compelling reasons to further explore the role of nonpharmaceutical forms of AN to treat human malaria.

Key words : malaria | drug resistance | artemisinin | Plasmodium | evolution

Action in vivo de la poudre de parties aériennes d’Artemisia annua sur la Malaria chez l’humain

2016

Pierre Lutgen
In Vivo Trials on The Therapeutic Effects of Encapsulated Artemisia annua and Artemisia afra.
Global Journal For Research Analysis, Peer Review, International Journal, Volume-5, Issue-6, June 2016

In Vivo Trials on The Therapeutic Effects of Encapsulated Artemisia annua and Artemisia afra

Abstract : This trial took place in the province of Katanga in the RDCongo and was handled in two parts 1. 82 volunteers suffering from malaria were treated during 7 days with capsules containing powdered leaves of Artemisia annua from Luxembourg (AAL) or from Burundi (AAB) and Artemisia afra (AAF). Total dose for AAL was 15 gr, for AAB 7.5 gr and for AAF 7.5 gr. Despite these low doses all patients were free of fever after 2 days and 85% were free of parasites after 7 days for AAL, 76% for AAB and 40% for AAF. 2. 44 volunteers carrying trophozoites were treated with capsules containing Artemisia afra leaf powder from Burundi. The total dose of Artemisia afra powder administered over 10 days was 20.gr. In order to better understand the prophylactic and therapeutic effect of Artemisia herbal medicine on malaria infection it is important to assess the CD4 count and gametocyte carriage before and after treatment. It was found that on day 10 the CD4 count had on the average increased by 20% and the trophozoite carriage was reduced to zero except in a few rare cases

2017

Nsengiyumva Bati Daddy , Luc Malemo Kalisya , Pascal Gisenya Bagire, Robert L. Watt, Melissa J. Towler, Pamela J. Weathers,
.Artemisia annua dried leaf tablets treated malaria resistant to ACT and i.v. artesunate : case reports
Phytomedicine : international journal of phytotherapy and phytopharmacology 32 · April 2017

Artemisia annua dried leaf tablets treated malaria resistant to ACT and i.v. artesunate : case reports

Abstract

Background : Dried leaf Artemisia annua (DLA) has shown efficacy against Plasmodium sp. in rodent studies and in small clinical trials. Rodent malaria also showed resiliency against the evolution of artemisinin drug resistance.
Purpose : This is a case report of a last resort treatment of patients with severe malaria who were responding neither to artemisinin combination therapy (ACT) nor i.v. artesunate. Study Design Of many patients treated with ACTs and i.v. artesunate during the 6 mon study period, 18 did not respond and were subsequently treated with DLA Artemisia annua.

Methods : Patients were given a dose of 0.5 g DLA per os, twice daily for 5d. Total adult delivered dose of artemisinin was 55 mg. Dose was reduced for body weight under 30 kg. Clinical symptoms, e.g. fever, coma etc., and parasite levels in thick blood smears were tracked. Patients were declared cured and released from hospital when parasites were microscopically undetectable and clinical symptoms fully subsided.

Results : All patients were previously treated with Coartem® provided through Santé Rurale (SANRU) and following the regimen prescribed by WHO. of 18 ACT-resistant severe malaria casescompassionately treated with DLA, all fully recovered. Of the 18, this report details two pediatric cases.
Conclusions : Successful treatment of all 18 ACT-resistant cases suggests that DLA should be rapidly incorporated into the antimalarial regimen for Africa and possibly wherever else ACT resistance has emerged.

Keywords : Artemisinin drug resistance, Artemisia annua, Coartem, ACT, Dihydroartemisinin, Synergism