African herbal medicines in the treatment of HIV: Hypoxis and Sutherlandia. An overview of evidence and pharmacology
Tóm tắt
In Africa, herbal medicines are often used as primary treatment for HIV/AIDS and for HIV-related problems. In general, traditional medicines are not well researched, and are poorly regulated. We review the evidence and safety concerns related to the use of two specific African herbals, which are currently recommended by the Ministry of Health in South Africa and member states for use in HIV: African Potato and Sutherlandia. We review the pharmacology, toxicology and pharmacokinetics of these herbal medicines. Despite the popularity of their use and the support of Ministries of Health and NGOs in some African countries, no clinical trials of efficacy exist, and low-level evidence of harm identifies the potential for drug interactions with antiretroviral drugs. Efforts should be made by mainstream health professionals to provide validated information to traditional healers and patients on the judicious use of herbal remedies. This may reduce harm through failed expectations, pharmacologic adverse events including possible drug/herb interactions and unnecessary added therapeutic costs. Efforts should also be directed at evaluating the possible benefits of natural products in HIV/AIDS treatment.
Tài liệu tham khảo
Fairfield KM, Eisenberg DM, Davis RB, Libman H, Phillips RS: Patterns of use, expenditures, and perceived efficacy of complementary and alternative therapies in HIV-infected patients. Arch Intern Med. 1998, 158: 2257-2264. 10.1001/archinte.158.20.2257.
Babb DA, Pemba L, Seatlanyane P, Charalambous S, Curchyard G, Grant AD: Use of traditional medicine in the era of antiretroviral therapy: experience from South Africa. eJIAS 2004, MedGenMed. 2004, 6: B10640-[eJIAS. 2004 Jul 11;1(1):B10640].
Colebunders R, Dreezen C, Florence E, Pelgrom Y, Schrooten W: The use of complementary and alternative medicine by persons with HIV infection in Europe. Int J STD AIDS. 2003, 14: 672-674. 10.1258/095646203322387929.
Duggan J, Peterson WS, Schutz M, Khuder S, Charkraborty J: Use of complementary and alternative therapies in HIV-infected patients. AIDS Patient Care STDS. 2001, 15: 159-167. 10.1089/108729101750123661.
Fleming J: Mozambican healers join government in fight against AIDS. J Int Assoc Physicians AIDS Care. 1995, 1: 32-
Homsy J, King R, Balaba D, Kabatesi D: Traditional health practitioners are key to scaling up comprehensive care for HIV/AIDS in sub-Saharan Africa. Aids. 2004, 18: 1723-1725. 10.1097/01.aids.0000131380.30479.16.
McMillen H: The adapting healer: pioneering through shifting epidemiological and sociocultural landscapes. Soc Sci Med. 2004, 59: 889-902. 10.1016/j.socscimed.2003.12.008.
Peters EJ, Immananagha KK, Essien OE, Ekott JU: Traditional healers' practices and the spread of HIV/AIDS in south eastern Nigeria. Trop Doct. 2004, 34: 79-82.
Ernst E: Heavy metals in traditional Indian remedies. Eur J Clin Pharmacol. 2002, 57: 891-896. 10.1007/s00228-001-0400-y.
Ernst E: Toxic heavy metals and undeclared drugs in Asian herbal medicines. Trends Pharmacol Sci. 2002, 23: 136-139. 10.1016/S0165-6147(00)01972-6.
Ernst E, Thompson Coon J: Heavy metals in traditional Chinese medicines: a systematic review. Clin Pharmacol Ther. 2001, 70: 497-504.
Morris K: South Africa tests traditional medicines. Lancet Infect Dis. 2002, 2: 319-10.1016/S1473-3099(02)00302-X.
Wittenstein B, Rogers V, Novelli V, Clayton PT, Kenny MB, Peters MJ: "African medicine" and Reye's syndrome. Lancet. 2004, 363: 860-10.1016/S0140-6736(04)15733-4.
MacPhail CL, Campbell CM, Pitts M: Operationalizing the dual use of traditional and Western health care for STIs and HIV. XIV International AIDS Conference: 2002; Barcelona: MoPeB3209. 2002
Sebit MB, Chandiwana SK, Latif AS, Gomo E, Acuda SW, Makoni F, Vushe J: Quality of life evaluation in patients with HIV-I infection: the impact of traditional medicine in Zimbabwe. Cent Afr J Med. 2000, 46: 208-213.
