editorial recent advances towards validating efficacy and safety...

EditorialRecent Advances towards Validating Efficacy and Safety ofAfrican Traditional Medicines

John R. S. Tabuti,1 Imed Eddine Hassen,2 Umar Usman Pateh,3

and Mohamad Fawzi Mahomoodally4

1 Makerere University College of Agricultural and Environmental Sciences, P.O. Box 7062, Kampala, Uganda2 Laboratoire des Methodes et Techniques d’Analyse (LMTA), Institut National de Recherche et d’Analyse Physico-Chimique (INRAP),Biotechpole de Sidi Thabet, 2020 Sidi Thabet, Tunisia

3 Department of Pharmaceutical and Medicinal Chemistry, Faculty of Pharmaceutical Sciences, Ahmadu Bello University,Zaria 1044, Nigeria

4Department of Health Sciences, Faculty of Science, University of Mauritius, 230 Reduit, Mauritius

Correspondence should be addressed to Mohamad Fawzi Mahomoodally; [email protected]

Received 12 December 2013; Accepted 12 December 2013; Published 16 January 2014

Copyright © 2014 John R. S. Tabuti et al. This is an open access article distributed under the Creative Commons AttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properlycited.

Traditional medicine (TM) has a significant role to play inthe African health care system for two main reasons. Thefirst one is the inadequate access to allopathic medicinesand western forms of treatments. The majority of people inAfrica cannot afford access to modern medical care eitherbecause it is too costly or because there are nomedical serviceproviders. Second, there is a lack of effective modernmedicaltreatment for some ailments such as malaria or HIV/AIDS,which, although global in distribution, disproportionatelyaffect Africamore than other areas in the world. It is generallybelieved that African TMs if revisited andmeshedwith recentdevelopments in science could provide substantial benefitsthat could help give a boost to the African health care systemand by doing so alleviate sufferings and livelihood of people.It is also believed that by rediscovering and adding value tothe ancient wisdoms it will also empower people at the grass-root level and help patients as well as scientists find solutionsto mitigate, inter alia, the global impact of diseases.

The last few decades have witnessed a growing numberof documentations concerning materials used in traditionaltreatments in Africa. Nonetheless, there is still a paucity ofclinical evidence to show that TMs are clinically effectiveand can be administered to patients safely. Without thisinformation, users of TMs in Africa and elsewhere remain

skeptical about the value of some therapies. Additionally, thisdenies people the freedom to choose complementary andalternativemedicines that are potentially less costly andmoreaccessible.

Another matter concerning TMs is the need to under-stand the clinical safety of these therapies. It is believed thatthe correctmethod of studying the effectiveness and potentialof TMs should be solely based on scientific principles. Ifthe remedies and practices applied by TMs are efficacious,they should be documented properly and their use should besupported and extended to other fields of practice. On theother hand, if they are found to be clinically ineffective orharmful, their use should be prohibited. One way to establishwhether they are effective or not is to embark on robustrandomized, double-blind controlled clinical studies. To thiseffect, there is an ever-pressing need to apply the principlesof evidence-based medicine to African TMs, particularlyherbal medicines, such that those therapeutic medicinalregimens which prove to be potent and safe become partof conventional medicine and those which fail to meetthis standard become obsolete. For these reasons, updatedinformation about efficacy and safety of TM is urgentlyrequired. Additionally, the documentation of medicinaluses of African plants and traditional systems is becoming

Hindawi Publishing CorporationEvidence-Based Complementary and Alternative MedicineVolume 2014, Article ID 260567, 2 pageshttp://dx.doi.org/10.1155/2014/260567

2 Evidence-Based Complementary and Alternative Medicine

an urgent issue because of the rapid loss of the natural habitatsof some of these plants due to anthropogenic activities andalso due to an erosion of valuable traditional knowledge.

For the present special issue, original research and reviewarticles that discuss aspects of efficacy and safety of AfricanTMs have been considered. In this special issue, recentfindings on evaluations of efficacies of TM from Africafor the management of obesity, stress, antioxidant activities,anticancer properties, and skin pigmentation are collatedin 6 original research articles and an overview of prioritymedicinal plants and fungi in 3 key review articles.

The antiobesity effects of Nitraria retusa ethanol extract(NRE) in 3T3-L1 cells and in high fat diet-induced obesityin mice was studied by F. Z. Kalai et al. It was foundthat NRE administration significantly decreased body weightgain, fat pad weight, serum glucose, and lipid levels in highfat diet-induced obese mice. The mRNA expression resultsshowed an enhancement of the expression of genes relatedto liver metabolism. It was suggested that NRE treatmenthad a protective or controlling effect against a high fat diet-induced obesity in C57B6J/L mice through the regulation ofexpression of genes involved in lipolysis and lipogenesis andthus the enhancement of the lipid metabolism in liver.

