Topic 9: Infectious Disease and Phytomedicines

Question 1

Human and Microbial Evolution

Answer 1

• humans and microbes evolve in response to each other
• microbial evolution is much faster than human evolution
• human evolution is much more complex than microbial evolution

Question 2

Human Genetic Adaptations That Protect Against Malaria

Answer 2

• 7% of humans = 400 million people
• in at least 25% of these 400 million people the consumption of certain foods, herbs, and medicinal plants enhances the protection against malaria

Question 3

Hematological Adaptations to Plasmodium Parasite that Causes Malaria

Answer 3

• G6PD (glucose 6-phosphate dehydrogenase)
• sickle cell disease
• thalassemias

Question 4

Sickle Cell Disease

Answer 4

• foods, herbs, medicinal plants can influence sickle cell disease in humans
• consumption of certain foods may reduce the risk of Plasmodium falciparum malaria and influence the gene frequency for sickle cell within the population

Question 5

Manihot esculeneta (Overview)

Answer 5

• in Euphorbiaceae
• common name: cassava, manihot
• geography: native to amazon basin, south america
• plant part used: root, leaves
• ethnomedical use: roots and leaves eaten as food and to treat malaria
• active compounds: cyanides and metabolic metabolites thiocyanate and cyanate

Question 6

Manihot esculenta

Answer 6

• cyanide and metabolites thiocyanate and cyanate may directly interact with and adversely effect Plasmodium survival and antigenicity
• low dietary organic cyanogen intakes lead to high regional Hgb S and higher mean prevalence clinical falciparum malaria
• high dietary organic cyanogen intakes lead to lower regional Hgb S and lower mean prevalence of clinical falciparum

Question 7

Anti-malarial Medicines

Answer 7

Cinchona officinalis
C. officinalis, var. calisaya
Cinchona ledgeriana
-plant family: Rubiaceae
-common names: quina, cinchona, calisaya bark, Jesuits; bark, yellow bark, LEdger bark, crown bark, Loxa bark
-geography: native to south america, introduced into africa andasia
-habitat/habit: forest trees, shrubs
-plant parts used: stembark, root
-ethnomedical use: fever

Question 8

Cinchona spp. (Malaria tx)

Answer 8

• active compounds: quinine, quinidine, cinchonidine, cinchonine
• chemical class: alkaloids
• chemical derivatives: chloroquine, mefloquine
• mechanism of action: antiplasmodial
• modern medical use: treatment of malaria

Question 9

Cinchona officinalis and C. ledgeriana

Answer 9

• mechanisms of action: antiplasmodial (quinine, quinidine, cinchonidine, cinchonine) and cardiac antiarrhythmic (quinidine)
• modern medical uses: malaria (quinine, quinidine, cinchonidine, cindhonine), cardiac arrhythmias (quinidine), rheumatoid arthritis (hydroxycholorquine), nocturnal recumbancy leg muscle cramps (quinine sulfate)

Question 10

Artemisia annua

Answer 10

• in Asteraceae
• geography: native china, vietnam
• ethnomedical use: plant leaves tx malaria
• compound: artemisinin
• derivatives of artemisinin: artemether, artesunate
• mechanism of action: antiplasmodial
• leaf extract used to treat malaria for thousands of years in china and vietnam
• molecules isolated from Artemisia annua: artemisinin and artemether

Question 11

Anthelminthic

Answer 11

-anti-intestinal worms
Artemisia maritima, A. cina, Artemisia spp.
-plant family: Asteraceae
-common name: wormseed
-ethnomedical use: anthelminthic
-active component: santonin
-mechanism of action: anthelminthic
-therapeutic use: ascaris worm intestinal infections

Question 12

Vernonia amygdalina

Answer 12

• “bitter leaf”
• leafy green garden vegetable in west africa
• one of hte most common medicinal platns to treat malaria in west africa
• observations of selective consumption by primates
• demonstrate anti-malarial activity

Question 13

Bitter Medicinal Plants/Herbs

Answer 13

• many of the medicinal plants/herbs and plant foods used to treat malaria are bitter to the taste
• bitter medicinal and food plants are commonly used for their anti-microbial qualities
• the greatest diversity of the PTC bitter taste gene exists in sub-Saharan africa where seven different forms have been identified

Question 14

Human Evolutionary Response to Malaria

Answer 14

• genes affecting red blood cell structure (e.g., sickle cell or thalassemia)
• genes affecting bitter taste sensation
• selective ingestion of specific plant foods/herbs/medicines

Question 15

Plasmodium Response to Medicines

Answer 15

• Plasmodium has effectively developed resistance to single molecule medicines (e.g., chloroquine) that have been used to treat malaria
• hypothesis: Plasmodium/microbes have difficulty developing resistance to plant foods and plant medicines that contain a large number of related, but different molecules

Question 16

Human Immunity to Malaria

Answer 16

-infected humans develop antibodies that can provide protection against malaria for up to 5 years

Question 17

Berberis vulgaris, B. aquafolium, B. spp.

