Christian Agyare

An ethnopharmacological survey and in vitro confirmation of ethnopharmacological use of medicinal plants used for wound healing in Bosomtwi-Atwima-Kwanwoma area, Ghana.

AIMS OF THE STUDY Wounds represent a major health burden and drain on healthcare resources in the world including Ghana and Africa. The majority of the people of Ghana and Africa still patronize traditional medicine for their health needs including various forms of wounds. The aim of this study is the identification of medicinal plants, type of wounds, dosage forms and collection methods used traditionally in treating wounds in the Bosomtwi-Atwima-Kwanwoma district, Ghana. In vitro screening of selected extracts from these plants on cell physiology of human dermal fibroblasts and keratinocytes was to be performed. MATERIALS AND METHODS Validated questionnaires were administered to 78 traditional healers in 54 communities of the district. Interviews and structured conversations were used to administer the questionnaires. Selected herbal material dominantly used by the healers was collected, identified and aqueous and ethanolic extracts were investigated in vitro on influence on cell physiology of keratinocytes and dermal fibroblasts (MTT-, BrdU-, LDH-assay). Antioxidant activities of ethanolic extracts were determined by free radical scavenging activity. Antiadhesive activity against Helicobacter pylori on human stomach cells was investigated for extracts reported to be used for stomach ulcer treatment. RESULTS The ethnopharmacological survey revealed 104 plants species belonging to 47 families. The detailed use of these plants is documented. Aqueous extracts of Phyllanthus muellerianus, Pycnanthus angolensis and Combretum smeathmanni influenced the mitochondrial activity and proliferation of dermal fibroblasts and keratinocytes significantly. Ethanolic extracts of selected plants exhibited strong antioxidant activities comparable to alpha-tocopherol. For Spathodea campanulata, Hoslundia opposita and Pycnanthus angolensis, which were reported by the healers to be used also for wound healing in case of stomach ulcers, strong antiadhesive activity against Helicobacter pylori was demonstrated, while the extracts did not exhibit any direct cytotoxicity against the bacterium. CONCLUSIONS Traditional use of many wound-healing plants from Ghana can be well rationalized by the in vitro investigation of aqueous extracts. E.g. extracts of Phyllanthus muellerianus, Pycnanthus angolensis and Combretum smeathmanni exhibited significant influence on the cell viability and proliferation of keratinocytes and dermal fibroblasts.

Ellagitannins from Phyllanthus muellerianus (Kuntze) Exell.: Geraniin and furosin stimulate cellular activity, differentiation and collagen synthesis of human skin keratinocytes and dermal fibroblasts.

Leaves from Phyllanthus muellerianus (Kuntze) Exell. are traditionally used for wound healing in Western Africa. Aqueous extracts of dried leaves recently have been shown to stimulate proliferation of human keratinocytes and dermal fibroblasts. Within bioassay-guided fractionation the ellagitannins geraniin (1), corilagin (2), furosin (3), the flavonoids quercetin-3-O-β-D-glucoside (isoquercitrin), kaempferol-3-O-β-D-glucoside (astragalin), quercetin-3-O-D-rutinoside (rutin), gallic acid, methyl gallate, caffeic acid, chlorogenic acid, 3,5-dicaffeoylquinic acid and caffeoylmalic acid (phaselic acid) have been identified in P. muellerianus for the first time. Geraniin was shown to be the dominant component of an aqueous extract. Suitable analytical methods for quality control of geraniin in P. muellerianus extract (methanol/water, 70/30) have been developed and validated based on ICH guidelines (ICH-compliant protocol). Geraniin and furosin increased the cellular energy status of human skin cells (dermal fibroblasts NHDF, HaCaT keratinocytes), triggering the cells towards higher proliferation rates, with fibroblasts being more sensitive than keratinocytes. Highest stimulation of NHDF by geraniin was found at 5 μM, and of keratinocytes at 50-100 μM. Furosin stimulated NHDF at about 50 μM, keratinocytes at about 150-200 μM. Necrotic cytotoxicity of geraniin, as measured by LDH release, was observed at 20 μM for NHDF and 150 μM for keratinocytes. Toxicity of furosin--less than that of geraniin--was observed at > 400 μM. Furosin and geraniin stimulated the biosynthesis of collagen from NHDF at 50 μM and 5-10 μM respectively. Geraniin at 105 μM significantly stimulated the differentiation in NHEK while furosin had a minor influence on the expression of involucrin and cytokeratins K1 and K10. The study proves clearly that hydrophilic extracts from P. muellerianus and especially the lead compound geraniin exhibit stimulating activity on dermal fibroblasts and keratinocytes, leading to increased cell proliferation, barrier formation and formation of extracellular matrix proteins. From these findings the traditional clinical use of such extracts for wound healing seems to be justified.