Zachariah R, Nkhoma W, Harries AD, Arendt V, Chantulo A, Spielmann MP, Mbereko MP, Buhendwa L: Health seeking and sexual behaviour in patients with sexually transmitted infections: the importance of traditional healers in Thyolo, Malawi. Sex Transm Infect. 2002, 78: 127-129. 10.1136/sti.78.2.127.
SADC: SADC Ministerial Consultative meeting on Nutrition and HIV/AIDS. Johannesburg. 20 January 2002
ARV roll-out begins today. Sunday Times (South Africa). March 1 2003, [http://www.sundaytimes.co.za/zones/sundaytimes/newsst/newsst1080795554]
Giraldo R: Brief report. SOUTHERN AFRICAN DEVELOPMENT COMMUNITY (SADC) MEETING ON NUTRITION AND HIV/AIDS: 2002; Johannesburg. 2002, [http://www.laleva.cc/choice/aids/aids_giraldo.html]
Snijman D: Hypoxidacea: cape plants – a conspectus of the cape flora of South Africa. Strelitzia. 2000, 9: 108-110.
Singh Y: Hypoxis: yellow stars of horticulture, folk remedies and conventional medicine. Veld & Flora. 1999, 85: 123-125.
Albrecht CF, Kruger PB, Smit BJ, Freestone M, Gouws L, Miller R, van Jaarsveld PP: The pharmacokinetic behaviour of hypoxoside taken orally by patients with lung cancer in a phase I trial. S Afr Med J. 1995, 85: 861-865.
Wilt TJ, Ishani A, Rutks I, MacDonald R: Phytotherapy for benign prostatic hyperplasia. Public Health Nutr. 2000, 3: 459-472.
Smit BJ, Albrecht CF, Liebenberg RW, Kruger PB, Freestone M, Gouws L, Theron E, Bouic PJ, Etsebeth S, van Jaarsveld PP: A phase I trial of hypoxoside as an oral prodrug for cancer therapy – absence of toxicity. S Afr Med J. 1995, 85: 865-870.
Mahomed IM, Ojewole JA: Hypoglycemic effect of Hypoxis hemerocallidea corm (African potato) aqueous extract in rats. Methods Find Exp Clin Pharmacol. 2003, 25: 617-623. 10.1358/mf.2003.25.8.778082.
Bouic PJ, Clark A, Brittle W, Lamprecht JH, Freestone M, Liebenberg RW: Plant sterol/sterolin supplement use in a cohort of South African HIV-infected patients – effects on immunological and virological surrogate markers. S Afr Med J. 2001, 91: 848-850.
Bouic PJ, Clark A, Lamprecht J, Freestone M, Pool EJ, Liebenberg RW, Kotze D, van Jaarsveld PP: The effects of B-sitosterol (BSS) and B-sitosterol glucoside (BSSG) mixture on selected immune parameters of marathon runners: inhibition of post marathon immune suppression and inflammation. Int J Sports Med. 1999, 20: 258-262.
Bouic PJ, Etsebeth S, Liebenberg RW, Albrecht CF, Pegel K, Van Jaarsveld PP: beta-Sitosterol and beta-sitosterol glucoside stimulate human peripheral blood lymphocyte proliferation: implications for their use as an immunomodulatory vitamin combination. Int J Immunopharmacol. 1996, 18: 693-700. 10.1016/S0192-0561(97)85551-8.
Whitney JR, Billoski TV, Jones VR: Evidence for Triceratops in Antarctica. New Directions in Paleontology. Edited by: Billoski TV. 1997, New York: Academic Press, 24-27.
"I read it in the paper" – Spud magic?. THE SA RETAIL CHEMIST. 1997, 1 AUGUST
Sengupta SSR, DeVillis R, Crouse Quinn S, DeVillis B, Ware WB: Factors Affecting African-American Participation in AIDS Research. JAIDS. 2000, 24: 275-284.
Aids conference starts. [http://www.news24.com/News24/South_Africa/Aids_Focus/0,2-7-659_1396465,00.html]
Albrecht CF, Theron EJ, Kruger PB: Morphological characterisation of the cell-growth inhibitory activity of rooperol and pharmacokinetic aspects of hypoxoside as an oral prodrug for cancer therapy. S Afr Med J. 1995, 85: 853-860.
Dietzsch E, Albrecht CF, Parker MI: Effect of rooperol on collagen synthesis and cell growth. IUBMB Life. 1999, 48: 321-325.
