Efficacy of a Combined Herbal Product Containing Indigofera argentea, Pistacia atlantica and Salvia hispanica in Zoonotic Cutaneous Leishmaniasis Patients Treated along Glucantime ®
-
Saeid-Ali Bozorgzade
,
Shahram Kalantari- Khandani
,
Rezvan Amiri
,
Tania Dehesh
,
Hossein Karegar-Borzi
Abstract
Background: Leishmaniasis is highly prevalent worldwide, and while conventional medicine offers numerous treatment methods for cutaneous leishmaniasis, Iranian traditional medicine suggests various remedies. We aimed to evaluate the efficacy of an herbal combination containing Indigofera argentea leaves, Pistacia atlantica resin, and Salvia hispanica seeds in patients with zoonotic cutaneous leishmaniasis.
Methods: This study was conducted at the Leishmaniasis Department of Chabahar Health Center in southeastern Iran in 2021. It was a double-blinded randomized clinical trial involving 68 patients enrolled after clinical diagnosis, examination of smear samples using Giemsa staining, and PCR confirmation. The volunteers were randomly divided into intervention and control groups. Both groups received 'Glucantime ® as the primary medication weekly until complete healing or up to 12 weeks. Glucantime ® was administered intralesionally at a dosage of 0.1 cc on the wound's margin, with repeat injections at 1 cm intervals along the wound edge when necessary. In addition to the main drug, the intervention group received the herbal product topically twice daily until wound healing or for up to 4 weeks, while the control group received a placebo in the same manner.
Results: 82.35% of patients in the intervention group and 20.58% in the control group achieved complete healing within four weeks. There was a significant difference between the two groups (P < 0.001).
Conclusion: The herbal product demonstrated effectiveness in treating patients with zoonotic cutaneous leishmaniasis.
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7. Avicenna H. Qanoon Dar Teb. University of Tehran medical science. Tehran; 1978.
8. Maleki M, Yousefi M, Bazzaz SMM, et al. An overview of skin lesions adapted to Cutaneous Leishmaniasis in Persian Medicine. Electronic Physician. 2017; 9(11):5854-5862.
9. Aqili-Khorasani MH. Qarabadin-e-Kabir. Research Institute for Islamic and Complementary Medicine .Tehran; 2007.
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12. Gharirvand-Eskandari E, Doudi M. The Study of Composition and Anti-leishmanial Effect of Portulaca Oleracea Aerial Organs Hydroalcoholic Extract on Leishmania. major (Mrho/Ir/75/Er) and A Clinical Isolate In Vitro. Journal of Rafsanjan University of Medical Sciences. 2016; 15(5):425-38.
13. Parvizi MM, Handjani F, Moein M, et al. Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial. PLoS Negl Trop Dis. 2017; 11(10):e0005957.
14. Armah FA, Amponsah IK, Mensah AY, et al. Leishmanicidal activity of the root bark of Erythrophleum Ivorense (Fabaceae) and identification of some of its compounds. J Ethnopharmacol. 2018; 211:207-16.
15. Taran M, Mohebali M, Esmaeli J. In vivo efficacy of gum obtained Pistacia atlantica in experimental treatment of cutaneous leishmaniasis. Iran J Public Health. 2010; 39(1):36-41.
16. Javed F, Jabeen Q, Aslam N, et al. Pharmacological evaluation of analgesic, anti-inflammatory and antipyretic activities of ethanolic extract of Ieishmania argentea Burm. f. J Ehnopharmacol. 2020; 259:112966.
17. Mhaidi I, El Kacem S, Ait Kbaich M, et al. Molecular identification of Leishmania infection in the most relevant sand fly species and in patient skin samples from a cutaneous leishmaniasis focus, in Morocco. PLoS Negl Trop Dis. 2018; 12(3):e0006315.
18. Aghili- Khorasani MH. Makhzan-al-advia. Tehran University of Medical Sciences. Tehran; 2009.
19. Afsharypuor S, Shams-Ardekani MR, Mosadegh M, et al. Iranian traditional pharmacy and pharmaceutical dosage forms. choogan. Tehran; 2017.
20. Tamargo A, Martin D, Navarro del Hierro J, et al. Intake of soluble fibre from chia seed reduces bioaccessibility of lipids, cholesterol and glucose in the dynamic gastrointestinal model simgi®. Food Res Int. 2020; 137:109364.
21. Raeiszadeh M, Pardakhty A, Sharififar F, et al. Phytoniosome: a Novel Drug Delivery for Myrtle Extract. Iran J Pharm Res. 2018; 17(3):804-17.