Antimicrobial, Antioxidant, and Wound Healing Properties of Kigelia africana (Lam.) Beneth. and Strophanthus hispidus DC.

Microbial infections of various types of wounds are a challenge to the treatment of wounds and wound healing. The study was to investigate antimicrobial and antioxidant properties of methanol leaf and stem bark extracts of Kigelia africana and methanol leaf and root extracts of Strophanthus hispidus and also to determine wound healing properties of the extracts. The antimicrobial activities of the methanol extracts were determined against two Gram-positive and two Gram-negative bacteria and a fungus using agar diffusion and micro-dilution methods. The antioxidant activity was determined using 1,1-diphenyl-2-picryl–hydrazyl (DPPH) method. The influence of the extracts on rate of wound closure was investigated using the excision wound model and histopathological investigation of treated and untreated wound tissues performed. The MICs of leaf extract of K. africana against test organisms were 2.5–7.5 mg/mL and stem bark extract were 2.25–7.5 mg/mL. The leaf extract of S. hispidus had MIC range of 2.5–7.5 mg/mL and 2.5–10 mg/mL for root extract. The IC50 of leaf and stem bark extracts of K. africana were 56.9 and 13.7 μg/mL, respectively and leaf and root of S. hispidus were 49.8 and 45.1 μg/mL, respectively. K. africana extracts (7.5% w/w) showed significant (P < 0.05) wound contraction at day 7 with 72% of wound closure whiles significant (P < 0.05) wound contractions were observed on day 11 for stem bark of K. africana, leaf and root extracts of S. hispidus. Wound tissues treated with the extracts showed improved collagenation, re-epitheliazition and rapid granulation formation compared with untreated wound tissues. The extracts were found to contain alkaloids, saponins, tannins, flavonoids, carbohydrates, and sapogenetic glycosides. The HPLC finger-printing of the extracts were developed. The leaf, stem bark and root extracts of K. africana and S. hispidus exhibited antimicrobial, antioxidant, and enhanced wound healing properties and these may justify the medicinal uses of the plants for treatment of microbial infections and wounds.

Review: African medicinal plants with wound healing properties

ETHNOPHARMACOLOGICAL RELEVANCE Wounds of various types including injuries, cuts, pressure, burns, diabetic, gastric and duodenal ulcers continue to have severe socio-economic impact on the cost of health care to patients, family and health care institutions in both developing and developed countries. However, most people in the developing countries, especially Africa, depend on herbal remedies for effective treatment of wounds. Various in vitro and in vivo parameters are used for the evaluation of the functional activity of medicinal plants by using extracts, fractions and isolated compounds. The aim of the review is to identify African medicinal plants with wound healing properties within the last two decades. MATERIALS AND METHODS Electronic databases such as PubMed, Scifinder(®) and Google Scholar were used to search and filter for African medicinal plants with wound healing activity. The methods employed in the evaluation of wound healing activity of these African medicinal plants comprise both in vivo and in vitro models. In vivo wound models such as excision, incision, dead space and burn wound model are commonly employed in assessing the rate of wound closure (contraction), tensile strength or breaking strength determination, antioxidant and antimicrobial activities, hydroxyproline content assay and histological investigations including epithelialisation, collagen synthesis, and granulation tissue formation. In in vitro studies, single cell systems are mostly used to study proliferation and differentiation of dermal fibroblasts and keratinocytes by monitoring typical differentiation markers like collagen and keratin. RESULTS In this study, 61 plants belonging to 36 families with scientifically demonstrated or reported wound healing properties were reviewed. Various plant parts including leaves, fruits, stem bark and root extracts of the plants are used in the evaluation of plants for wound healing activities. CONCLUSION Although, a variety of medicinal plants for wound healing can be found in literature, there is a need for the isolation and characterization of the bioactive compounds responsible for the wound healing properties. Also, cytotoxicity studies should be performed on the promising agents or bioactive fractions or extracts.

