Empirical efficacy of artemisinin
What is artemisinin
Artemisinin is a compound extracted from Artemisia annua (also known as Artemisia annua or sweet wormwood) of the artemisia annua genus, which contains a wealth of active biological compounds, including: terpenoids, sesquiterpenoids, flavonoids and coumarins.
Artemisinin’s stability and easy crystallizability make its extraction and purification relatively simple, but its low solubility in oil and water largely limits its therapeutic value. Therefore, its derivatives, such as artesunate, artemether, artemether, and dihydroartemisinin, have been synthesized successively.
Artemisinin extracted from Artemisia annua has recently become the focus of attention, due to its antipyretic effect, artemisinin was recorded in traditional Chinese medicine more than 2,000 years ago. In the 1970s, Dr. Tu Youyou and her research team began to study the antipyretic effect of this plant, and discovered artemisinin and its chemical structure as a new anti-malaria therapy. He was awarded the Nobel Prize for Medicine in 2015.
What is the empirical efficacy of artemisinin
1. Treatment of severe malaria
Malaria is a tropical disease caused by a blood malaria parasite of the genus Plasmodium and transmitted through the bite of an infected female anopheles mosquito.
In general, malaria is a febrile disease that is uncomplicated and goes into remission over time. However, depending on age, exposure, and immune status, about 1% to 2% of malaria cases develop severe disease, which can lead to death.
The most common pathogen of severe malaria is Plasmodium falciparum, which is characterized by immune-mediated cytotoxicity after the parasite parasitized these organs, leading to hyperparasitemia and organ lesions (such as liver and spleen enlargement, dyspnea, and kidney failure).
A systematic review and Meta-Analysis of 33 randomised controlled trials involving 7,795 children and 3,182 adults with severe malaria has shown that artemisinin derivatives (artesunate) reduce mortality in adults and children (including cerebral malaria) in Asia and Africa compared with quinine.
2. Prevention or treatment of schistosomiasis
Schistosomiasis is an acute or chronic human worm disease caused by schistosomiasis. Human infections are caused by ingestion of eggs (roundworms and Trichomonas) or by larvae in the soil penetrating the skin (Hookworm Americana and Anorectal Roundworms duodenum). It is estimated that more than 230 million people worldwide are infected with schistosomiasis, causing 200,000 deaths each year.
The five species of schistosoma associated with human disease are schistosoma mansoni, Schistosoma japonicum and Schistosoma Maicon, which cause diseases of the genitourinary system.
Routine prophylactic chemotherapy in populations at high risk of developing the disease is a cost-effective public health intervention for controlling the morbidity caused by these infections.
A systematic literature review and Meta-Analysis (including 40 trials in healthy villagers living in schistosomiasis endemic areas) suggest that the combination of artemisinin derivatives and praziquantel improves the cure rate of schistosomiasis treatment, but artesunate monotherapy may not be beneficial. Because its activity only affects the early stages of the parasite.
In addition, repeated dose administration of artemisinin derivatives (artesunate and artesether) significantly reduced schistosomiasis infection, especially in studies where the target population was infected at a specific time due to flooding.
3. Adjuvant cancer therapy
Cancer is defined as abnormal cells that rapidly proliferate beyond the usual limits of damage or aging, and in some cases these cells invade other organs (metastasize), outnumber healthy cells, and alter their common function.
The highest incidence types of cancer are breast, lung, colorectal and prostate cancers, and 30 to 50 percent of cancers are preventable by controlling specific risk factors
A randomized, double-blind, placebo-controlled 14-day trial in 20 patients with colorectal cancer showed that oral artesunate (200 mg daily) increased the rate of apoptosis of tumor epithelial cells, reduced Ki67 staining (an important marker of prognosis) and increased CD31 protein expression compared with placebo.
A randomised controlled trial of 120 patients with non-small cell lung cancer showed that chemotherapy combined with oral artesunate improved short-term survival and extended the time to progression.
4. Beneficial for rheumatoid arthritis
Rheumatoid arthritis is a systemic autoimmune disease, the incidence of about 0.5-1.0% of the total population, mainly manifested by joint function decline, cartilage erosion and osteoporosis, may appear joint stiffness, hand edema, weakness, fever and fatigue. And other symptoms.
Genetics, smoking, air pollution, occupational exposure… Environmental factors, such as diet, have been linked to the onset of rheumatoid arthritis, which increases the risk of cardiovascular disease, cancer and respiratory complications.
A 48-week randomized controlled clinical trial of 159 patients with active rheumatoid arthritis showed that artemisia annua extract combined with drug use further improved clinical outcomes compared to drug use alone, including: Objective pain score, tenderness score, number of painful joints, number of swollen joints, quality of life Health Assessment Questionnaire (HAQ) score, serum rheumatoid factor (RF) level, anti-cyclic citrulline protein antibody (CCP-Ab) level, erythrocyte settlement rate (ESR), C-reactive protein (CRP), pain visual analogy score (VAS), and overall efficacy.
5. Improve menopausal emotional problems
Because of the huge increase in human longevity, about 40% of women’s life begins after menopause, and this period is the most volatile hormonal time, the most prone to problems.
Whether physiological or psychological, symptoms may occur during menopause, which has the greatest impact on psychological and emotional problems, becoming easy to get frustrated, angry, restless, etc., there are also many cases of clinical depression.
In a study of menopausal mood disorders, safflower alfalfa extract (80mg daily for 90 days) was found to reduce anxiety and depression in subjects by up to 76%, as measured by the Chong Depression Scale.
Another study also showed that taking safflower alfalfa improved subjects’ self-rated emotional state (66-68 points using the VAS rating scale, compared with 8-15 points in the placebo group)
6. Improves the condition of skin, hair and nails
As we age, our skin will become drier, thinner and less elastic due to reduced water content, collagen and lipids. In addition to wrinkles, the appearance and texture of our skin will gradually change.
In a double-blind controlled study, oral administration of safflower alfalfa improved overall skin condition (including moisture content and texture) in menopausal women, with an overall improvement score of about 18 points, compared with only 5 points (out of 100) of placebo, and other parts of the study also reported some improvement in hair and nails.
