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Rectal Artemisinins Rapidly Eliminate Malarial Parasites
Artemisinin-based suppositories can help 'buy time' for malaria patients who face a delay in accessing effective, injectable antimalarials, according to new research.
Plasmodium falciparum malaria can progress to severe disease and death in a number of hours, so prompt treatment is crucial. As such, rectal artemisinins can be used as emergency treatment, particularly in rural areas with limited access to injectable antimalarial therapy and suitably trained staff.
Derived from sweet wormwood, artemisinin has been used in traditional Chinese medicine for thousands of years. In the 1990s, researchers recognised its antimalarial activity and since then a number of safe and effective artemisinin derivatives have been developed. These drugs, given by mouth, as a rectal suppository or injected into a vein or muscle have been shown to rapidly reduce heavy parasite infection. Oral artemisinin-based combination treatments now form the basis of antimalarial treatment policies in most malaria endemic countries.
Suppositories are easy to administer and the World Health Organization Malaria Treatment Guidelines currently recommends rectal artemisinins as a pre-referral treatment for severe malaria. However, more information is needed about the comparative efficacy of the different artemisinin derivatives. Researchers pooled the individual patient data of over 1000 patients from 15 clinical trials of rectal artemisinins -- artemisinin, artesunate and artemether -- to compare the efficacy of these drugs with each other and conventional injectable antimalarials such as quinine.
In the 24 hours after treatment, rectal artemisinins -- artemisinin, artesunate, and artemether - cleared malarial parasites in the blood more rapidly than quinine injection. A higher single dose of rectal artesunate to initiate treatment was five times more likely to reduce the number of parasites by over 90% than multiple lower doses of artesunate -- suggesting that immediate rapid achievement of high drug concentration in severe malaria might be key to effectively killing parasites. This analysis did not look at whether the early use of rectal artemisinins saves lives, but it is hoped that their ability to rapidly kill large numbers of parasites might make a real difference to survival.
The authors write: "Early effective treatment with artemisinin-based suppositories has potential as a lifesaving intervention, particularly at the periphery of the health-care system, where suppositories might be administered early in lieu of parenteral treatment in remote communities by relatively untrained personnel. Combined with accurate diagnosis and artemisinin-based combination therapy, rectal artemisinins have been effectively used to reduce malaria incidence and mortality in Asia, an approach which holds great promise for malaria control elsewhere."
Journal reference: Rectal artemisinins for malaria: a review of efficacy and safety from individual patient data in clinical studies. Melba Gomes, Isabela Ribeiro, Marian Warsame, Harin Karunajeewa and Max Petzold. BMC Infectious Diseases (in press)
Artemisinins: A New Hope For Women With Polycystic Ovary Syndrome
Plant-derived compounds best known for their antimalarial properties relieve polycystic ovary syndrome, a major public health problem that affects millions of women worldwide. These compounds, called artemisinins, achieve their affect by suppressing ovarian androgen production in multiple rodent models as well as in a small cohort of human patients, according to a new study. The findings not only underscore the versatility of artemisinins but reveal a promising new approach for preventing and treating the disorder. Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. It is characterized by elevated androgen levels (hyperandrogenemia) and associated with a wide range of health impacts, including metabolic dysfunction, impaired ovulation, and often infertility.
However, despite the high prevalence of the syndrome, the mechanistic basis of PCOS is poorly understood, and drug treatments often focus only on specific symptoms with limited effectiveness. Because hyperandrogenemia is the main feature and cause of most PCOS-associated symptoms and comorbidities, treatments aimed at suppressing androgen production could be beneficial in treating PCOS.
Here, Yang Liu and colleagues evaluated the effect of artemisinin and its derivatives on PCOS development. While better known for their antimalarial effects, these compounds have also been shown to have beneficial metabolic effects. In rodent models, Liu et al. found that artemether (ATM), an artemisinin derivative isolated from Artemisia plants, reduces ovarian androgen synthesis by targeting CYP11A1, a crucial enzyme in androgen production. ATM induces CYP11A1 degradation by enhancing its interaction with the protease LONP1. And, LONP1 overexpression, the authors found, suppresses ovarian androgen production. In a pilot clinical study of 19 women with PCOS, Liu et al. further demonstrated the therapeutic potential of artemisinin.
For these women, taking dihydroartemisinin – a drug used to treat malaria – for 12 weeks substantially reduced key PCOS biomarkers and led to more regular menstrual cycles without side effects. "Although further studies will be needed to fully understand the long-term effects and to optimize dosing strategies to maximize therapeutic outcomes, the discovery of artemisinins as effective remedies for PCOS nonetheless represents a promising new approach for the development of specific therapies that will potentially change the landscape of PCOS treatment," writes Elisabet Stener-Victorin in a related Perspective.
Source:
Journal reference:
Liu, Y., et al. (2024). Artemisinins ameliorate polycystic ovarian syndrome by mediating LONP1-CYP11A1 interaction. Science. Doi.Org/10.1126/science.Adk5382.
What Is Sweet Annie And What Are The Benefits?
Sweet Annie (Artemisia annua) is a plant with small yellow flowers. It contains flavonoids, essential oils, and artemisinin, which is a compound that may offer health benefits.
Other names for this plant include sweet wormwood and qinghao. It's native to China and has been used in traditional Chinese medicine for many years.
Read on to learn about the possible health benefits of sweet Annie, including whether it can treat malaria.
Malaria is a life threatening illness caused by a parasite that mosquitoes carry. Health experts have found that artemisinin-based products help kill these parasites.
The World Health Organization (WHO) explains that the most common antimalarial treatments are artemisinin-based combination therapies (ACTs). These are produced with pure artemisinin compound, which is extracted from Artemisia annua plants.
However, the WHO also explains that they do not support the use of Artemisia plant material, or the use of nonpharmaceutical forms, for the treatment or prevention of malaria. There is no evidence to suggest that herbal sweet Annie products are effective in treating malaria.
More research is necessary to determine if sweet Annie is a useful treatment for cancer.
According to research from 2022, the artemisinins in sweet Annie are generally safe and tolerable in medication. The article suggests that it may be possible to repurpose existing medications containing artemisinins for the treatment of certain cancers, but that clinical trials are necessary to confirm this.
Some studies of artesunate, a semisynthetic derivative of artemisinin, have shown tolerability in people with advanced cancer. However, other studies didn't produce a response.
More research is necessary to confirm the benefits and tolerability of sweet Annie and artemisinins in people with cancer.
According to a 2020 review, sweet Annie has the potential to offer the following properties:
Although studies are currently limited, this review suggests that sweet Annie may help in treating a wide range of conditions.
Some anecdotal reports suggest that an extract of sweet Annie may be beneficial for managing COVID-19. However, there is not enough research to support this at present.
Anecdotally, some people believe sweet Annie can help treat:
However, there is currently no research to support these claims.
Be sure to contact your doctor for advice before taking sweet Annie. It may not be suitable for everybody. For example, it can be dangerous for people with ulcers or stomach disorders.
Sweet Annie contains artemisinin, a compound found in antimalarial drugs. Some research suggests it may also have the potential to help treat several kinds of cancer, but more research is necessary.
As sweet Annie contains anti-inflammatory, antioxidant, and antimicrobial properties, it may help treat numerous other conditions. However, research is currently limited.
It's important to contact your doctor before adding sweet Annie to your treatment plan. They can advise on the benefits and safety of sweet Annie based on your individual circumstances.
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