Medicinal plants and finished marketed herbal products used in the treatment of malaria in the Ashanti region, Ghana

ETHNOPHARMACOLOGICAL RELEVANCE Ethnobotanical survey was performed to document medicinal plants employed in the management of malaria in the Bosomtwe and Sekyere East Districts of the Ashanti Region (Ghana), in comparison with the plant ingredients in herbal antimalarial remedies registered by the Ghana Food and Drug Administration. MATERIALS AND METHODS Two hundred and three (203) herbalists from 33 communities within the two districts were interviewed on medicinal plants they use to manage malaria. A literature search was made to determine already documented plants. In addition, 23 finished marketed herbal products indicated for the management of malaria were identified and their labels examined to find out which of the plants mentioned in our survey were listed as ingredients and whether these products are in anyway regulated. RESULTS Ninety-eight (98) species of plants were cited for the management of malaria. In comparison with literature citations, 12 (12.2%) species were reported for the management of malaria for the first time and 20 (20.4%) others for the first time in Ghana. Twenty-three (23) finished marketed herbal antimalarial products examined contained aerial or underground parts of 29 of the plants cited in our survey as ingredients. Twenty-two (22) of these products have been registered by the Ghana Food and Drugs Authority, four (4) of which were included in the recommended herbal medicine list for treating malaria in Ghana. CONCLUSION This study provides new additions to the inventory of medicinal plants used for the management of malaria and reports the commercial availability and regulation of finished marketed labelled herbal products intended for the treatment of malaria in Ghana.

Antimicrobial and anti-inflammatory activities of pterygota macrocarpa and cola gigantea (sterculiaceae)

Pterygota macrocarpa and Cola gigantea are African medicinal plants used in traditional medicine for the treatment of sores, skin infections, and other inflammatory conditions including pains. This study therefore aims at investigating the antimicrobial properties of ethanol leaf and stem bark extracts of P. macrocarpa and C. gigantea using the agar diffusion and the micro-dilution techniques and also determining the anti-inflammatory properties of the extracts of these plants in carrageenan-induced foot edema in seven-day old chicks. The minimum inhibitory concentration of both ethanol leaf and bark extracts of P. macrocarpa against the test organisms was from 0.125 to 2.55 mg/mL and that of C. gigantea extracts was 0.125 to 2.75 mg/mL. Extracts with concentration of 50 mg/mL were most active against the test organisms according to the agar diffusion method. All the extracts of P. macrocarpa and C. gigantea at 30, 100, and 300 mg/kg body weight except ethanol leaf extract of C. gigantea exhibited significant anti-inflammatory effects (P ≤ 0.001).