22. Amini F, Amini-Khoei H, Haratizadeh S, et al. Hydroalcoholic extract of Passiflora incarnata improves the autistic-like behavior and neuronal damage in a valproic acid-induced rat model of autism. J Tradit Complement Med. 2023; 13(4):315-24.
23. Mehrabani M, Raeiszadeh M, Najafipour H, et al. Evaluation of the Cytotoxicity, Antibacterial, Antioxidant, and Anti-inflammatory Effects of Different Extracts of Punica granatum var. pleniflora. Journal of Kerman University of Medical Sciences. 2020; 27(5):414-25.
24. El-Hajj R, Bou-Youness H, Lachaud L, et al. EAPB0503: An Imiquimod analog with potent in vitro activity against cutaneous leishmaniasis caused by Leishmania major and Leishmania tropica. PLoS Negle Trop Dis. 2018; 12(11):e0006854.
25. WHO. Basic laboratory methods in medical parasitology. World Health Organization; 1991. https://apps.who.int/iris/handle/10665/40793
26. Khademvatan S, Neisi N, Maraghi S, et al. Diagnosis and identification of Leishmania spp. from Giemsa-stained slides, by real-time PCR and melting curve analysis in south-west of Iran. Ann Trop Med Parasitol. 2011; 105(8):559-65.
27. Soleimanpoor H, Dabirzadeh M, Fooladi B. Identification of Species Causing Cutaneous Leishmaniasis by PCR in Chahbahar, Iran. Medical Laboratory Journal. 2016; 10(2):46-51.
28. Hanada K. Introduction and perspectives of DNA electrophoresis. Springer. 2020.
29. Hesami D, Ghaffarifar F, Dalimi Asl A, et al. A study on the effects of Pistacia atlantica Desf. essential oil on Leishmania major in vitro and in vivo. Iranian Journal of Medicinal and Aromatic Plants Research. 2019; 35(1):44-53.
30. Mahjoub F, Rezayat KA, Yousefi M, et al. Pistaci atlantica Desf. A review of its traditional uses, phytochemicals and pharmacology. J Med Life. 2018; 11(3):180-186.
31. Zargari A. Iranian medicinal plants. University of Tehran Publishing Institute Tehran; 2014.
32. Many JN, Sarasvathi V. Analysis of Chia Seed –Physiochemical and Proximate Analysis. Research Journal of Recent Sciences. 2016; 227:2502.
33. Shen Y, Zheng L, Jin J, et al. Phytochemical and biological characteristics of mexican chia seed oil. Molecules. 2018; 23(12):3219.
34. Atta E, Al-faifi T, El-Shabasy A. Chemotaxonomic and morphological classification of six Indigofera species in Jazan region, KSA. Journal of Saudi Chemical Society. 2022; 26(3):101476.
35. Isah MB, Tajuddeen N, Umar MI, et al. Chapter 7 - Terpenoids as Emerging Therapeutic Agents: Cellular Targets and Mechanisms of Action against Protozoan Parasites. Elsevier; (2018).
36. Monzote L, Córdova WHP, García M, et al. In-vitro and In-vivo Activities of Phenolic Compounds A gainst Cutaneous Leishmaniasis. Records of Natural Products. 2016; 10(3):269-276.
37. Tasdemir D, Kaiser M, Brun R, et al. Antitrypanosomal and Antileishmanial Activities of Flavonoids and Their Analogues: In Vitro, In Vivo, Structure-Activity Relationship, and Quantitative Structure-Activity Relationship Studies. Antimicrob Agents Chemother. 2006; 50(4):1352-64.
38. Fitzmaurice SD, Sivamani RK, Isseroff RR. Antioxidant Therapies for Wound Healing: A Clinical Guide to Currently Commercially Available Products. Skin Pharmacol Physiol. 2011; 24(3):113-26.
39. Roy S, Khanna S, Nallu K, et al. Dermal wound healing is subject to redox control. Mol Ther. 2006; 13(1):211-20.
40. Bennett JE, Dolin R, Blaser MJ. Mandell, douglas, and bennett's principles and practice of infectious diseases E-book. Elsevier health sciences; 2019.
41. Mohebali M, Fotouhi A, Hooshmand B, et al. Comparison of miltefosine and meglumine antimoniate for the treatment of zoonotic cutaneous leishmaniasis (ZCL) by a randomized clinical trial in Iran. Acta Trop. 2007; 103(1):33-40.
42. Masmoudi A, Maalej N, Mseddi M, et al. Glucantime injection: benefit versus toxicin. Med Mal Infect. 2005; 35(1):42-5.