Mills EJ, Foster BC, van Heeswijk RP, Wilson K, E P, Kosuge K, Leonard B, Kanfer I: Impact of African herbal medicines on antiretroviral metabolism. AIDS. 2005, 19: 95-7. 10.1097/00002030-200501030-00013.
Terreblanche C: HIV warning on African potato. IOL. 2003, [http://www.iol.co.za/index.php?sf=125&click_id=31&art_id=vn20030715134316530C349682&set_id=1]
Clarke L: African potato gets bum rap as vital remedy. Sunday Independent. 2003, [http://www.iol.co.za/index.php?set_id=1&click_id=31&art_id=ct20030726175801155P4532454]
Gericke N, Albrecht CF, Van Wyk B, Mayeng B, Mutwa C, Hutchings A: Sutherlandia frutescens. Australian Journal of Medical Herbalism. 2001, 13: 9-15. 10.1046/j.1442-2026.2001.00172.x.
Dalvi S: Sutherlandia for immune support. Positive Health. 2003, 23-25.
Seier JV, Mdhuli M, Dhansay MA, Loza J, Laubschner R, Matsabisa G: A toxicity study of Sutherlandia leaf powder (sutherlandia microphylla) consumption. South African Ministry of Health Document. 2002, [http://www.sahealthinfo.org/traditionalmeds/cancerbush2.pdf]
Fernandes AC, Cromarty AD, Albrecht C, van Rensburg CE: The antioxidant potential of Sutherlandia frutescens. J Ethnopharmacol. 2004, 95: 1-5. 10.1016/j.jep.2004.05.024.
Tai J, Cheung S, Chan E, Hasman D: In vitro culture studies of Sutherlandia frutescens on human tumor cell lines. J Ethnopharmacol. 2004, 93: 9-19. 10.1016/j.jep.2004.02.028.
Green M: Method of treating viral infections with amino acid analogue. US Patent. 5110, Jan 25 1988., ,600
Oslund R, Sherman W: Pinotol and derivatives thereof for the treatment of metabolic disorders. US Patent. 5,882,896. March 4, 1996.
A toxicity study of Sutherlandia leaf powder (sutherlandia microphylla) consumption. [http://www.saheatlhinfo.org/traditionalmeds/cancerbush2.pdf]
Capasso R, Izzo AA, Pinto L, Bifulco T, Vitobello C, Mascolo N: Phytotherapy and quality of herbal medicines. Fitoterapia. 2000, 71 (Suppl 1): S58-65. 10.1016/S0367-326X(00)00173-8.
Prete PE: Effects of L-canavanine on immune function in normal and autoimmune mice: disordered B-cell function by a dietary amino acid in the immunoregulation of autoimmune disease. Can J Physiol Pharmacol. 1985, 63: 843-854.
Prete PE: The mechanism of action of L-canavanine in inducing autoimmune phenomena. Arthritis Rheum. 1985, 28: 1198-1200.
Van Wyk B, Gericke N: People's plants – a guide to the useful plants in South Africa. Pretoria: Briza. 2000
Adjuik M, Babiker A, Garner P, Olliaro P, Taylor W, White N: Artesunate combinations for treatment of malaria: meta-analysis. Lancet. 2004, 363: 9-17. 10.1016/S0140-6736(03)15162-8.
Slichenmyer WJ, Von Hoff DD: Taxol: a new and effective anti-cancer drug. Anticancer Drugs. 1991, 2: 519-530.
Egberg DC, Potter RH, Honold GR: The semiautomated determination of trypsin inhibitors in textured soy protein. J Agric Food Chem. 1975, 23: 603-605. 10.1021/jf60199a042.
Egeblad K: Effects of soy bean trypsin inhibitor on fibrin clot lysis. Thromb Diath Haemorrh. 1966, 15: 542-553.
Rabek V, Mansfield V: Gel filtration of protease inhibitors from potatoes. Experientia. 1963, 19: 151-152.
Miles SH, Ololo H: Traditional surgeons in sub-Saharan Africa: images from south Sudan. Int J STD AIDS. 2003, 14: 505-508. 10.1258/095646203767869057.
Munk K: Traditional healers, traditional hospitals and HIV / AIDS: a case study in KwaZulu-Natal. AIDS Anal Afr. 1997, 7: 10-12.
Sidley P: South Africa to regulate healers. BMJ. 2004, 329: 758-10.1136/bmj.329.7469.758-b.
Haynes RB, Devereaux PJ, Guyatt GH: Physicians' and patients' choices in evidence based practice. BMJ. 2002, 324: 1350-10.1136/bmj.324.7350.1350.