An ethnopharmacological survey and in vitro confirmation of the ethnopharmacological use of medicinal plants as anthelmintic remedies in the Ashanti region, in the central part of Ghana

ETHNOPHARMACOLOGICAL RELEVANCE Infections with helminths are still a big problem in many parts of the world. The majority of the people in West Africa treat such infections with medicinal plants related to the local traditional medicine. The present study aims at identifying medicinal plants traditionally used for worm infections in the Ashanti region, Ghana. In vitro screening of selected extracts from plants on which scientific knowledge is limited was to be performed. MATERIALS AND METHODS Validated questionnaires were administered to 50 traditional healers in the Ashanti region, Ghana. Interviews and structured conversations were used to obtain relevant information. Quantitative and qualitative evaluation was performed additionally to structured cross-referencing of the data using SciFinder(®) data base. Selected plant species were used for in vitro testing on anthelmintic activity against the free-living model nematode Caenorhabditis elegans. RESULTS 35 plant species were recorded for the use in humans and 6 for the use in animals. Plant material most frequently used were the seeds from Carica papaya, mentioned by nearly all healers. The plausibility of most plants used for treatment of infections with helminths was given in most cases by documentation of potential anthelmintic activity in recent scientific literature. 9 species from plants not or scarcely described in literature for this indication were investigated on in vitro activity. A hydroethanolic (1:1) extract of Combretum mucronatum was most active with a survival rate of nematodes of 89% at 0.1mg/mL and 58% at 1mg/mL respectively (levamisole 16%). Extracts of Paullinia pinnata and Phyllanthus urinaria were also assessed to exhibit a minor (85% and 89% respectively at 1mg/mL), but still significant activity. CONCLUSION Traditional use of anthelmintic plants from Ghana can be well rationalized by cross-referencing with published literature and phytochemical/pharmacological plausibility.The in vitro investigations of extracts from Combretum mucronatum, Paullinia pinnata and Phyllanthus urinaria exhibited significant effects against nematodes. The anthelmintic activity of these plants should be investigated in detail for pinpointing the respective lead structures responsible for the activity.

Antimicrobial and anti-inflammatory properties of Funtumia elastica

Context: Funtumia elastica (Preuss) Stapf. (Apocynaceae) has a long ethnopharmacological history for uses such as treatment of whooping cough, asthma, blennorhea, painful menstruation, fungal infections, and wounds. Objective: To investigate the antimicrobial and anti-inflammatory properties of ethanol extracts from the leaves and stem bark of Funtumia elastica based on its ethnopharmacological uses and also determine the secondary metabolites present in the extracts. Materials and methods: The antimicrobial activities of ethanol leaf and bark extracts of F. elastica were determined using the microdilution technique (MIC determination) and agar diffusion method using 10, 25, and 50 mg/mL concentrations against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus subtilis, Candida albicans, Aspergillus flavus and Aspergillus niger as test organisms. Anti-inflammatory activities of the doses of extracts at 30, 100, and 300 mg/kg per body weight were determined by carrageenan-induced edema in the footpad of 7-day-old chicks and the foot volumes measured at hourly interval post-treatment for 5 h. Results: The MIC ranges of both ethanol leaf and bark extracts against the test organisms were 125 (lowest MIC) to1550 µg/mL (highest MIC) and 125 (lowest MIC) to 1750 µg/mL (highest MIC), respectively. The ethanol leaf and bark extract of F. elastica showed significant anti-inflammatory activity (p ≤ 0.001) at 30, 100 and 300 mg/kg. Preliminary phytochemical screening revealed that F. elastica bark contains hydrolysable tannins, sapogenetic glycosides, steroids and saponins while the leaves contain hydrolysable tannins, flavonoids, starch and alkaloids. Tannin contents of the leaf and stem bark were 2.4 and 1.3% w/w (related to the dried material), respectively. Discussion and conclusion: Both ethanol leaf and bark extracts of F. elastica showed antimicrobial and anti-inflammatory activities and these pharmacological properties may be responsible for the ethnomedicinal uses of the leaves and stem bark of the plant.

