burtlancast
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- Jan 1, 2013
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Interestingly in malaria as well the dried leaf extract remains effective when there is resistance to artesunate. Compounds in the dried leaf extract seem to help absorption of artemisinin.
Artemisia annua dried leaf tablets treated malaria resistant to ACT and i.v. artesunate: Case reports. - PubMed - NCBI
Daddy NB1, Kalisya LM2, Bagire PG3, Watt RL4, Towler MJ5, Weathers PJ6.
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 0.5g DLA per os, twice daily for 5d. Total adult delivered dose of artemisinin was 55mg. Dose was reduced for body weight under 30kg. 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 cases compassionately 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.
Artemisinin permeability via Caco-2 cells increases after simulated digestion of Artemisia annua leaves. - PubMed - NCBI
ETHNOPHARMACOLOGICAL RELEVANCE:
Artemisia annua has been used for > 2000yrs to treat fever and is more recently known for producing the important antimalarial drug, artemisinin.
AIM OF THE STUDY:
Artemisinin combination therapies (ACTs) are effective for treating malaria, but are often unavailable to those in need. Dried leaves of A. annua (DLA) have recently been studied as a cost effective alternative to traditional ACTs. DLA was shown to dramatically increase oral bioavailability compared to pure artemisinin, so more investigation into the mechanisms causing this increased bioavailability is needed.
MATERIALS AND METHODS:
In this study, we used a simulated digestion system coupled with Caco-2 cell permeability assays to investigate the intestinal permeability of DLA compared to pure artemisinin. We also determined the effects of different phytochemicals (7 flavonoids, 3 monoterpenes, 2 phenolic acids, scopoletin and inulin) and the cytochrome P450 isoform CYP3A4 on artemisinin intestinal permeability.
RESULTS:
Artemisinin permeability, when delivered as digested DLA, significantly increased by 37% (Papp = 8.03 × 10-5cms-1) compared to pure artemisinin (Papp = 5.03 × 10-5cms-1). However, none of the phytochemicals tested or CYP3A4 had any significant effect on the intestinal permeability of artemisinin. We also showed that essential oil derived from A. annua negatively affected the intestinal permeability of artemisinin, but only after simulated digestion. Finally, we showed that A. annua essential oil reduced the transepithelial electrical resistance of Caco-2 monolayers, but only in the presence of bile. Although also reduced by essential oils, artemisinin Papp subsequently recovered in the presence of plant matrix.
CONCLUSIONS:
These results shed light on the mechanisms by which DLA enhances the oral bioavailability of artemisinin.
These are truly dramatic recent studies, since it demonstrates thousands of people unnecessarily died from malaria resistant to artemisinin combination therapy.
The original chinese discoverers claimed the tea was too weak for malaria treatment, but conveniently forgot to test the dried leaf extract ( how is that even possible?).
Let's see if the establishment dares to follow this breakthrough and recommends the whole plant.
Once any substance is recognized safe and effective for treatment of a disease, it automatically makes it legally available for off label treatment, to the discretion of any physician willing to use it.
Should we hold our breath?