M. Ben Othman et al. investigated the antistress prop-erties of Cymbopogon schoenanthus (CSEE), growing wild inthe southern part of Tunisia and used in local folk medicineas diuretic, antispasmodic, rheumatism, anorexia, and diges-tive disorders including food poisoning. They demonstratedthat pretreatment of SH-SY5Y cells with CSEE significantlyinversedH

2O2-induced neurotoxicity.Moreover, CSEE treat-

ments significantly reversed heat shock protein expressionin heat-stressed HSP47-transformed cells andmRNA expres-sion of HSP27 and HSP90 in H

2O2-treated SH-SY5Y. They

concluded that the effect of CSEE on animal behavior wasconcordant with a significant regulation of blood serumcorticosterone and cerebral cortex levels of catecholamine.

The efficacy of treatment of knee osteoarthritis using Sheanut oil (an extract from the indigenous African Vitellariaparadoxa tree) was validated by S.-p. Chen et al. The mainfindings showed significant change between the baselineand post-16-week testing, both in terms of morphologicalchanges andmuscle activity. Pain significantly reduced by the16th week. Indeed, after sufficient dosage and intervention,the effects of Shea nut Oil include decreased inflammation,increased collagen, amelioration of pain, and improved mus-cle function. These results indicate that Shea nut oil extractcan be used as a complementary option to improve thesymptoms and function in relation to knee osteoarthritis.

M. Boulaaba et al. studied the phenolic contents, antiox-idant activities, and anticancer effects of Arthrocnemumindicum, a traditional medicinal halophyte used in the treat-ment of poisonous snakebites and scorpion stings in Tunisia.The antiproliferative effect as compared to the control wascharacterized by substantial total polyphenol content andhigh antioxidant activity. DAPI staining revealed that theseextracts decrease DNA synthesis and reduce the proliferationof Caco-2 cells which are stopped at the G

2/M phase. The

changes in the cell cycle-associated proteins correlate with thechanges in cell cycle distribution. Eight phenolic compounds

were also identified. In conclusion, A. indicum was found topossess interesting antioxidant capacities associated with asignificant anti-proliferative effect explained by a cell cycleblocking at the G

2/M phase.

The melanogenesis regulatory effect of argan oil (Arganiaspinosa) was evaluated by M. O. Villarel et al. using B16murine melanoma cells. The oil treatment was reported tocause MITF phosphorylation which subsequently inhibitedthe transcription of melanogenic enzymes. The inhibitoryeffect of argan on melanin biosynthesis was attributed totocopherols as well as the synergistic effect of its components.The results of this study tend to provide the scientific basisfor the traditionally established benefits of argan oil andpresent its therapeutic potential against hyperpigmentationdisorders.

M.-S. Wu et al. revealed the cytotoxic effect of the flavon-oid fisetin (FIS) on humanCOLO205 colon cancer cells in thepresence and absence of the HSP90 inhibitors, geldanamycin(GA), and radicicol (RAD). A reduction in p53 proteinwith increased ubiquitin-tagged proteins was observed inCOLO205 cells treated with FIS. Furthermore, GA andRAD reduced the stability of the p53 protein in COLO205cells under FIS stimulation. The evidence supports HSP90inhibitors possibly sensitizing human colon cancer cells toFIS-induced apoptosis and treating colon cancer by combin-ing HSP90 inhibitors with FIS deserves further in vivo study.

M. F. Mahomoodally has provided an updated overviewof 10 promising medicinal plants from the African biodiver-sity which have short- as well as long-term potential to bedeveloped as into phytopharmaceuticals to treat and/or man-age a panoply of infectious and chronic conditions. On theirpart H. El Enshasy et al. have summarized currently availableinformation related to the nutritional and medicinal valueof African and Middle Eastern macrofungi and highlightedtheir application in complementary folkmedicine in this partof the world. Lastly, S. Z. Moghadamtousi et al. reviewedinformation and findings concerning current knowledge onthe biological activities, pharmacological properties, toxicity,and chemical constituents of the eastern Nigerian species—Loranthus micranthus, which has been widely used in Nige-ria and South Africa as ethnomedicine for treatment ofhypertension, diabetes, and schizophrenia and as an immunesystem booster.

Within the structure of enhancing the significance ofAfricanTMs, this special issue has highlighted several aspectsrelated to the efficacy and safety of traditional Africantreatments, particularly medicinal plants, with a focus onpromoting rational utilization for better health care. Muchmore research and documentation is still required to achievethis ambitious goal.

John R. S. TabutiImed Eddine HassenUmar Usman Pateh

Mohamad Fawzi Mahomoodally

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