2. Shirzadi MR. Guideline to the care of cutaneous leishmaniasis in Iran. Ministry of Health, Disease Management Center. Tehran; 2012.
3. Goldman L, Schafer AI. Goldman-Cecil Medicine E-Book. Elsevier Health Sciences; 2019.
4. Loscalzo J, Fauci AS, Kasper DL, et al. Harrison's Principles of Internal Medicine. McGraw Hill LLC; 2022.
5. Dinulos JGH. Habif'Clinical Dermatology E-Book. Elsevier Health Sciences; 2019.
6. Firooz A, Mortazavi H, Khamesipour A, et al. Old world cutaneous leishmaniasis in Iran: clinical variants and treatments. J Dermatolog Treat. 2021; 32(7):673-83.
7. Avicenna H. Qanoon Dar Teb. University of Tehran medical science. Tehran; 1978.
8. Maleki M, Yousefi M, Bazzaz SMM, et al. An overview of skin lesions adapted to Cutaneous Leishmaniasis in Persian Medicine. Electronic Physician. 2017; 9(11):5854-5862.
9. Aqili-Khorasani MH. Qarabadin-e-Kabir. Research Institute for Islamic and Complementary Medicine .Tehran; 2007.
10. Mohseni N, Sajjadi SE, Eskandarian AA, et al. Natural Anti-Leishmaniasis Compounds in Traditional Iranian Medicine. Journal of Islamic and Iranian Traditional Medicine. 2012; 3(1):41-50.
11. Moghaddas E, Khamesipour A, Mohebali M, et al. Iranian Native Plants on Treatment of Cutaneous Leishmaniosis: A Narrative Review. Iran J Parasitol. 2017; 12(3):312-22.
12. Gharirvand-Eskandari E, Doudi M. The Study of Composition and Anti-leishmanial Effect of Portulaca Oleracea Aerial Organs Hydroalcoholic Extract on Leishmania. major (Mrho/Ir/75/Er) and A Clinical Isolate In Vitro. Journal of Rafsanjan University of Medical Sciences. 2016; 15(5):425-38.
13. Parvizi MM, Handjani F, Moein M, et al. Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial. PLoS Negl Trop Dis. 2017; 11(10):e0005957.
14. Armah FA, Amponsah IK, Mensah AY, et al. Leishmanicidal activity of the root bark of Erythrophleum Ivorense (Fabaceae) and identification of some of its compounds. J Ethnopharmacol. 2018; 211:207-16.
15. Taran M, Mohebali M, Esmaeli J. In vivo efficacy of gum obtained Pistacia atlantica in experimental treatment of cutaneous leishmaniasis. Iran J Public Health. 2010; 39(1):36-41.
16. Javed F, Jabeen Q, Aslam N, et al. Pharmacological evaluation of analgesic, anti-inflammatory and antipyretic activities of ethanolic extract of Ieishmania argentea Burm. f. J Ehnopharmacol. 2020; 259:112966.
17. Mhaidi I, El Kacem S, Ait Kbaich M, et al. Molecular identification of Leishmania infection in the most relevant sand fly species and in patient skin samples from a cutaneous leishmaniasis focus, in Morocco. PLoS Negl Trop Dis. 2018; 12(3):e0006315.
18. Aghili- Khorasani MH. Makhzan-al-advia. Tehran University of Medical Sciences. Tehran; 2009.
19. Afsharypuor S, Shams-Ardekani MR, Mosadegh M, et al. Iranian traditional pharmacy and pharmaceutical dosage forms. choogan. Tehran; 2017.
20. Tamargo A, Martin D, Navarro del Hierro J, et al. Intake of soluble fibre from chia seed reduces bioaccessibility of lipids, cholesterol and glucose in the dynamic gastrointestinal model simgi®. Food Res Int. 2020; 137:109364.
21. Raeiszadeh M, Pardakhty A, Sharififar F, et al. Phytoniosome: a Novel Drug Delivery for Myrtle Extract. Iran J Pharm Res. 2018; 17(3):804-17.
22. Amini F, Amini-Khoei H, Haratizadeh S, et al. Hydroalcoholic extract of Passiflora incarnata improves the autistic-like behavior and neuronal damage in a valproic acid-induced rat model of autism. J Tradit Complement Med. 2023; 13(4):315-24.
23. Mehrabani M, Raeiszadeh M, Najafipour H, et al. Evaluation of the Cytotoxicity, Antibacterial, Antioxidant, and Anti-inflammatory Effects of Different Extracts of Punica granatum var. pleniflora. Journal of Kerman University of Medical Sciences. 2020; 27(5):414-25.
