Traditional application and modern pharmacological research of Artemisia annua L.
Introduction
Artemisia annua L. (A. annua), a plant belonging to the Asteraceae family, grows wild in Asia (mainly China, Japan and Korea) and it was introduced to Poland, Brazil, Spain, France, Italy, Romania, United States and Austria, where it became domesticated (Klayman, 1993). It has been used by Chinese herbalists for the treatment of various diseases since ancient times (Hsu, 2006; Liu, 2017). In 1967, a national research project against malaria was initiated in China. More than 380 herbal extracts were evaluated by Chinese scholar Tu Youyou for their anti-malarial activities and A. annua was found to be the most active herb (Tu, 2011). Then, in 1971, an endoperoxide sesquiterpene lactone named artemisinin was isolated and characterized as the active principle of A. annua against malaria. From then on, as the only commercial source of artemisinin, A. annua gained a widespread attention (de Ridder, van der Kooy, & Verpoorte, 2008).
Nowadays, there are still continuous efforts in delineating the mechanisms of action for anti-malaria activities of A. annua and artemisinin (Ding, Beck, & Raso, 2011; Wang et al., 2015). In the meantime, within the last few decades, A. annua has been investigated for its effects in various diseases, ranging from inflammatory, cancers to viral, bacterial and parasite-related infection (Alesaeidi & Miraj, 2016; Bilia, Santomauro, Sacco, Bergonzi, & Donato, 2014; Efferth, 2017). The extensive biological activities made A. annua a promising therapeutic to be widely used in clinical therapy. The aim of this review was to provide a comprehensive overview on the traditional application and the modern pharmacological research associated with A. annua, providing novel insights of A. annua in the treatment of various diseases.
Section snippets
Traditional application of A. annua
A. annua was first recorded in “52 Sickness Sides (Wu Shi Er Bing Fang)”, a medical prescription excavated in the Mawangdui Han Tombs for the treatment of haemorrhoids. Application of A. annua for the treatment of fever and chills related to malarial was first mentioned by Hong Ge (284–365 CE) in “Handbook of Prescriptions for Emergencies”. Nowadays, A. annua has been officially recognized as a medicinal plant and listed in Chinese Pharmacopeia. As recorded in ancient medical textbooks, A. annua
Malaria parasites (Plasmodium)
Infection with malaria parasites may result in a wide variety of symptoms, ranging from absent or very mild symptoms to severe disease and even death. Malaria is still a leading cause of illness and death in several countries. The World Health Organization (WHO) recommends artemisinin-based combination therapy (ACT) for the treatment of uncomplicated malaria due to Plasmodium falciparum. Nowadays, a number of herbal remedies made of A. annua are available and suggested for the prevention and
Novel components isolated from A. annua and their biological activities
A. annua had been one of the most widely investigated herbs since the isolation of artemisinin in 1972. During the past few decades, phytochemical investigations have demonstrated that sesquiterpenoids, flavonoids, coumarins, triterpenoids and phenolics were the main components existing in A. annua (Bhakuni, Jain, Sharma, & Kumar, 2001). Even though over 600 components were isolated and identified, investigators were still doing their best to fully elucidate the phytochemical profiles of A.
Current developments and limitations of A. annua
As described in this review, A. annua has been proved to possess a variety of pharmacological activities (Fig. 5). Compared with its recommended therapeutic usages recorded in ancient Chinese medical textbooks, there are still several traditional usages are not estimated by modern pharmacological researches, including wounds, dysentery, haemorrhoids, rhinopolyp, tuberculosis, et al. Further investigations are still needed to fully reveal the potential clinical application of A. annua and the
Summary
In summary, extensive in vitro and in vivo data have revealed that A. annua possess excellent anti-malarial effects and multiple other biological activities, including anti-parastic, anti-viral, anti-fungal, anti-bacterial, anti-inflammatory, anti-cancer, anti-adipogenic, anti-osteoporotic, anti-asthmatic, anti-ulcerogenic, anti-nociceptive and immunoregulation, supporting the promising therapeutic application of A. annua in various human diseases. For the next decade, more clinical indications
Declaration of Competing Interest
The authors have no conflict of interest.
Acknowledgment
This work was supported by the Technology Major Project of China “Key New Drug Creation and Manufacturing Program” (2017ZX09301012-001) and the Major State Basic Research Development Program of China (No. 2014CB560706).
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