South African plants used in traditional medicine to treat epilepsy have an antagonistic effect on NMDA receptor currents

In vitro and in vivo anti-seizure activity of hydromethanolic extract and fractions of Pterolobium stellatum

ETHNOPHARMACOLOGICAL RELEVANCE

In Ethiopia, the whole plant juice of Pterolobium stellatum is used to treat seizures and epilepsy.

AIM OF THE STUDY

To investigate the antiseizure activity of hydromethanolic crude extract and fractions collected from leaves of P. stellatum using both in vitro, and in vivo seizure models in mice.

MATERIALS AND METHODS

Fresh leaves of P. stellatum were collected from Awash Melka, Addis Ababa, Ethiopia. An 80% crude methanol extract was further fractionated to produce petroleum ether, chloroform, butanol, and aqueous fractions. Anti-seizure activity of the crude extract and fractions (petroleum ether, chloroform, butanol, and water) were assessed at a concentration of 0.7 mg/ml using the in vitro 0 Mg²⁺ model of seizures in mouse brain slices prepared from 14- to 21-day-old C57BL/6 mice. The maximal electroshock seizure (MES) model and the pentylenetetrazol (PTZ) seizure model for seizures were performed on male BALB/c mice using 400 mg/kg and 800 mg/kg of crude 80% methanol extract, as well as the four fractions described above. Diazepam and phenytoin were used as positive controls for PTZ and MES test respectively.

RESULTS

Addition of 0.7 mg/ml of crude 80% methanol extract of P. stellatum prevented the onset of SLEs in most brain slices in the 0 Mg²⁺in vitro model of seizures, with similar efficacy to diazepam (3 μM). The same extract at 400 and 800 mg/kg was efficacious in reducing the hindlimb extension time in the MES model and delaying the onset of myoclonic convulsions in the PTZ model, although not to the same extent as phenytoin (10 mg/kg) or diazepam (5 mg/kg). The chloroform and water fractions of the crude extract also showed significant anti-seizure activity across all three models whilst the non-polar petroleum ether and butanol fractions did not. The UPLC-MS analysis indicated the presence of gallic acid, ellagic acid, kaempferol, myricitrin, isoquercitrin and quercitirin in the crude extract. Gallic acid and ellagic acid were observed in chloroform fraction and in the water fraction ellagic acid, kaempferol, myricitrin and isoquercitrin were detected.

CONCLUSION

The crude hydromethanolic extract of P. stellatum has significant anti-seizure activity. The chloroform and aqueous fractions have antiseizure activity. The extracts have previously identified compounds with anticonvulsant activity which indicates the antiseizure potential of the plant.

Phytochemical Investigation and Biological Studies on Selected Searsia Species

Searsia is the more recent name for the genus Rhus, which contains over 250 individual species of flowering plants in the family Anacardiaceae. Several Searsia species are used in folk medicine and have been reported to exhibit various biological activities. Although known to exhibit different terpenoids and flavonoids, the chemistry of the Searsia genus is not comprehensively studied due to the structural complexity of the compounds. In this study, the extraction, isolation, and identification of secondary metabolites from three Searsia species (Searsia glauca, S. lucida, and S. laevigata) were conducted using chromatographic and spectroscopic techniques and afforded five known terpenes, viz., moronic acid (1), 21β-hydroxylolean-12-en-3-one (2), lupeol (11), α-amyrin (9), and β-amyrin (10), in addition to six known flavonoids, myricetin-3-O-β-galactopyranoside (3), rutin (4), quercetin (5), apigenin (6), amentoflavone (7), and quercetin-3-O-β-glucoside (8). The structural elucidation of the isolated compounds was determined based on NMR (1D and 2D) and comparison with the data in the literature. Biological assays, such as antioxidant and enzyme inhibition activity assays, were conducted on the plant extracts and the isolated compounds. The antioxidant capacities of hexane, dichloromethane, ethyl acetate, methanol, and butanol main extracts were investigated using ferric ion reducing power (FRAP), oxygen radical absorbance capacity (ORAC), and Trolox equivalent antioxidant capacity (TEAC) assays. The results showed high antioxidant activities for methanol and butanol extracts of the three plants. The isolated compounds were tested against alpha-glucosidase and alpha-amylase, and the results showed the potent activity of moronic acid (C1) (IC₅₀ 10.62 ± 0.89 and 20.08 ± 0.56 µg/mL, respectively) and amentoflavone (C7) (IC₅₀ 5.57 ± 1.12 µg/mL and 19.84 ± 1.33 µg/mL, respectively). Isolated compounds of and biological assays for S. glauca, S. lucida, and S. laevigata are reported for the first time.

Epilepsy research in Africa: A scoping review by the ILAE Pediatric Commission Research Advocacy Task Force

OBJECTIVE

Despite the high prevalence of epilepsy in Africa, evaluation of epilepsy research trends on the continent is lacking. Without establishing effective research, improvement in care for people with epilepsy cannot be effectively strategized or targeted.