Answer 17

• plant family: Berberidaceeae
• common names/geography: barberry in Europe (B. vulgaris) and oregon berry in northwest USA (B. aquafolium)
• habitat: forests, open areas
• plant part used: bark of shrub
• ethnomedical use: dysentery, diarrhea, skin disease
• active compound: berberine

Question 18

Berberis spp. and Berberine

Answer 18

therapeutic uses: 
-of bark extract of B. vulgaris and B. aquafolium and berberine molecule:
bacillary dysentery
Entamoeba histolytica dysentery
Giardia lamblia diarrhea 
cholera
AIDS related diarrhea
-B. aquafolium bark extract
topically tx psoriasis

Question 19

Cinnamomum zeylanicum to Treat Helicopbacter pylori (Associated with Gastritis and Ulcers)

Answer 19

• common name: cinnamon
• origin: asian common spice in cooking
• bark extract takenorally to treat gastritis and stomach and duodenal ulcers by inhibiting the bacterium Helicobacter pylori which is associated with development of ulcers and gastritis

Question 20

Hydrastis canadensis

Answer 20

• in Ranunculaceae
• common name: goldenseal
• geography: eastern north america
• habitat: perennial herb in rich forests
• plant parts used: rhizome, root
• cultural origins: multiple native amereican groups
• active components: rhizome herbal, hyrastine compound
• therapeutic use/mechanism of action: astringent and hemostatic (topical), antiinfective (oral and topical), strengthem mucosal membranes in upper respiratory tract

Question 21

Allium sativum

Answer 21

• in Alliaceae
• common name: garlic
• ethnomedical uses: antimicrobial, antihyperlipidemic, aphrodisiac
• active components: garlic cloves
• therapeutic use/mechanism of action: antimicrobial, antihyperlipidemic

Question 22

Zingiber officinalis (Upper Respiratory Viruses tx)

Answer 22

• common name: ginger
• origin: asia
• rhizome tuber taken orally or as a vapor to treat upper respiratory viruses

Question 23

Sambucus nigra (Upper Respiratory Viruses tx)

Answer 23

• common name: elderberry
• origin: mediterranean region
• fruit and flower extracts taken orally to treat upper respiratory viruses

Question 24

Panax ginseng (Upper Respiratory Viruses tx)

Answer 24

• common name: ginseng
• origin: china, korea
• rhizome extract taken orally to treat upper respiratory viruses

Question 25

Echinacea spp. (Overview)

Answer 25

-in Asteraceae -common names: echinacea, coneflower Echinacea angustifolia (coneflower) E. purpurea (purple coneflower) E. pallida (narrow-leaved coneflower) -geography: glasslands and open fields of great plains of US -plant parts used: roots and/or aerial parts of herb -cultural origins: american indians including sioux, pawnee, blackfoot

Question 26

Echinacea spp. (Uses)

Answer 26

- in Asteraceae - ethnomedical uses: infections, immunostimulant, respiratory infections, intestinal infections, urinary tract infections - mechanisms of action: immunostimulation by increased leukocytes (WBCs), stimulate phagocytosis, increase cytokines in peripheral blood macrophages - therapeutic use: immunostimulant, respiratory infections

Question 27

Astragalus Influence on Immune Cells

Answer 27

- root from china - immune cells lose ability to divide as they age because telomeres become progressively shorter, decreasing disease fighting ability - Astragalus decreases telomere shortening

Question 28

Uncaria tomentosa

Answer 28

- in Rubiaceae - common names: una de gato, cat's claw - geographyL: amazon basin - habitat/habit: rainforest vine - paltn parts used: aerial parts - ethnomedical uses: immunostimulant and viral infections

Question 29

Croton lechleri

Answer 29

-in Euphobiaceae -formulations: SP-303 (crofelemer) SB-300 = standardized extract of bark latex -mechanism of actions: antidiarrhea antisecretory mechanism, antiherpes antiviral mechanism through interfering with replication of herpes virus -human clinical studies: human studies in tx of diarrhea and herpes simplex -modern medical uses: herpes simplex (applied topically)

Question 30

Illicium verum

Answer 30

- common name: star anise - origin: china and vietnam - active compound: tamiflu - tamiflu is synthetic analogue of molecule extracted from Illicium verum - western medical use: taken orally or treat avian influenza

Question 31

Melaleuca alternifolia

Answer 31

- in Myrtaceae tea tree oil - plant family: Myrtaceae - geographical origin: australia - ethnomedical uses: topical antifungal, antivital, and antibacterial

Question 32

Thumus vulgaris

Answer 32

- in Lamiaceae - common name: thyme - geography: mediterranean - habitat/habit: herb in open areas - plant parts used: leaves (thymol is main component) - ethnomedical uses: expectorant, treating lung infections, bronchospasms, fungal infections - therapeutic uses/mechanisms of action: antifungal (topical), antibacterial (oral and topical), expectorant (oral), bronchial antispasmodic (oral)

Question 33

Senna (=Cassia) alata

Answer 33

- plant family: Fabaceae - geographical origins: tropical america - ethnobotanical uses: leaf extract applied topically to treat fungal skin infections

Question 34

Fungal Dermatophytes Keratinous Infections

Answer 34

- pathogens: Trichophyton spp., Microsporum spp., Epidermophytum floccosum - mode of transmission: associate with mior skin trauma and spoor skin hygiene, relateively low rate of person-person contagion except with occasional clustering of humans wtih Tinea capitis - reservoirs: anthropophilic, geophilic, zoophilic - pathophysiology: infect keratinous structures of the body and are usually restricted to stratum corneum layer

Question 35

Insect Repellants

Answer 35

- pyrethrums, pyrethrines, permethrins from Chrusanthemum cinerariifolium from eruope repels mosquitoes and treats head lice - lemon eucalyptus oil from Corymbia (=Eucalyptus) citriodora the lemon-scented gum from Australia repels mosquitoes - neem extract from Azadirachta indica from India repels insects

Question 36

Salycylic Acid from Filipendula ulmaria and Slix alba from Europe

Answer 36

applied topically to treat skin warts caused by papilloma virus and acne caused by bacteria

Question 37

Cantharidin from Lytta vesicatoria (Spanish Fly From Europe)

Answer 37

applied topically to treat papilloma wart virus and molluscum contagiosum skin virus

Question 38

Rhizome Resin and Podophyllotoxin from Podophyllum peltatum from North America

Answer 38

applied topically to treat genital papilloma wards = condylomata acuminata