Anti-inflammatory activity of aqueous leaf extract of Phyllanthus muellerianus (Kuntze) Exell. and its major constituent, geraniin

ETHNOPHARMACOLOGICAL RELEVANCE Phyllanthus muellerianus (Kuntze) Exell. which belongs to the Family Euphorbiaceae is a shrub widely distributed in West Africa. It is used traditionally to manage wounds and wound infections, menstrual disorders, fevers, pain and inflammation. Hence to confirm its ethnobotanical uses in managing inflammation, we investigated the anti-inflammatory properties of aqueous leaf extract of P. muellerianus (PLE) and its major isolate, geraniin in experimentally-induced inflammation in rats. MATERIALS AND METHODS Carrageenan induced oedema and adjuvant induced arthritis models in rats were used in this study. RESULTS In the carrageenan-induced acute inflammation, both 300mg/kg PLE-treated and 10mg/kg geraniin-treated groups significantly reduced the mean maximal swelling attained at 4h to 46.75±4.97% (p<0.01) and 61.65±6.70% (p<0.05), respectively, from the inflamed control response of 122.60±16.39%. In the adjuvant-induced chronic inflammation, both PLE-treated (100 and 300mg/kg) groups and geraniin-treated (10 and 30mg/kg) groups significantly (p<0.001) reduced the total limb swelling over 16 days in the polyarthritic phase compared to the arthritic control. These observations were supported by the radiograph records and the histological investigations of the hind limbs which showed reduced bone damage in both PLE and geraniin-treated rats. CONCLUSION The findings may confirm the ethnobotanical use of PLE in the management of inflammatory disorders or conditions and observed anti-inflammatory property of PLE may largely be due to its major constituent, geraniin.

Evaluation of Antimicrobial and Wound Healing Potential of Justicia flava and Lannea welwitschii

Microbial infections of various types of wounds are a challenge to the treatment of wounds and wound healing. The aim of the study is to determine the antimicrobial, antioxidant, and in vivo wound healing properties of methanol leaf extracts of Justicia flava and Lannea welwitschii. The antimicrobial activity was investigated using agar well diffusion and microdilution methods. The free radical scavenging activity of the methanol leaf extracts was performed using 1,1-diphenyl-2-picryl-hydrazyl (DPPH). The rate of wound contraction was determined using excision model. The test organisms used were Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 4853, Bacillus subtilis NTCC 10073, Staphylococcus aureus ATCC 25923, and clinical strains of Candida albicans. The MICs of methanol leaf extract of J. flava against test organisms were E. coli (7.5 mg/mL); P. aeruginosa (7.5 mg/mL); S. aureus (5 mg/mL); B. subtilis (7.5 mg/mL); and C. albicans (5 mg/mL). The MICs of methanol leaf extract of L. welwitschii against test organisms were E. coli (5 mg/mL); P. aeruginosa (10 mg/mL); S. aureus (5 mg/mL); B. subtilis (2.5 mg/mL); and C. albicans (2.5 mg/mL). The MBC/MFC of the extract was between 10 and 50 mg/mL. The IC50 of the reference antioxidant, α-tocopherol, was 1.5 μg/mL and the methanol leaf extracts of J. flava and L. welwitschii had IC50 of 65.3 μg/mL and 81.8 μg/mL, respectively. The methanol leaf extracts of J. flava and L. welwitschii gave a significant reduction in wound size as compared to the untreated. The rates of wound closure after the application of the extracts (7.5% w/w) were compared to the untreated wounds. On the 9th day, J. flava extract had a percentage wound closure of 99% (P < 0.01) and that of L. welwitschii exhibited wound closure of 95% (P < 0.05) on the 13th day compared to the untreated wounds. The two extracts significantly (P < 0.01) increased the tensile strength of wounds compared to the untreated wounds. The extracts treated wound tissues showed improved angiogenesis, collagenation, and reepithelialization compared to the untreated wound tissues. The preliminary phytochemical screening of J. flava and L. welwitschii leaf extracts revealed the presence of tannins, alkaloids, flavonoids, and glycosides. The above results indicate that methanol leaf extracts of J. flava and L. welwitschii possess antimicrobial and wound healing properties which may justify the traditional uses of J. flava and L. welwitschii in the treatment of wounds and infections.