METHODS

A scoping review of the peer-reviewed literature on epilepsy from Africa (1989-2019) was conducted. The aim was to understand from this what areas are well researched versus underresearched based on published epilepsy topics.

RESULTS

A total of 1227 publications were identified and assessed. A significant increase in publications occurred over the 30 years assessed. African author leadership was evident in most reports. Nine countries had >50 publications identified; the remaining 45 countries had <50 or no publications. Research studies were typically of lower quality (case series and observational studies). Research themes were more focused on clinical epilepsy (descriptive observational studies) and social aspects (qualitative surveys). However, there were a number of unique and strong themes, specifically for neurocysticercosis and nodding syndrome, where strong research collaborations were evident, basic science understandings were explored, and interventional models were established.

SIGNIFICANCE

Despite Africa being the continent with the most countries, it is lacking in the quantity, quality, and for some areas, relevance of research on epilepsy. Targeted approaches are needed to upskill the strength of research undertaken with more basic science, interventional, and randomized controlled studies. Themes of research need to promote those with unique African content but also to align with current international research areas that have impact on care delivery, such as epilepsy surgery and epilepsy genetics. For this to be possible, it is important to strengthen research hubs with collaborations that empower Africa to own its epilepsy research journey.

Herbal medicine for epilepsy seizures in Asia, Africa and Latin America: A systematic review

RELEVANCE

More than 70 million people suffer epilepsy worldwide. Low availability of anti-epileptic drugs, side-effects and drug-resistant epilepsy affect the quality of life of persons with epilepsy in countries with a poorly developed health system. Herbal medicine is frequently used for this neurological condition.

OBJECTIVES

The main objective was to provide a detailed analysis of Herbal Medicine used for neurological conditions related with epilepsy in Asia, Africa and Latin America. More broadly, this study aims to highlight species with assessed efficacy (cross-cultural use, pharmacological effects on models of epileptic seizures) and safety (toxicological data in laboratory) information, in order to point out species of interest for further studies. A critical assessment of models used in pharmacological evaluations was done.

MATERIALS AND METHODS

The systematic search for Herbal Medicine treatments for epilepsy was performed considering all the articles published until February 2017 through three scientific databases. It was made with MeSH terms and free text defining the epilepsy seizures and plant species. We included studies carried out in Asia, Africa and Latin America. All articles reporting the use of Herbal Medicine to treat epilepsy seizures and/or their pharmacological evaluation were retained for further analysis.

RESULTS

The search yielded 1886 articles, from 30 countries. Hundred and six articles published between 1982 and 2017 were included, corresponding to a total of 497 use reports for 351 plant species belonging to 106 families. Three hundred and seventy seven use reports corresponding to 264 species in ethnopharmacological surveys and 120 evaluation reports corresponding to 107 species were noted. Twenty-nine reports, for 29 species, combined both ethnopharmacological and pharmacological evaluation. Fifty eight studies originated from Africa, 35 studies from Asia and 18 from Latin America. Highest use report was noted for rhizomes of Acorus calamus L. (12 use report in 1 country) and leaves of Bacopa monnieri (L.) Wettst. (8 use report in 2 countries). Therefore these species display the highest use convergence. Regarding pharmacological evaluation most studied species were: Leonotis leonurus (L.) R.Br. (4 evaluation reports in 1 country), Uncaria rhynchophylla (Miq.) Miq. ex Havil. (3 evaluation reports in 2 countries) and Calotropis gigantea (L.) Dryand. (3 evaluation reports in 1 country). In vivo models of chronic epilepsy were more relevant than in vitro models or chemical models inducing acute seizures for pharmacological assessment.

CONCLUSION

Species with the highest use report were not those with pharmacological evaluation. It will be pertinent to assess the pharmacological effects and safety of medicinal plants used mostly by traditional healers on predictive models of seizures.

Exploring Pharmacological Mechanisms of Lavender (Lavandula angustifolia) Essential Oil on Central Nervous System Targets

Lavender essential oil is traditionally used and approved by the European Medicines Agency (EMA) as herbal medicine to relieve stress and anxiety. Some animal and clinical studies reveal positive results in models of anxiety and depression although very little research has been done on molecular mechanisms. Our work consisted of evaluating the effects of lavender (Lavandula angustifolia) essential oil on central nervous system well-established targets, such as MAO-A, SERT, GABA_Aand NMDA receptors as well as in vitro models of neurotoxicity. The results showed that lavender essential oil and its main components exert affinity for the glutamate NMDA-receptor in a dose-dependent manner with an IC₅₀ value of 0.04 μl/mL for lavender oil. In addition, lavender and linalool were also able to bind the serotonin transporter (SERT) whereas they did not show affinity for GABA_A-benzodiazepine receptor. In three different models of neurotoxicity, lavender did not enhance the neurotoxic insult and improved viability of SH-SY5Y cells treated with hydrogen peroxide. According to our data, the anxiolytic and antidepressant-like effects attributed to lavender may be due to an antagonism on the NMDA-receptor and inhibition of SERT. This study suggests that lavender essential oil may exert pharmacological properties via modulating the NMDA receptor, the SERT as well as neurotoxicity induced by hydrogen peroxide.