24. El-Hajj R, Bou-Youness H, Lachaud L, et al. EAPB0503: An Imiquimod analog with potent in vitro activity against cutaneous leishmaniasis caused by Leishmania major and Leishmania tropica. PLoS Negle Trop Dis. 2018; 12(11):e0006854.
25. WHO. Basic laboratory methods in medical parasitology. World Health Organization; 1991. https://apps.who.int/iris/handle/10665/40793
26. Khademvatan S, Neisi N, Maraghi S, et al. Diagnosis and identification of Leishmania spp. from Giemsa-stained slides, by real-time PCR and melting curve analysis in south-west of Iran. Ann Trop Med Parasitol. 2011; 105(8):559-65.
27. Soleimanpoor H, Dabirzadeh M, Fooladi B. Identification of Species Causing Cutaneous Leishmaniasis by PCR in Chahbahar, Iran. Medical Laboratory Journal. 2016; 10(2):46-51.
28. Hanada K. Introduction and perspectives of DNA electrophoresis. Springer. 2020.
29. Hesami D, Ghaffarifar F, Dalimi Asl A, et al. A study on the effects of Pistacia atlantica Desf. essential oil on Leishmania major in vitro and in vivo. Iranian Journal of Medicinal and Aromatic Plants Research. 2019; 35(1):44-53.
30. Mahjoub F, Rezayat KA, Yousefi M, et al. Pistaci atlantica Desf. A review of its traditional uses, phytochemicals and pharmacology. J Med Life. 2018; 11(3):180-186.
31. Zargari A. Iranian medicinal plants. University of Tehran Publishing Institute Tehran; 2014.
32. Many JN, Sarasvathi V. Analysis of Chia Seed –Physiochemical and Proximate Analysis. Research Journal of Recent Sciences. 2016; 227:2502.
33. Shen Y, Zheng L, Jin J, et al. Phytochemical and biological characteristics of mexican chia seed oil. Molecules. 2018; 23(12):3219.
34. Atta E, Al-faifi T, El-Shabasy A. Chemotaxonomic and morphological classification of six Indigofera species in Jazan region, KSA. Journal of Saudi Chemical Society. 2022; 26(3):101476.
35. Isah MB, Tajuddeen N, Umar MI, et al. Chapter 7 - Terpenoids as Emerging Therapeutic Agents: Cellular Targets and Mechanisms of Action against Protozoan Parasites. Elsevier; (2018).
36. Monzote L, Córdova WHP, García M, et al. In-vitro and In-vivo Activities of Phenolic Compounds A gainst Cutaneous Leishmaniasis. Records of Natural Products. 2016; 10(3):269-276.
37. Tasdemir D, Kaiser M, Brun R, et al. Antitrypanosomal and Antileishmanial Activities of Flavonoids and Their Analogues: In Vitro, In Vivo, Structure-Activity Relationship, and Quantitative Structure-Activity Relationship Studies. Antimicrob Agents Chemother. 2006; 50(4):1352-64.
38. Fitzmaurice SD, Sivamani RK, Isseroff RR. Antioxidant Therapies for Wound Healing: A Clinical Guide to Currently Commercially Available Products. Skin Pharmacol Physiol. 2011; 24(3):113-26.
39. Roy S, Khanna S, Nallu K, et al. Dermal wound healing is subject to redox control. Mol Ther. 2006; 13(1):211-20.
40. Bennett JE, Dolin R, Blaser MJ. Mandell, douglas, and bennett's principles and practice of infectious diseases E-book. Elsevier health sciences; 2019.
41. Mohebali M, Fotouhi A, Hooshmand B, et al. Comparison of miltefosine and meglumine antimoniate for the treatment of zoonotic cutaneous leishmaniasis (ZCL) by a randomized clinical trial in Iran. Acta Trop. 2007; 103(1):33-40.
42. Masmoudi A, Maalej N, Mseddi M, et al. Glucantime injection: benefit versus toxicin. Med Mal Infect. 2005; 35(1):42-5.
| Files | ||
| Issue | Vol 19 No 2 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijpa.v19i2.15856 | |
| Keywords | ||
| Leishmaniasis Indigofera argentea Pistacia atlantica Salvia hispanica Iran | ||
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How to Cite
1.
Bozorgzade S-A, Kalantari- Khandani S, Amiri R, Dehesh T, Karegar-Borzi H. Efficacy of a Combined Herbal Product Containing Indigofera argentea, Pistacia atlantica and Salvia hispanica in Zoonotic Cutaneous Leishmaniasis Patients Treated along Glucantime ®. Iran J Parasitol. 2024;19(2):203-213.
