Antimalarial Properties of Aqueous Crude Extracts ofGynostemma pentaphyllumandMoringa oleiferaLeaves in Combination with Artesunate inPlasmodium berghei-Infected Mice

Abstract

Due to the emergence and spread of malaria parasite with resistance to antimalarial drugs, discovery and development of new, safe, and affordable antimalarial are urgently needed. In this respect, medicinal plant extracts are targets to optimize antimalarial actions and restore efficacy of standard antimalarial drugs. The present study was aimed at determining the antimalarial activities of Gynostemma pentaphyllum and Moringa oleifera leaf extracts in combination with artesunate against Plasmodium berghei-infected mice. P. berghei ANKA maintained by serial passage in ICR mice were used based on intraperitoneal injection of 1 × 107 parasitized erythrocytes and subsequent development of parasitemia. These infected mice were used to investigate the antimalarial activity of artesunate (6 mg/kg) in combination with 500, 1,000, and 2,000 mg/kg of G. pentaphyllum and M. oleifera leaf extracts using 4-day suppressive test. It was found that these extracts showed significant (P < 0.05) antimalarial activity in dose-dependent manner with percentage of suppression of 45, 50, and 55% for G. pentaphyllum leaf extract and 35, 40, and 50% for M. oleifera leaf extract. Additionally, artesunate combined with these extracts presented higher antimalarial activity, compared to extract treated alone with percentage of suppression of 78, 91, and 96% for G. pentaphyllum leaf extract and 73, 82, and 91% for M. oleifera leaf extract. The results indicated that combination treatment of G. pentaphyllum or M. oleifera leaf extracts with artesunate was able to increase the antimalarial activity by using low dose of artesunate. Hence, these results justified the combination of these extracts and artesunate in antimalarial herbal remedies.

A systematic review of pharmacological activities and safety ofMoringa oleifera

“…M. oleifera in combination with other plants has been actively used as antimalarial in many parts of Africa and Asia (2,24). For instance, M. oleifera and Gynostemma pentaphyllum leaf extracts were combined with Artesunate in mice infected with Plasmodium berghei and adjudged effective in the treatment of malaria (135). The infected mice were subjected to artesunate treatment (6 mg/kg) in combination with M. oleifera and G. pentaphyllum using standard doses.…”

Antiplasmodial activity of Ethanolic extract of Cassia spectabilis DC leaf and its inhibition effect in Heme detoxification

“…The advantage of the combination therapy was to increase the effectiveness of extract to prevent or slow the onset of resistance to a single antimalarial drug [ 29 ]. Selection of 90% ethanolic extract of C. spectabilis DC leaf combination with artesunate referred to the basis of malaria treatment which is a standard antimalarial drug recommended by WHO [ 30 ].…”

Potensi Kombinasi Ekstrak Daun Kelor (Moringa oliefera) dan Artemisia (Artemisia annua) Sebagai Antimalaria Plasmodium falciparum

“…Kondisi resistensi obat serta kondisi lingkungan yang mempengaruhi prevalensi di suatu daerah membuat banyak peneliti mulai mencari alternatif obat malaria terutama dari tanaman (Tajuddeen & Herdeen, 2019). Penelitian menyatakan beberapa tanaman dapat meningkatkan kinerja artemisia sebagai antimalarial (Somsak et al, 2016). Oleh karena itu, penulis tertarik untuk meninjau kajian pustaka terkait kombinasi alternatif tanaman artemisia dengan tanaman lain yang berpotensi menjadi alternatif antimalarial dalam menghambat Plasmodium falciparum seperti daun kelor.…”

“…Keterangan: Kelompok Positif : Terinfeksi Plasmodium berghei tanpa diberi pengobatan Artemisin : Terinfeksi Plasmodium berghei serta hanya diberikan Artemisia dosis0, 12 mg/hari DK1 : Terinfeksi Plasmodium berghei + kombinasi artemisia dosis 0,12 mg/hari + ekstrak daun kelor 3,75 mg/hari DK2 : Terinfeksi Plasmodium berghei + kombinasi artemisia dosis 0,12 mg/hari + ekstrak daun kelor 7,5 mg/hari DK3 : Terinfeksi Plasmodium berghei + kombinasi artemisia dosis 0,12 mg/hari + ekstrak daun kelor 15 mg/hari Penelitian oleh Somsak et al pada tahun 2016 juga menyatakan bahwa kombinasi daun kelor dan artemisia dapat menurunkan jumlah Plasmodium berghei pada tikus yang terinfeksi sebesar 91%. Jumlah ini lebih tinggi jika dibandingkan dengan pemberian artesunat saja dengan penurunan plasmodium sebesar 50% (Somsak et al, 2016). Ekstrak daun kelor pada kombinasi daun kelor dengan artemisia dapat memaksimalkan kinerja artemisin.…”