The importance of botanical treatments in traditional societies and challenges in developing countries

Epilepsy is one of the most common neurological conditions worldwide, with many affected persons found in Asia, Latin America, and sub-Saharan Africa. Relatedly, the large majority found in these regions does not receive the appropriate therapy with antiepileptic drugs (AEDs), stemming from various reasons among which are lack of access to AEDs, social stigma, and negative cultural attitudes. The presence of epilepsy resistant to the available AEDs coupled with the frequent AED side effects has further fueled the widespread and growing use of botanicals as alternative therapy in several traditional societies in these developing countries since people with epilepsy (PWE) consider them as safe and effective. There have, however, been few botanicals that have been examined for their pharmacological activities related to traditional uses, and there is hardly any conclusive evidence regarding their efficacy in humans or knowledge about the exact mechanism(s) of action. This review discusses some botanical treatments that have been used for epilepsy in developing countries and the challenges faced. This article is part of a Special Issue entitled "Botanicals for Epilepsy".

The Potential of Sub-Saharan African Plants in the Management of Human Immunodeficiency Virus Infections: A Review

Acquired immunodeficiency syndrome, caused by human immunodeficiency virus (HIV), is a leading cause of mortality and morbidity in Sub-Saharan Africa, particularly in Southern Africa. Phytomedicines are an integral part of African health care. The Southern African flora is composed of at least 23 400 taxa. Despite this richness, only a handful of botanical products have been assessed for activities against HIV. This study aimed to summarize the potential of Sub-Saharan African plants, based on their composition and the established bioactivities, as sources of agents to manage HIV symptoms and as retroviral therapy. At least 109 plant species from 42 families and 94 genera that are found in Southern Africa were shown to have potential or actual activities against HIV. Only 12 of these plant species from 6 families and 10 genera were shown to harbour anti-HIV properties. Phytochemicals that include β-sitosterols, terpenoids, glycosides, saponins, flavonoids, triterpenoids, tannins and alkaloids, which harbour anti-HIV properties, were found to have a near cosmopolitan presence across the plant families in the region. Bioactivities of multiple phytochemicals are comparable to those for standard allopathic antiretroviral drugs. Research to determine the anti-HIV activities of the identified and other plants, including clinical trials, is long overdue.

Insights from zebrafish and mouse models on the activity and safety of ar-turmerone as a potential drug candidate for the treatment of epilepsy

In a previous study, we uncovered the anticonvulsant properties of turmeric oil and its sesquiterpenoids (ar-turmerone, α-, β-turmerone and α-atlantone) in both zebrafish and mouse models of chemically-induced seizures using pentylenetetrazole (PTZ). In this follow-up study, we aimed at evaluating the anticonvulsant activity of ar-turmerone further. A more in-depth anticonvulsant evaluation of ar-turmerone was therefore carried out in the i.v. PTZ and 6-Hz mouse models. The potential toxic effects of ar-turmerone were evaluated using the beam walking test to assess mouse motor function and balance. In addition, determination of the concentration-time profile of ar-turmerone was carried out for a more extended evaluation of its bioavailability in the mouse brain. Ar-turmerone displayed anticonvulsant properties in both acute seizure models in mice and modulated the expression patterns of two seizure-related genes (c-fos and brain-derived neurotrophic factor [bdnf]) in zebrafish. Importantly, no effects on motor function and balance were observed in mice after treatment with ar-turmerone even after administering a dose 500-fold higher than the effective dose in the 6-Hz model. In addition, quantification of its concentration in mouse brains revealed rapid absorption after i.p. administration, capacity to cross the BBB and long-term brain residence. Hence, our results provide additional information on the anticonvulsant properties of ar-turmerone and support further evaluation towards elucidating its mechanism of action, bioavailability, toxicity and potential clinical application.

Understanding the basic mechanisms underlying seizures in mesial temporal lobe epilepsy and possible therapeutic targets: a review

Despite years of research, epilepsy remains a poorly understood disorder. In the past several years, work has been conducted on a variety of projects with the goal of better understanding the pathogenesis and progression of mesial temporal lobe epilepsy (MTLE), in particular, and how to exploit those properties to generate innovative therapies for treatment of refractory epilepsies. This review seeks to give an overview of common morphological and biochemical changes associated with epilepsy and proposed treatments to address those changes. Furthering the understanding of ictogenesis and epileptogenesis remains an important goal for scientists seeking to find more effective treatments for MTLE.